"One of the things that makes fentanyl dangerous is its potency," says Thomas Hall, director of Orange County's Drug-Free Coalition. "It's 100 times more potent than meth."
Ninety-four percent of the time a fentanyl analog was found in the toxicology report of a person who died in Florida in 2017, it was the cause of death. Straight fentanyl proved only slightly less wildly lethal, causing death 84 percent of the time it was found in the blood of a decedent.
Together, fentanyl and fentanyl-analog deaths were the leading cause for drug-related fatalities for the year, according to the Florida Department of Law Enforcement's 2017 medical examiner report, leading to 3,331 deaths.
And things aren't slowing down. In 2013 there were less than 500 fentanyl-related deaths in Florida. From 2016 to 2017, the toll went up 25 percent for deaths caused by fentanyl, the synthetic opioid, and an even more staggering 65 percent increase for deaths caused by fentanyl analogs, an increase of over 600.
The numbers are just as bleak when you drill down into Orange County. In 2012, six people died after using fentanyl or synthetic fentanyl. In 2016, 68 died this way, an Orange County Heroin Task Force report found. In 2017, 196 people died because of the stuff in Orlando alone.
"It doesn't take a lot," says Hall, who notes that just two milligrams of fentanyl is a lethal dose for a non-opioid user. A fentanyl analog, like carfentanil, which Hall says was created to tranquilize elephants and rhinoceros, can be even deadlier.
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Though the number of people seeking out fentanyl is going up, says Orlando Police Department Lt. Carter Gowen, in many instances when someone overdoses on fentanyl, the victim, after being revived, didn't know they were using a drug laced with fentanyl or another analog.
"Drug dealers cut other drugs with fentanyl," says Gowen.
Both fentanyl and fentanyl analogs are cheaper to buy in large quantities than cocaine or heroin. The stuff that's showing up in Central Florida is coming from the same places as that infiltrating the rest of the nation: Pharmaceutical fentanyl is largely smuggled by cartels from Mexico, and other, cheaper, more-lethal fentanyl synthetics are often shipped stateside after being quickly and unscientifically manufactured by exporters in China.
As more people suffer, Hall says, there is more of a political will to solve the problem.
Opioid and fentanyl-focused task forces have been launched by the federal government all the way down to regional and municipal governments like Orange County. In February 2018, Osceola County became the first Florida county to file suit against big pharmaceutical companies in an attempt to hold them accountable for law enforcement, first responder, and increased healthcare costs.
As harrowing as the epidemic is, the way out is pretty straightforward: medical treatment and destigmatizing medical treatment.
Naloxone (brand name: Narcan) reverses overdoses. Gowen says Orlando city emergency services like police and paramedics have naloxone doses on them at all times, which he says has helped decrease the number of overdose deaths.
Hall says medicines for treating addiction have proven just as successful, but that stigma around addiction is getting in the way.
"Some people don't like it, like it's replacing one drug with another," says Hall.Stay on top of Orlando news and views. Sign up for our weekly Headlines newsletter.