Toxic cocktail: Overdose deaths from mixing fentanyl with other drugs on the rise in N.H.

  • Last year saw the state’s first annual decline in drug overdose deaths in six years. So far, it appears that 2019 will see an increase in such deaths driven by overdoses caused by mixing fentanyl with cocaine or methamphetamines.  NH Medical Examiner's Office—Courtesy

  • FILE - In this 1989 file photo, a razor blade is used to divide the contents of a five-dollar vile of crack, a smokable, purified form of cocaine, at a crack house in the South Bronx section of New York. Cocaine deaths have been rising, health officials said Thursday, May 2, 2019, in their latest report on the nation’s drug overdose epidemic. After several years of decline, overdose deaths involving cocaine began rising in 2013. And they jumped by more than a third between 2016 and 2017. (AP Photo/Mark Lennihan, File) MARK LENNIHAN

Monitor staff
Published: 7/16/2019 6:01:27 PM

Fewer people are dying from taking fentanyl by itself this year in New Hampshire than last but more are being killed by mixing it with other drugs, like methamphetamine and cocaine – a shift that may undo recent progress in cutting the number of overdose deaths.

Through mid-July, according to the Office of the Chief Medical Examiner, the number of overdose deaths caused by fentanyl alone has fallen sharply, from 75 as of mid-July last year to 44 in the same period this year. But at the same time, 88 people have died in New Hampshire this year from taking fentanyl mixed with other drugs, twice the number (44) who died from mixing fentanyl last year.

As a result, the total number of overdose deaths in the state is slightly greater than at this time in 2018, although scores of cases are still being processed so it’s too early to be sure.

The news is no surprise to Franklin Police Chief David Goldstein, who said law enforcement has been noticing the trend.

“We have spoken among ourselves on a number of occasions – we are seeing that the fentanyl is being mixed with other stuff,” he said.

Goldstein said the switch indicates that the underlying problem of drug usage isn’t improving even if some aspects appear to improve.

“We knew that eventually as we began to solve the opioid problem, other drugs would make a reappearance,” he said. “If we’re solving the problems, let’s solve the whole problem.”

Dan Andrus, fire chief for Concord, said the trend is making it harder for responders because it can reduce the effectiveness of Narcan, the fast-acting way to reverse an opioid overdose.

“Narcan only works on opioids, so any non-opioid pharmaceutical is not going to be affected by it,” Andrus said. “If there’s a concurrent use of other drugs, it tremendously complicates the whole matter.”

Andrus said first responders in Concord have been using Narcan more often, and more of it at a time, to deal with overdose calls.

“Until the last few years, the maximum dose was 2 milliliters. That maximum dose has been increased to 10 ml,” he said. “For many of our incidents there are multiple administrations – 4, 6, 8 – of Narcan.”

Law enforcement agencies throughout the country have been warning for months that they are increasingly seeing cocaine being mixed opioids, often to fatal effect. It’s not entirely clear why this is happening, but some federal sources have said a glut of coca leaves in South America has pushed down cocaine’s price; mixing it with far more potent opioids is one way that dealers can lure customers.

So far this year, 33 deaths in New Hampshire have been attributed to cocaine mixed with opioids, compared to just two due to cocaine alone and none to cocaine mixed with any other type of drug. The mix of cocaine and opioids led to 56 New Hampshire deaths last year, indicating that 2019’s tally is likely to be somewhat higher.

And cocaine isn’t the only drug being taken with fentanyl. Deaths due to methamphetamine mixed with opioids are also going up, from 22 last year to 16 through the first half of this year.

A total of 471 deaths were attributed to drug overdoses in New Hampshire in 2018, a drop from 2017’s all-time high of 488 deaths.

As late as 2013, when the fentanyl crisis began, fewer than 200 people died from drug overdoses in the state each year.

(David Brooks can be reached at 369-3313 or or on Twitter @GraniteGeek.)

David Brooks bio photo

David Brooks is a reporter and the writer of the sci/tech column Granite Geek and blog, as well as moderator of the monthly Science Cafe Concord events. After obtaining a bachelor’s degree in mathematics he became a newspaperman, working in Virginia and Tennessee before spending 28 years at the Nashua Telegraph . He joined the Monitor in 2015.

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