FENTANYL AMPS UP DANGER

Geoffrey Dankovich's life ended May 28 in a hotel room in Fayette
County. He was 27.

Hours before his death, Dankovich and a companion allegedly purchased
patches infused with fentanyl, a powerful medication for chronic pain,
from Jeffrey Moore, 43, of Redstone Township, a man he did not know.

Dankovich and his friend cut one patch in half and chewed the pieces
to suck out the gel, which is designed to deliver the narcotic over a
three-day period. Both also stuck a patch to their bodies, police said.

Under the combined effects of the fentanyl, cocaine, opiates and
muscle relaxers, Dankovich fell unconscious and died. The Fayette
County Coroner's Office ruled his death a drug overdose.

Across the nation, there has been a surge in fentanyl-related deaths,
according to statistics compiled by federal agencies. The National
Drug Intelligence Center reported in its 2006 drug threat assessment
that Pennsylvania is becoming one of the primary markets for fentanyl.

There were 120 deaths linked to fentanyl patches in the U.S. in 2005,
according to the U.S. Food and Drug Administration, up from 100 the
previous year.

Fentanyl is one of nine narcotics listed by the FDA as responsible for
the most emergency room treatments for drug overdoses.

Between 1995 and 2000, there were more than 108,000 cases of opiate
abuse nationwide that required treatment in emergency rooms. More than
42,000 cases involved fentanyl abuse, according to the Substance Abuse
and Mental Health Services Administration.

The National Drug Intelligence Center in Johnstown suspects there may
be more fentanyl-related deaths than the reports include because many
overdoses were classified as heroin-related. Chemically, fentanyl is
hard to distinguish from heroin. Testing for it requires specialized
toxicological screening.

In Pennsylvania, the Centers for Disease Control and Prevention
reports that in 2005 more than 13,400 people were admitted for
treatment for heroin abuse; another 3,300 were treated for abusing
other opiates such as fentanyl. However, the CDC did not break down
the exact number of fentanyl users. In 2004, more than 19,000 were
admitted for heroin treatment, another 4,300 for other opiates.

Developed in the 1960s, fentanyl is a synthetic narcotic used by
cancer patients and those with chronic pain. The medicine became
available in patch form in the 1990s.

Abusers risk overdosing when they dilute or cut fentanyl, according to
the substance abuse administration. Normally, physicians prescribe 45
micrograms of the drug as a pain reliever, which is less than the
weight of a grain of salt.

Sources of the drug include health care workers, according to
experts.

The U.S. Drug Enforcement Agency reports that the patches are being
stolen by health care professionals and employees of hospitals and
doctors offices, then sold on the streets. The state Attorney
General's Office said narcotics agents are reporting that many of the
patches are coming from prescriptions.

"Fentanyl prescriptions are being overprescribed," spokesman Kevin
Harley said. "They go to a doctor and say they need one patch and are
getting three. There are still a lot of bad pain doctors out there.
They'll go to a doctor and say, 'My knee hurts. I need a fentanyl patch.'"

Bill Houcker, spokesman for the DEA's regional office in Philadelphia,
said agents are monitoring use.

"We are always looking for trends because addicts are constantly
looking for new drugs. They'll do it, and it will kill them," he said.

Fentanyl-laced heroin has been a problem in the region this
summer.

At least nine people have died and more than 50 people have been
treated in Pittsburgh and Allegheny County for overdoses of the deadly
cocktail. Nationwide, more than 100 have died.

Guillermo Cole, a spokesman for the Allegheny County Health
Department, said his office is reviewing a recent slew of
heroin-related overdoses in the county to see how many are actually
fentanyl-related. He said investigators will determine whether the
fentanyl came from patches or other sources.

"That could be turning up," Cole said.

In May, FBI agents in Philadelphia seized 25,000 bags of fentanyl
mixed with heroin. Last month, Pittsburgh police seized more than 1,000 bags.

"The use of fentanyl does appear to be picking up," said Trooper James
Pierce, of the Uniontown barracks, who investigated Dankovich's death.
"We are seeing a lot more of it. This is a medication available only
by prescription, so people are selling scripts or taking other means
to get it."

Moore was later charged with criminal conspiracy and possession of
prescription drugs with no labeling, in connection with Dankovich's
death. Anita Lynn Workman, 39, of Greensboro, Greene County, who
allegedly took Dankovich to Moore's house, was charged with criminal
conspiracy to commit drug delivery.

Pierce recounted another case in which a drug addict nearly died from
using a patch to get high.

"This man took it orally and apparently went into cardiac arrest.
Fortunately, when he was taken to the hospital, he regained
consciousness and recovered," he said.

Dankovich wasn't the only fatal case in Fayette County this
year.

The accidental overdose death of Anthony Bauer, 40, of Scottdale, at a
Connellsville residence on June 13 was attributed to ingestion of
fentanyl, according to the Fayette County Coroner's Office.

Marissa Spring, a Fayette County deputy coroner, said there have been
six drug overdose deaths since 2004 in which fentanyl was found in the
victim's system.

"There was one in 2004, two in 2005 and four in 2006, so it's
definitely becoming a little more popular," she said.

Dennis Johns, deputy coroner in Westmoreland County, said drug deaths
overall have spiked since 2000 and that fentanyl abuse is among the
culprits.

"Prior to 2000, we had eight or nine overdose deaths annually. Last
year, we had 50. We have 16 this year," he said.

Johns recalled the recent case of a young Derry Township man who had
chewed a fentanyl patch and died and another who placed three to four
patches on his body at once, releasing a week's worth of medication in
a single dose.

"We've definitely been seeing it more recently," he
said.

Addicts and dealers appear to be turning to the drug since the law
enforcement limelight is on OxyContin and methamphetamine, said Esther
Rahl, a pharmacist at Vaccare's Pharmacy in Greensburg.

"It's the new fad. Six months from now, it will be something else,"
she said. "Everybody's looking for OxyContin and meth labs, so
unfortunately the fentanyl patch is making the drug scene."

Rahl said that as a health care professional, her greatest concern is
that the people who really need it can get it.

"There are people that take it correctly, so there is a need for the
drug. It's regulated as much as it can be regulated, but you'll never
be able to totally control it. You can't see pain, so people can get
over on physicians when they say they are in pain. It's a problem."