Boston warns of surge in overdoses linked to cocaine laced with fentanyl

Boston public health officials have alerted health care providers in the city about a “concerning” increase in overdoses that connect the powerful opioid fentanyl to the use of cocaine.

Within 24 hours spanning Feb. 20-21, Boston EMC responded to 11 calls to revive people who had said they were taking the stimulant, cocaine. The first calls were in the Nubian Square area of Boston’s Roxbury neighborhood. Boston Public Health Commissioner Dr. Bisola Ojikutu said in a statement that EMS also responded to calls in other parts of Boston.

“Unfortunately, several of the overdoses across the city were fatal,” Ojikutut said.

People who buy what they think is cocaine and don’t have any tolerance for fentanyl are at greater risk for death from even a trace amount of this opioid, which can stop a person's breathing almost instantly.

“That’s a real concern,” said Stephen Murray, the Harm Reduction Program manager at Boston Medical Center. “People who use cocaine infrequently may not be engaged with harm reduction, have fentanyl test strips or even be aware that this happens. It can catch people by surprise."

Murray said these hyperlocal spikes in overdoses and deaths are happening around Massachusetts and the U.S. It might be a dealer who packages cocaine on the same table where he or she prepared bags or fentanyl. Or another dealer who sells fentanyl instead of cocaine to stretch the supply. It might be a group of opioid-naive students who share drugs on Spring Break.

The most recent statewide report shows fentanyl in 12% of cocaine samples in Boston. Murray said that is likely an undercount because people who use drugs often only ask to test samples that seemed usual.

A poisoning of the cocaine supply with fentanyl is linked to the increase in drug overdoses among Black people who use drugs, men in particular.

Murray says xylazine, the animal tranquilizer showing up in more than a quarter of the state’s drug supply, complicates the overdose recovery. Xylazine doesn’t respond to naloxone, the drug that can restart breathing after an opioid overdose. So the person may still be heavily sedated for hours.

People who take drugs alone are more likely to die after an overdose. Murray manages the Massachusetts Overdose Prevention Helpline at 1-800-972–590. If the person stops responding, the hotline staffer calls for help.

The Boston Public Health Commission said it is taking a number of steps to alert providers and people who use drugs about the latest cluster of overdoses and deaths. They include stepped-up efforts to distribute fentanyl test strips, naloxone and treatment information in Nubian Square. The commission plans more naloxone trainings and a new van stop in Roxbury for people who want transportation to day centers with resources for people managing a substance use disorder.

Material from the Associated Press was used in this report.