PHILADELPHIA -- The deaths came in an unexpected spring wave. At the medical examiner's office here, investigators counted 53 fatal overdoses between April and June alone, the lethal toll of heroin mixed with the potent painkiller fentanyl. In Detroit, 12 people died in a 24-hour period. In Chicago, where the same concoction has been linked to nearly 100 deaths this year, some dealers lured addicts by promising a version of the drug so powerful it was intended as a tranquilizer for large animals.
Across the country, at least 300 deaths and hundreds more non-fatal overdoses this year have been blamed on fentanyl, a prescription drug 80 times more powerful than morphine that was cut into heroin to boost the high and sold under brazen street brands as "Drop Dead," "Lethal Injection," and "Get High or Die Trying."
The pace of fentanyl-related deaths has slowed in recent weeks, but the rash of overdoses remains one of the summer's puzzling mysteries - and cities are prepared for the possibility of more deaths.
"We're predicting more than 100 deaths here, and of course, we don't know where it will stop," said William Wingert, chief toxicologist with the Philadelphia medical examiner's office who became alarmed in mid-April when the number of fatal overdose first accelerated.
Many of the victims died so quickly that emergency workers found hypodermic needles still in their arms.
Despite the high-profile bust of a Mexican lab suspected of producing clandestine fentanyl and arrests of key members of an entrenched Chicago drug gang accused of dealing heroin and fentanyl, authorities still cannot say with certainty what sparked the string of overdose deaths from the Midwest to the Mid-Atlantic. Nor can they explain how some cities, including heroin-rich Baltimore, have so far managed to largely escape the threat.
"It's been a big puzzle to put together in a hurry, and it's been critical to do so," said David Murray, a senior policy analyst with the White House Office of National Drug Control Policy, who said fentanyl has gained appeal as a dope additive as the purity of heroin trafficked inside the United States has declined.
"A lot of it depends on how much is still out there. ... In the back of my mind, I think this is an episode that will subside," Murray said. "But on the other hand, what it represents is the new type of drug threat we're increasingly going to be facing."
