KILLER DRUG HITS YOUNG, OLD IN CITY, SUBURBS

Deadly Illegal Drug And Painkiller Mix Spans All Age Ranges And
Socioeconomic Groups

The deadly mix of illegal drugs and a powerful painkiller ravaging
Metro Detroit is killing more old than young, and almost as many
suburbanites as city dwellers.

Offering the most detailed accounting yet of the breadth of the
damage, the Wayne County Medical Examiner's Office said Friday that
at least 1 of every 3 killed by mixing heroin or cocaine with the
painkiller fentanyl lives outside Detroit and that more than half of
those who died are older than 40. The findings are based on a review
of more than 130 confirmed cases in Wayne County between January 2005
and April.

Experts on drug use said those patterns point to how broad the impact
has been. "People think of substance abuse as people in alleys in the
inner-city. But that's not what this is," said Dr. Calvin Trent, who
runs the Detroit Health Department's substance abuse programs.

James Hall's mother warned him about the spate of drug-related deaths
Wednesday morning. By Wednesday night, he was dead, apparently from the drugs.

Hall, 33, of Wyandotte was discovered by police in his van in
Detroit, a syringe still in his leg, said his sister, Elizabeth Hall.
Authorities told her the death likely was connected to fentanyl
because of how swiftly he died.

Elizabeth Hall remembered her brother as being so friendly that he
could sell ice to an Eskimo, she said. "We had a tough life, but he
was compassionate," she said. "He would help anyone out."

He had stayed clean of drugs for almost three years, she said, but
returned to his habit a week ago. He had two sons, ages 10 and 12,
who live with their mother in Georgia.

Hall said she believes the drug scourge is more widespread than
people believe and that more should be done to warn people about it.
"I think a lot more people are doing it than people know about," she
said. "One of your colleagues may be doing it and you don't know it."

The medical examiner's accounting came as Wayne County officials
attributed eight more deaths that occurred Thursday and Friday in the
county to the drug mix, bringing to 39 the number of suspected deaths
since May 18. That toll has made the county the epicenter of a
growing national concern over deaths linked to the drugs, though
officials said they cannot conclusively link the most recent deaths
to fentanyl until toxicology tests are completed.

But those tests completed over the past year and a half show that
deaths from fentanyl-laced drugs have touched a broad group: 43
percent of those who died lived in Detroit, compared to 37 percent
who lived outside the city. Dr. Cheryl Loewe, Wayne County's deputy
chief medical examiner, said she did not know where the other 20
percent of victims lived.Victims are a broad group

Loewe said the toxicology tests also showed:

"This pattern is typical in what we're seeing for people who abuse
drugs," said Dr. Michele Reid, medical director of the Detroit/Wayne
County Community Mental Health Agency. "Drug use spans all age
ranges, all socioeconomic groups. Substance abuse is a disease for everybody."

The findings are similar to what other cities have encountered. In
Chicago, where authorities have linked 50 deaths to fentanyl over the
past year, 24 were older than 40, said Dr. Edmund Donoghue, Cook
County's chief medical examiner.Impact felt nationwide

The rash of fentanyl-related deaths has touched cities from Chicago
to Philadelphia, but in Michigan health officials said so far it has
largely been confined to Wayne County. Medical examiners elsewhere in
the state said they have not seen overdoses linked to illicit drugs.
In Macomb County, for instance, authorities found six suspicious
deaths over a three-day period two weeks ago, but do not believe they
are linked to fentanyl, said Thomas Kalkofen, the county's Health
Department director.

Fentanyl is a powerful painkiller usually prescribed for cancer
patients or people in pain so severe it can't be controlled with
morphine or other more common pain medications. Taking too much of
the drug can leave people unable to breathe.

The U.S. Food and Drug Administration warned last year that fentanyl
is especially dangerous for people who are taking other opiates, such
as heroin.

People who mix the drugs "are playing Russian roulette with their
lives," said Carolyn Gibson, a spokeswoman for the U.S. Drug
Enforcement Administration, which is investigating the Wayne County deaths.

Detroit police and health officials also are investigating the deaths.

Among the questions investigators are trying to unravel, Gibson said,
is where the fentanyl came from. In recent years, authorities have
documented cases of people going to doctors with fake injuries to get
prescriptions, and have found at least one laboratory that was
producing black-market fentanyl pills.

Investigators also don't know whether users who bought drugs cut with
fentanyl knew what they were getting, Gibson said.

They hope chemical tests on the drugs can offer clues about where the
painkiller is introduced into drugs ultimately sold on the street,
but much of the investigation also hangs on authorities' ability to
track down the dealers who sold to victims, then to work backward
through a complicated chain of suppliers.

Authorities said they found cases of fentanyl-laced drugs as long ago
as the 1980s, though the mix was not widespread. More recently, they
said, the drug has been abused by itself. Last year, for example,
federal prosecutors in Grand Rapids said a man had passed
prescription fentanyl on to two other users, who died.

But the new cocktails pose a particularly serious threat. "Nowhere
before have we seen the numbers of people or the geographic
dispersion we have now," said Robert Lubran, who has tracked the
deaths for the U.S. Substance Abuse and Mental Health Administration.

Detroit News Staff Writer Francis X. Donnelly contributed to this report.