Philadelphia Court Visitor Collapses from Heroin Overdose

Man collapses on floor of court building in opioid overdose

Around 10:30AM today on Wednesday a court visitor had collapsed from an opioid overdose while visiting the Philadelphia Court of Common Pleas building across from City Hall.

In a sign of how bad the heroin crisis has become the unidentified man was accompanied with a female–also displaying clear signs of visible opioid intoxication according to witnesses at the court.

It is not known what business the man had at court that morning.   Witnesses at the court say that the man had collapsed in one of the heavily-trafficked halls that run along the spine of the 17 story building which houses most of the courtrooms for the Commonwealth’s criminal court division (civil cases are heard in City Hall).  The court visitor was unresponsive on the floor as others inside the court building tended to him as the Philadelphia Sheriff’s Department responded.

One source at the First Judicial District expressed frustration that Philadelphia Sheriff’s Department, who provides the security for the city’s courtrooms, does not carry naloxone; the drug commonly known as Narcan.   Nor are many of the Sheriff’s Department officers trained on how to dispense the drug.   Narcan is a fast-acting opioid receptor blocking agent that is widely used to revive addicts who have overdosed on heroin and other synthetic opioids.

Deadly Heroin Sweetener Is On Its Way to Philly

Carfentanil is coming

The Feds are gearing up to prosecute Reginald Davis, a Beaver County man who was caught distributing heroin laced with the drug that delivered a fatal overdose.

Last week it turned up in New Hampshire and has resulted the direct deaths of three people so far.

Carfentanil is a veterinary tranquilizer that’s meant to be used on very large animals such as elephants.  It’s a much more concentrated form of fentanyl that makes fentanyl overdoses look like child’s play.

Gram-for-gram, carfentanil is 10,000 times stronger than the same amount in morphine in terms of potency.  As it’s a molecular cousin of fentanyl, the drug can be taken up merely by skin contact which is how medically-proscribed fentanyl is administered to patients in the form of patches, dissolvable tab sheets and lollipops.

But the receptive effects of carfentanil is so strong that emergency aid workers who come into skin contact with it may have to take Narcan if they succumb to exposure when helping out a overdose patient.

Further, direct use of carfentanil by heroin users may not be fixable with Narcan, certainly not if emergency workers don’t have enough vials on hand to distribute.  If dealers and suppliers insist on adding this agent to the streets of Philadelphia, overdose deaths in Philly will climb past the horrific rate we checked in at last year: over 900 fatal overdoses, 3 times the murder rate.

Acrylfentanyl is also a thing and it’s here, too

Another knockoff to add to the batch of heroin fun is acrylfentanyl.  While not concentrated and deadly as carfentanil is, its presence amongst US drug users is worrisome.   Acrylfentanyl exposure has turned up in drug users in Eastern Europe and Sweden and it’s thought to be acquired in China and distributed through online merchants.

The US Department of Justice has filed charges today against Anthony Corza, age 31, of York County.   Corza was found to have packets of acrylfentanyl on him.

Best Heroin Stamp of New Jersey, ever
Best Heroin Stamp of New Jersey, ever

If this shit’s so deadly, why are they adding it to heroin?

The logic behind the fentanyl sweeteners is product differentiation and concentrates.  For a heroin addict who was on normal strains of heroin and running up a 10-12 bag a day habit, concentrations matter a lot.

It’s not that uncommon for junkies to work their way up to 300-500mg a day habits.  With any illicit drug of the powdered variety concentration matters to both the suppliers and to the users.

Pushing more weight of illicit substance in the transport network creates more risk for a drug supplier.  Heroin is pretty easy to lace with other substances to boost the opioid high that a user gets.  So if it’s possible to cut heroin and later add trace amounts of other opioids that can be sourced domestically it can be cost effective.  Fentanyl is so concentrated and powerful that a supplier can afford to boost the cutting agent in the packet they’re selling.  It lets heroin suppliers sell the same amount of heroin at higher prices simply by changing the ratio of what goes in the packaging.

Fentanyl is also tempting to downstream suppliers.  Some suppliers and even dealers are trying to use it to fix production mistakes.

Sample sizes of deadly doses of heroin, fentanyl and carfentanil (NHPR)
Sample sizes of deadly doses of pure heroin, fentanyl and carfentanil (NHPR)

Fixing mistakes and making more

Junkies value heroin concentration a lot.   Heroin isn’t mass produced here, it’s imported.  For the United States most of it enters from Mexico.  The concentrations of heroin found in apprehensions in the Southwest are very pure, some heroin hauls by border agents are north of 70% pure product.   As the product weaves its way to the Rust Belt the concentration tends to go down as it gets cut before the final point of sale.  Concentrations of heroin content in the final bag can be as low as 15%, though for Philly that would be rare.

For a junkie who has worked themselves up to 1 bundle a day habit–10 bags–if the supply is changing from one bundle to the next the concentration is also likely to be going up and down like a yo-yo, too.   Heroin addicts try to find consistency with their dosing.  How much heroin they’re actually ingesting could be as low as 200mg or as high as 600mg for the entire bundle.  Stamp bags was one way to do that but most people on heroin know by now that stamping the bags guarantees diddly squat.  A stamped batch that might be good one day might be shit the next and a waste of $100.

One problem heroin dealers face besides the cops and the dying customers is dissatisfied customers.   A bad batch, particularly one that’s perceived to be weak and easily recognizable among users once it’s stamped (which many in Philly still are)… if it’s proven to be unpopular, lacing and re-bagging can solve one problem downstream dealers have had to deal with for ages: how to dump a product nobody likes?   They can’t reverse a cutting that happened earlier before they were given the product to sell, or fix a problem with not getting the right concentration in the first place.

For dealers, fentanyl is like typewriter correction fluid that can magically go back and “fix” a mistake an upstream supplier created.   Lace the product, customers get high,  next week you get happy customers.  Unless of course, they’re dead.

For the dealers playing at-home chemistry experiments on their stashes, junkies are stupid as fuck.  And there’s been enough times to prove that whenever news of a major heroin overdose wave hits it seems to bring different sets of junkies out of the woodwork looking to score the bags that killed the others they heard about.  The business will still go on even if several hundred people get sent to the hospital within a weekend and it’s all over the news.  NBD.

Both Philly and Camden have seen “death waves,” with fentanyl being laced on top of high concentrations of heroin hitting the streets.  Once the news spread that a very concentrated drug was in circulation it was like someone hit the gas pedal on the overdoses.

Upstream suppliers and dealers seem to be determined to experiment with all the fentanyl derivatives they can get their hands on.  For that we’re going to be paying the price in bodybags.