A string of overdose deaths and robberies all linked to the same powerful painkiller, fentanyl, raised concerns among police officials in parts of Pennsylvania, New York and Ohio that they would have yet another drug scourge to deal with.
All of the deaths occurred when people cut open fentanyl patches prescribed for treatment of chronic pain, and sucked out the drug, which the Drug Enforcement Administration describes as 50 times stronger than heroin and 80 times more powerful than morphine.
Fentanyl, like OxyContin, is one of the morphine-like painkillers used primarily for long-term treatment of chronic pain, and like OxyContin, it has caught on in isolated pockets around the country, according to the National Institute on Drug Abuse.
These drugs, along with other prescription drugs like Vicodin and Percocet, are the most recent in the long line of painkillers that have become powerful lures for abuse, and like others before them, such as opium and heroin, they are highly addictive.
"The potent painkillers are all opioids and these are all very addictive," said Dr. Carol Warfield, chief of anesthesia at Beth Israel Deaconess Medical Center in Boston. "They provide a lot of euphoria, and folks become physically addicted to them."
The euphoria these powerful painkillers provide is part of their attraction, but it is because users want more -- the rush -- that so many move from taking the drugs orally to snorting or smoking them to injecting them directly into their veins.
"The high is associated with the rise of blood level of the drug," Warfield said. "The faster the rise, the greater the high. That's why addicts prefer to inject."
And that search for the rush -- coupled with the physical tolerance to any drug that develops with repeated use -- leads abusers to try higher and higher doses.
Fentanyl has been in use since the 1950s, and abuse of the drug within the medical profession has been documented since the 1970s, according to the DEA. However, fentanyl first drew widespread attention in 1991, when, during one weekend, 12 people in New York, Connecticut and New Jersey died of overdoses.
And in the years since, the link between fentanyl and death has dominated media reports about the abuse of the painkiller. Among the most recent cases was one in Tremont, Pa., in which a 21-year-old man, Joseph Brommer, was accused of giving two friends fatal doses of the drug, weeks apart.
"Young people are squeezing the drug out of the patches and using it illegally," DEA pharmaceuticals expert Dale Shick said. "They're taking a drug that is supposed to be used in small, time-released doses, and they're using it all at once. It's very dangerous."
Brommer admitted stealing the patches containing the drug from his mother's house and giving the drug to his two friends, police said at a hearing on the case earlier this year. But his attorney disputed the murder charges against the man, saying it was not clear whether the two died from the fentanyl or from other drugs in their systems.
While neither fentanyl or OxyContin has reached the nationwide epidemic proportions of methamphetamine, they are part of a trend that is disturbing.