Tests conducted on 13 of those who died indicated the presence of the painkiller fentanyl, or a fentanyl-like drug. The powerful synthetic opioid is available through prescription and, increasingly, sold or traded on the black market.

PROVIDENCE, R.I. � Twenty-two people died of drug overdoses in Rhode Island during a 13-day period this month � far more than the average for that time period, health officials said Friday.

Tests conducted on 13 of those who died indicated the presence of the painkiller fentanyl, or a fentanyl-like drug. The powerful synthetic opioid is available through prescription and, increasingly, sold or traded on the black market.

Health officials offered no explanation for the spike in deaths, up from the usual three to four per week. The deaths involved a variety of illicit and prescription drugs and were scattered in 13 cities and towns around the state. Those who died from Jan. 1 through Jan. 13 ranged in age from 20 to 62.

Most of the deaths occurred during the weekends, suggesting that people may have been bingeing, said Health Director Michael D. Fine.

Richard Holcomb, director of Project Project Weber, a Providence-based nonprofit that works with addicts, said that two of the people who died during the past two weeks were clients in his program. Most of his clients are intravenous drug users.

�The word on the street is that there�s bad heroin out there,� Holcomb said. �People believe that they�re shooting heroin but the substance does not look like heroin and they�re shooting it and they�re dying.�

The state medical examiner had not heard such reports, James Palmer, a Health Department spokesman, said.

�We don�t have any information on heroin,� he said.

Michelle McKenzie, senior project director at The Miriam Hospital, who has done extensive research on addiction, said the spike in overdose deaths from illicit drugs is part of an unfortunate but predictable pattern occurring here and around the country as health officials tighten controls on prescription drugs.

�We have all these folks who are opioid addicted,� McKenzie said, �� and there is a shortage of treatment in Rhode Island.�

Among those who died of overdoses during the past two weeks is a 23-year-old man who was in recovery and relapsed, said Tom Coderre, chief of staff for Senate President M. Teresa Paiva Weed and chairman of RICARES, an addiction recovery advocacy group. Coderre was planning to attend his wake Friday night.

�If you have people dying we should be addressing this a little more aggressively,� Coderre said. �It�s like we can�t do anything fast enough.�

Of the 22 deaths, 19 were screened with blood tests that found evidence of an overdose. Three cases were presumed overdoses because of �history and things found at the scene,� said Dr. Christina Stanley, chief medical examiner.

Of the 19 screened, 13 indicated the presence of the painkiller fentanyl, but not the acetyl fentanyl linked to deaths last June. Other drugs detected included cocaine, opiates, benzodiazepines, methamphetamine, oxycodone and carisoprodol.

Fentanyl is estimated to be 80 times as potent as morphine and hundreds of times more potent than heroin, according to the U.S. Centers for Disease Control and Prevention. It is generally administered intravenously, by injection or as a skin patch.

�Fentanyl is showing up more frequently than it usually does,� Fine said, but cautioned, �that doesn�t mean it�s the culprit. It�s essentially impossible to know, when you�ve got a mixed cocktail like this, which drug is responsible for the death.�

The latest spike in overdose deaths is significantly higher than those seen in the same period during the last two years, Fine said. He said that there have been only two deaths since Jan. 13, but he feared what would happen over the weekend.

�We�re here to issue a warning,� Fine said at the news conference Friday morning, where he was accompanied by Craig S. Stenning, director of the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, and state police Lt. Robert S. Wall.

The warning, he said, was aimed at drug users and their friends and families, in the hope that news of the deaths would encourage people to seek treatment. �People live in a certain kind of denial sometimes � that they can get high without risking death,� Fine said. �The thing to emphasize here is getting high is risking death.�

Stenning, the BHDDH director, said that treatment is both accessible and affordable, and that people can call (401) 462-4680 during business hours and 211 at any time to find help. He noted that with the expansion of Medicaid under the Affordable Care Act, many formerly uninsured people will have easier access to treatment because they will have coverage and won�t have to wait for a state-funded treatment slot.

The officials also urged actions to prevent deaths when overdoses do occur: by using the drug Narcan and by not fearing arrest if they call 911.

Narcan, which is available over the counter at Walgreens, can stop an overdose in its tracks, administered by injection or nasal spray. People who know someone with an addiction problem should keep the drug handy, Fine said.

Wall, of the state police, said that the 2012 Good Samaritan Overdose Prevention Act ensures that someone who calls for help during an overdose will not face arrest or prosecution for drug possession.

�Don�t be afraid to call 911,� Wall said. �Call the police. You may save a life.�

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