Medical Examiner Reports Deaths from Powerful Opioids

December 9, 2016

The Cook County Medical Examiner's Office has confirmed two recent deaths due to powerful opioids never before seen in Cook County.

The office has confirmed that a 46-year-old Chicago man died Sept. 10 from a lethal combination of fentanyl analogs, which are not pharmaceutical-grade drugs like those administered by medical professionals for severe pain.  Toxicology testing found the man had the fentanyl analog carfentanil in his system. Carfentanil is a fentanyl analog that is 10,000 times more potent than morphine, which is the active component of heroin. Carfentanil is used in veterinary practices to immobilize large animals.

 In addition, the office has confirmed a 35-year-old Lake Zurich man died June 8 from a 3-Methylfentanyl overdose. 3-Methylfentanyl is also a fentanyl analog and it is 400 times more potent than morphine and four times more potent than fentanyl. 

These cases represent the first deaths in Cook County from those specific fentanyl analogs; however, the office this year has seen a marked increase in deaths from fentanyl and other fentanyl analogs.

"Fentanyl and fentanyl analogues, like carfentanil, are very powerful drugs that are likely to be lethal," said Dr. Ponni Arunkumar, Cook County’s Chief Medical Examiner. “Just one dose can easily stop a person from breathing, causing immediate death.”

"Carfentanil is an elephant tranquilizer. It is not a drug that humans should be ingesting. These high-potency opioids and opioid analogs are thousands of times stronger than street opioids like heroin and are far more likely to cause death," said Dr. Steve Aks, emergency medicine physician and toxicologist at Cook County Health & Hospitals System's Stroger Hospital.

In 2016, 380 deaths were caused, at least in part, by fentanyl or fentanyl analogs. The data for 2016 is not a real time number, as toxicology testing can take up to 90 days.

In 2015, the office found 102 deaths were caused, at least in part, by fentanyl or fentanyl analogs. 

In 2014, 20 deaths were attributed to fentanyl, according to the Medical Examiner's Office.

The most common fentanyl analogs in Cook County include furanyl fentanyl and a precursor/metabolite of fentanyl called despropionyl fentanyl or 4-ANPP.

The Medical Examiner's Office began routinely testing for fentanyl starting in June 2015 after national trends showed a spike in fentanyl use. Previously, the office tested for fentanyl at the discretion of the pathologist. Often, testing was done due to the circumstance of the case; for example, if an unknown substance was found with a decedent.

Toxicology tests show decedents have used fentanyl alone, with heroin and with other drugs, such as cocaine.