Is Cocaine Laced with Fentanyl Causing Overdoses in Cleveland?

By Zachary Siegel 02/14/17

Maybe. It’s more likely that drug users are speedballing. 

A drug deal.

Law enforcement officials in Cleveland, Ohio believe a toxic blend of fentanyl and cocaine caused 14 overdose deaths in the area last weekend. 

"If someone is using cocaine, they might not be expecting it to be mixed with fentanyl," U.S. Attorney Carole Rendon said. "It's very dangerous."

Rendon went on to say that drug dealers are likely lacing cocaine with heroin and fentanyl in order to get customers hooked. She also said it only takes one dose of an opioid to become addicted. 

Though addiction science is fraught with debate, one thing scientists know for certain is that it takes repeated exposure of drugs in higher doses in greater frequency to cause a bona fide addiction. Rendon’s claim that one dose of an opioid can ignite full-blown addiction is nowhere in the scientific literature.  

Moreover, cocaine is a stimulant and part of an entirely different class of drugs than opioids, which are depressants. Cocaine users looking for a speedy high will be let down if their coke turns out to be heroin or fentanyl. So it’s unlikely that cocaine dealers are actively ruining their product to “create more opioid users” when their customer base wants cocaine—a drug that’s plenty addictive on its own. 

It seems that Cleveland authorities ruled out the notion that opioid users sometimes inject a mix of opioid and cocaine in one shot—it’s called a speedball. 

But last week, The Fix reported a fluke event that occurred in New Haven, Connecticut, wherein drug users bought cocaine that had fentanyl in it. The Centers for Disease Control and Prevention investigated the case and determined the drug users who bought cocaine were not opioid users. Those users unknowingly took fentanyl thinking it was cocaine, and three of them died. 

There’s reason to doubt that this is what’s happening in Cleveland. For example, local law enforcement near Cleveland posted on Facebook last Wednesday that three people overdosed on marijuana tainted with an “unknown opiate.” They later retracted their statement because the users admitted to taking several drugs, including crack cocaine, and authorities say they also likely used heroin or another opioid before overdosing.

Again, that’s a speedball. The users who overdosed may have said they only smoked pot to avoid the legal trouble of being in possession of many narcotics. (Tests revealed that the marijuana was not tainted.)

In 2016, the number of opioid overdose deaths hit an all-time high of 517 in Cuyahoga County, more than doubling the 228 deaths in 2015, according to the county medical examiner.

Fentanyl manufactured in clandestine labs is a serious problem affecting the illicit opioid market, making it increasingly dangerous. The Cleveland area saw 19 deaths from fentanyl or heroin during the first month of 2017. 

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.