I was struck by the strikingly similar clinical language contained in the 11 Hennepin County medical examiner reports I read this week.
“Manner of death: accident.”
“Cause of death: Mixed carfentanil and ethanol toxicity.”
“How the injury occurred: deceased self administered carfentanil and ethanol.”
There’s a silent and elusive killer on the loose in Minnesota and nationally in recent months. This killer is responsible so far for those 11 deaths, if not more. Concerned law enforcement authorities and medical personnel are hoping and praying there won’t be more victims.
I’m talking here about carfentanil, the common link and likely cause of all those fatalities. According to published reports, the drug — used to tranquillize elephants, horses and other large animals — is 10,000 times more powerful than morphine and 100 times more potent than the opioid that claimed the life of pop icon Prince and countless others.
In 2002, Russian military forces accidentally unleashed an aerosol canister of the stuff inside a building where Chechen terrorists were holed up with hostages. More than 100 hostages died from exposure to the chemical. According to drug enforcement agents, it is mostly mixed with heroin, cheap to buy and get online, and gives a longer-lasting high. But just two salt-sized specs of it can kill.
There is little doubt in Andrew Baker’s mind that the fatal carfentanil-related overdose victims in Minnesota — all known drug or opioid abusers — did not intentionally ingest the deadly chemical.
“I cannot believe most of them wanted to do this,” Baker, Hennepin County’s chief medical examiner, told me this week. “But when you are buying heroin on the streets, you are always taking a risk because you don’t know what you are getting.”
It was Baker’s office that first detected the disturbing new wrinkle of the disturbing national opioid-drug epidemic. An autopsy and routine toxicology tests performed on a 31-year-old male OD victim in Minneapolis who died in late January came up negative. Staffers aware of carfentanil-related overdose cases elsewhere in the country decided to send samples to a reference lab in Pennsylvania that conducts more-complex testing. The process can take several weeks.
The test on the 31-year old victim, along with results from four other subsequent OD cases — two in Minneapolis, one in Apple Valley, and one in Faribault — came back positive for carfentanil by the end of March. Baker immediately contacted and informed local authorities as well as agents from the local Drug Enforcement Agency office. Since then, Baker’s office has identified six other such deaths. The latest carfentanil victim was identified this week as a 63-year-old heroin user from Brooklyn Park who died April 26. In Ramsey County, there has been one such confirmed carfentanil death, involving a death in late December.
One homicide investigator assigned to the Minneapolis cases has been comparing notes with the DEA and counterparts in Rice, Ramsey and Dakota counties, where other deaths took place, according to Minneapolis Deputy Chief Bruce Folkens. No single drug source has yet been found in connection with the local deaths “but we are making headway,” Folkens said.
The victims in the 11 Hennepin County medical examiner reports I read? Seven men, four women. Age range? 23-63. If we care about ethnic or racial backgrounds, eight were Caucasian, two of American Indian descent and one was black. One, a 34-year old woman, was found dead in a back alley. Most overdosed at home or indoors.
As Folkens stressed, the deceased hail “not just from the inner city. It’s all over.”
Tainted batches do happen. But this is hardly a passing drug fad, noted Joseph Lee, medical director of the Hazelden Betty Ford Foundation Youth Continuum. It’s tied to addiction, demand and supply, and basic economics.
The mixture of opiates such as heroin with easily accessible and cheaper chemicals such as carfentanil has become a growing black market on the underground internet, Lee explained. Individuals and drug cartels buy and sell drugs through the bitcoin currency, which cloaks identity. He credits U.S. Sen. Amy Klobuchar, D-Minn., for coming up with proposed legislation to attempt to cut off the overseas, dark-web pipeline through more postal-inspection interdictions and other means.
Behind every case number in the reports I read was a person — a sister, brother, son, daughter, a parent — mourned by someone out there. Addiction is an ugly, sad thing.
“It’s not only gang members accessing these secret labs around the world through the dark web,” Lee said. “Teenagers are doing it across the country.”
As for the plight of the users who unwittingly come in contact with the deadly synthetic drug “these are not zombies,” Lee added. “They are not trying to die. They are not trying to be a menace to others. That’s why we need to approach this as a public health issue.”
I remember a kindhearted but troubled friend of mine whose heroin addiction led to a lonely death in a desolate park more than 40 years ago. I still think about him. I’m sure he had a case number, like the woman found in that Minneapolis back alley, Case No. 2017-1076. But that’s not how I remember him, nor how loved ones will remember the 11 lives.