By Lauren Lindstrom

The Blade

TOLEDO, Ohio — Ohio is ground zero for illicit fentanyl use in the United States, according to a new report documenting the deadly synthetic opioid’s flow from China to American addicts.

A report from the U.S.-China Economic and Security Review Commission details the drug’s path, primarily from China and sometimes through Mexico, creating “a fentanyl crisis in the United States, with significant increase in U.S. opioid overdoses, deaths, and addiction rates occurring over the last several years.”

Ohio had the most investigative fentanyl samples tested of any state in 2015, according to National Forensic Laboratory Information System, which collects results from state and local forensic laboratories.

Ohio documented 3,897 samples of fentanyl that year, while second-place Massachusetts had 2,556.

Fentanyl, a powerful synthetic opioid about 50 times more potent than heroin and 100 times more potent than morphine, has become a growing concern for law enforcement and health officials. Its potency is part of the attraction, the report states, because users typically require less than a milligram for a single use. Just two milligrams — equivalent to two grains of salt — can be lethal.

The drug was introduced more than 50 years ago as a treatment for severe pain, particularly for cancer patients, but has since gained popularity as an illicit drug. It is the synthetic opioid most frequently seized by U.S. Customs and Border Protection, according to the report.

The Ohio Bureau of Criminal Investigation has seen a steady rise in positive fentanyl samples collected by law enforcement agencies. In 2016, BCI tested 2,396 cases of fentanyl, up from 1,110 in 2015 and 34 in 2010, according to agency spokesman Jill Del Greco.

The year 2016 also marked the first time BCI reported positive tests for carfentanil, an animal tranquilizer 100 times stronger than fentanyl. The agency recorded 214 positive carfentanil tests in 2016.

As synthetic opioid occurrences rose, positive tests for heroin dropped from 6,832 in 2015 to 5,768 in 2016 after increasing every year since 2010.

The grim statistics are not all that surprising, said Lt. Robert Chromik, who leads the Drug Abuse Response Team through the Lucas County Sheriff’s Office.

Fentanyl is “overtaking the market tremendously,” he said. “We don’t even say heroin anymore, we say fentanyl [and other synthetics]. There is some heroin in there but there isn’t that much and that’s what’s killing everybody.”

DART officers responded to 19 overdose calls Friday through Sunday, Lieutenant Chromik said. He assumes most were caused by fentanyl at least in part, though they are waiting on toxicology to confirm.

Because fentanyl is so much more potent than heroin, users can overdose within minutes of taking the drug, he said.

“It’s not like it was before when they were using,” he said. “The [overdose] onset happens so fast, they know they are in trouble and realize this is a bad batch.”

Toledo police administered the anti-overdose drug naloxone to 168 people in 2016, said Lt. Joe Heffernan, the department’s spokesman. The department began equipping its officers with naloxone a year ago.

In the first six months of 2016, Lucas County had 75 fatal opioid overdoses, according to Dr. Robert Forney, chief toxicologist at the Lucas County Coroner’s Office. Of those, 38 were due to fentanyl with no heroin detected, eight from a mixture of heroin and fentanyl, and 29 from heroin mixed with other drugs, he said.

Ohio has long been at the center of the ever-shifting heroin and opioid abuse epidemic, going back to pill mills that put cities like Portsmouth on the map for all the wrong reasons.

More recently, Ohio in 2014 had the most opioid overdose deaths in the country, according to a Kaiser Family Foundation analysis, surpassing more populous states.

And an executive order by Gov. John Kasich in May made Ohio one of the first states to make illegal the synthetic opioid U-47700, sometimes known as “pink,” after a number of overdoses. It has since been permanently moved to a Schedule I designation — declaring it has no acceptable medical use and a high potential for abuse — by the Ohio Board of Pharmacy, where it joins heroin and other narcotics.

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