INDIANAPOLIS — Addicts who use it can overdose in an instant. Medics can need up to 10 times more Narcan to bring somebody back. One Ohio officer overdosed after he accidentally touched a small amount on his uniform.
It’s called Gray Death. It’s exponentially more powerful than heroin, it's cheap and it has police and health officials worried.
Gray Death is heroin mixed with powerful synthetic drugs that are commonly used to tranquilize elephants and other large animals. Or it is one of the synthetic drugs on its own.
"The Mexican cartels, they don't tell their supplier what's in the drugs," said Nick Ernstes, a Hancock County Sheriff’s Department deputy. "It's not going to a chemistry lab for them to test it."
Synthetic opioids such as fentanyl and carfentanyl give Gray Death its punch. Police started finding heroin laced with synthetic drugs in central Indiana more than a year ago. Its presence, and its risks, continue.
Ernstes was part of a task force that in August seized 5 pounds of fentanyl during a traffic stop on I-70 in Henry County. Investigators believe dealers were planning to mix the fentanyl with heroin, baking soda, flour and other substances and then sell it.
In March in Greenwood, a 20-year-old man and a 19-year-old woman snorted what they thought was heroin. The woman overdosed.
"When she did it she immediately almost died," Johnson County Prosecutor Brad Cooper said. "She overdosed almost upon contact with it."
Tests showed the drug was loaded with fentanyl derivatives. The couple unknowingly consumed Gray Death.
"It was more fentanyl than heroin," Cooper said.
Synthetic opioids have come into vogue in part because they are so much cheaper than heroin to produce, said Dr. Michael Olinger, medical director of EMS for the Department of Homeland Security.
A hit can cost as little as $10.
Heroin requires opium from poppy plants. Drugs such as fentanyl are made in a laboratory. Until a few months ago, fentanyl was sold legally online through Chinese distributors.
Carfentanyl is fentanyl's more potent cousin. It can be bought legally in the U.S. by veterinarians who use it as a tranquilizer for large animals. It is 100 times more potent than fentanyl, which is already 50 times more potent than heroin, according to the United States Drug Enforcement Agency.
Put another way, it is 10,000 times more powerful than morphine.
When humans take either drug, it stimulates the same receptors in the brain as other opiates, Olinger said. It dulls pain and can produce a feeling of euphoria. It also can slow bodily functions.
Sometimes, when users sleep, the drug causes the body to forget to breathe — with deadly consequences.
"Because they’re so much more potent, it will take more Narcan than we’re used to giving for heroin or opioid overdose," Olinger said. "It might take five to 10 times.”
Experts have warned law enforcement and public safety officers not to breathe or touch synthetic opiates when they come across them during traffic stops or investigations.
Heroin is made up of big, bulky molecules that don’t get absorbed as easily, Olinger said. These synthetic drugs, however, are made of smaller molecules that can go through the skin.
Police officers routinely wear masks and gloves when investigating drug scenes. The slightest exposure can bring immediate trouble.
Earlier this month, Officer Chris Green of the East Liverpool Police Department in Ohio took such precautions when he stopped a motorist. White powder was on the car and driver.
But when Green returned to his office, a colleague told him some powder was on the back of his shirt. Green brushed it off with his bare hand.
Within about 10 minutes, Green started getting sick, East Liverpool Police Chief John Lane told The Indianapolis Star.
"He basically passes out," Lane said. "The ambulance was already on station, so the medics ran over to deal with Officer Green."
The medics administered one dose of Narcan and rushed Green to a hospital, where he was given three more doses of the life-saving overdose antidote. He survived.
The powder was fentanyl.
The recent overdose in Greenwood serves as a warning that more synthetic drugs will come, Indiana State Police Capt. David Bursten said.
“It’s kind of like cockroaches. If you see one, you know there are more. You just don’t see them,” Bursten said. “If we’re seeing one, the likelihood of seeing more is very probable."
Clinical experts say as addicts use more, their tolerance grows. They need more drugs to get high. It is a vicious and dangerous cycle.
They also need to stay high to avoid going through withdrawals.
“Instead of running from (Gray Death), addicts are running towards it because they feel it’s strong enough to help them not get sick,” said Robin Parsons, Fairbanks Hospital's chief clinical officer.
Fairbanks Hospital staff have seen more people coming in and testing positive for fentanyl. Often, Parsons said, they think they have been using only heroin.
“They’re not in a situation at that point where they’re going to be picky about what they use and don’t use,” Parsons said. “They’re willing to try whatever it takes because physiologically they feel like they need the drug to survive.
"They’re more afraid of withdrawal than overdose, unfortunately.”
Overdose cases already are rising.
“It’s definitely going to become a bigger problem now that it’s synthetic as opposed to pure heroin,” she said. “Opioid addiction is a fatal diagnosis with the drugs on the street right now.”
Knowing the risks, why would anyone take a drug whose street name foreshadows a possible fatal result?
"It's not that they want to die," said Karen Fitzgerald, the clinical supervisor at Tara Treatment Center in Franklin. "They are going for that ultimate high."
They rationalize, Fitzgerald said, telling themselves: "It's not going to happen to me. I've been using a long time. I'm different."
Fitzgerald said a 20-something patient at Tara told her he took Gray Death because he believed it would give him a really good high.
"He vomited profusely, passed out and that was it," Fitzgerald said.
He told her that if he were told Gray Death would kill you 100% of the time but you're going to get the best high before you die, he would do it.
Follow Vic Ryckaert and Shari Rudavsky on Twitter: @vicryc and @srudavsky