Health & Medicine

Sacramento fentanyl overdoses show opiate addiction’s toll knows no boundaries

Fentanyl victim's mother speaks at vigil

Natasha Butler, mother of 28-year-old Jerome Butler who died of opioid overdose Wednesday, speaks at a vigil in south Sacramento.
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Natasha Butler, mother of 28-year-old Jerome Butler who died of opioid overdose Wednesday, speaks at a vigil in south Sacramento.

On the outside, she was a portrait of a stable, healthy young woman. Lexie grew up in Fair Oaks in an intact, upper middle-class family. She rode horses, played soccer and was a high school track star.

Then she broke her back in a riding accident at age 19, and began taking Norco pills for her pain. Soon she became addicted to its euphoric effects. When her prescription ran out a couple of years later, she suffered severe withdrawals and began seeking the drug on the streets. She bought it, for $3 to $7 per pill, from people who came into the bar she managed. She bought it from strangers in a motel room off Freeport Boulevard. She told no one, not even her parents or her best friends, that she was hooked.

Now, as a rash of overdoses and deaths in the Sacramento area from pills resembling Norco – but apparently laced with the powerful painkiller fentanyl – grabs national headlines, Lexie, who remains in treatment but believes she has kicked her addiction, has gained a new perspective.

“That could have been me,” she said. “I probably would have taken five of those pills at once and been dead.”

Because her family and friends still are unaware of her addiction, Lexie declined to be fully named, although her doctor confirmed her identity. “This is really hitting home,” Lexie, now 33, said of the recent wave of overdoses that started March 24. “I feel lucky that it wasn’t me, and I worry about some of my friends” who continue to abuse opiates.

As of Friday afternoon in the Sacramento area, 36 overdose cases including nine deaths had been linked to drugs sold on the street as Norco but believed to contain fentanyl, which in prescription form is used to treat severe and chronic pain and can be fatal even in tiny doses.

The victims, authorities said, are from a wide variety of backgrounds and neighborhoods and may not fit the stereotype of what many consider to be an addict. “This kind of thing happens in urban settings, suburban areas, wealthy suburbs, poor and rural areas,” said federal Drug Enforcement Administration Special Agent Casey Rettig. “It’s not limited to a certain demographic or geographic area.”

The DEA is leading the investigation into the overdoses, and Rettig said the probe has become “our No. 1 priority.”

“We are working around the clock on this,” she said.

Agents are interviewing survivors, their friends and others in an effort to determine who is mixing and selling the tainted drugs, which elsewhere have been traced to laboratories in Mexico and China and distributed by street gangs in the United States.

When laced with fentanyl, the pills can shut down breathing, cause cardiac arrest and kill within minutes.

The suspected drugs have killed eight people in Sacramento County and one in Yolo County, and have led to the hospitalizations of 27 others. The overdose victims range in age from 18 to 59 and are scattered throughout the region, authorities have said.

George Berry, one of the people who fatally overdosed, was 18 years old. His family lives in an upscale neighborhood in El Dorado Hills. Another, Jerome Butler, was 28, a father of three and came from working-class south Sacramento.

According to family members, Butler, who was training to be a security guard, was hanging out with friends when he was stricken on March 25. His mother, Natasha, said the group started drinking beer, and drugs apparently came into the picture later in the evening.

Sometime after midnight, Butler took what he believed to be a Norco pill given to him by someone who lived in the house where he was staying, his mother said. Shortly afterward, he complained that “his heart was hurting,” she said, and lay down.

The exact circumstances of what happened next are unclear. But at some point, Butler became unconscious. Panicky efforts to revive him with CPR failed. Someone called 911.

When paramedics arrived, they rushed Butler to Kaiser South medical center, where doctors placed him on a ventilator to help him breathe. He never regained consciousness, Natasha Butler said. On March 30, his family authorized his medical team to remove him from life support.

Jerome, the oldest of four children, grew up in a Sacramento neighborhood marked by drug dealers and gangsters. He “wanted to stay away from that kind of life,” said Velma Savage, a neighbor of the Butlers who said she and her husband, Jerry, considered Jerome part of the family.

Jerome was “happy, cheerful, always polite,” and a good father to his three children, said Savage.

But at some point, Butler’s mother said, he “got hooked up with the wrong crowd.”

Natasha Butler said she hopes investigators will bring closure to her son’s death.

“He can’t just die and no one is accountable for what happened to my baby,” she said.

Fentanyl is the latest scourge in a national epidemic of abuse of opiates, which are legally used to treat pain associated with surgery, back injury and other conditions. Many patients become addicted, and turn to the streets when they no longer can get it by prescription.

The drug is estimated to be as much as 50 times more powerful than heroin, making it attractive to addicts and lucrative for traffickers. Heroin spiked with fentanyl is marketed under brand names including China White and Fire, which addicts request by name. In other cases, users believe they are purchasing pure heroin or Norco or Oxycontin pills, when in fact the drugs have been laced with fentanyl.

The Centers for Disease Control and Prevention tracked 202,157 deaths from drug overdoses between 2009 and 2013. Of these, 57 percent involved heroin and opiates. Authorities across the United States documented 8,511 seizures of illegal fentanyl between January and September 2015, compared with 5,217 in all of 2014.

California hospitals treated more than 11,500 patients suffering an opioid or heroin overdose in 2013, state figures show.

Emergency room physicians across the Sacramento region are now on alert for suspected overdose cases that might be related to fentanyl. In San Joaquin County, there have been 18 reported cases of overdoses possibly tied to fentanyl since March 30, according to a county public health services spokeswoman.

“I haven’t seen anything like this since the ’70s and ’80s in L.A.,” when hospitals treated waves of patients who had overdosed on heroin, said Dr. Keith Rosing of Mercy General Hospital. “It’s alarming.”

Rosing recently treated a young man who had collapsed in a dentist’s office from an apparent opiate overdose. He told doctors he had swallowed one Norco tablet before going to the dentist. When paramedics arrived, they treated him with naloxone, an antidote used to restore breathing. At the hospital, he received several more doses before he was placed in the intensive care unit with an intravenous drip of the drug. The hospital declined for privacy reasons to disclose whether he survived.

At UC Davis, 17 patients have been treated with overdoses linked to fentanyl. It is so potent that simply handling or inhaling it “could potentially kill you,” said Dr. Tim Albertson, a toxicologist and chair of the Department of Internal Medicine.

Capt. Stu Greenberg, head of the investigations division in the Orange County Sheriff’s Department, said stiffer penalties are needed to curtail illicit manufacture and sales of the drug.

Greenberg is scheduled to testify next week at a state Senate committee hearing on Senate Bill 1323, which would enhance penalties for traffickers.

Because fentanyl can easily be absorbed through the skin, he said, he has warned his deputies and other “first responders” about handling suspected overdoses of the drug.

“I’m terrified about exposure to kids,” he said. “I’m worried about friends and families of drug users.”

Fentanyl, he said, “is scary stuff.”

The Bee’s Sammy Caiola contributed to this report.

Cynthia Hubert: 916-321-1082, @Cynthia_Hubert

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