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When a Hamden man texted his dealer for four 30-milligram oxycodone in March, he may not have known what he was actually buying.
It wasn't until after the 30-year-old man died that it was discovered those pills were dangerous counterfeits.
An autopsy revealed the victim, not identified by authorities, overdosed on drugs including fentanyl, a powerful synthetic opioid 50 to 100 times stronger than morphine. Oxycodone was not one of those drugs, records show.
As part of a continued effort to go after suspected dealers behind deadly overdoses, the U.S. Attorney's office is prosecuting the suspected dealer, Agustin Cirino, for selling these counterfeit pills — one of the first cases of its kind in Connecticut, officials said.
Though cases like these aren't yet common in Connecticut, the U.S. Drug Enforcement Administration released a report that counterfeit pills disguising fentanyl, more powerful and cheaper to produce, has become another growing threat in the deadly opioid epidemic.
Special Agent Timothy Desmond with the DEA's New England Division said word of this trend picking up started on the West Coast about a year ago.
"As is typical, it worked its way to the East Coast, where we have a strong opioid epidemic," Desmond said.
After Hamden police were called to the untimely death the morning of March 9, they soon found three blue pills marked "M 30," along with a cut orange straw in the home, a criminal complaint charging Cirino said.
Using the victim's cellphone, investigators with a DEA task force traced the purchase of the pills.
They learned that the victim had set up with Cirino to buy four oxycodone at a price of $120, matching the common street value for the common prescription opioid: roughly $1 a milligram, the records show. Text messages continued until not long after the purchase. The next morning, his mother found him lifeless in his bedroom.
Federal investigators collected the three remaining pills from Hamden police. An internet search by a task force agent turned up that the markings on the pills would identify them as oxycodone produced by Mallinckrodt Pharmaceuticals, but he sent them to a DEA lab for testing.
Results received in April showed the pills were made of fentanyl, acetaminophen and dipryone. The task force agent would write in his report: "The pills did not contain oxycodone."
Among those to have seen first-hand the lethal impact of fentanyl is Dr. Gail D'Onofrio, chief of emergency medicine at Yale-New Haven Hospital. Though reports of these types of cases are rare in the New Haven area, D'Onofrio acknowledges fentanyl can be made into a counterfeit pill, a dangerous proposition for a drug user.
"Unfortunately, since they are so much more powerful than oxycodone, the user doesn't know that and they take them and can overdose," she said.
D'Onofrio said fentanyl can compound the danger as much as "50 to 100 times" over other morphine-like drugs.
Officials and experts have long said that prescription opioids have proven a powerful gateway to addiction. Exploiting this demand, the DEA says drug traffickers have taken to creating counterfeits with stronger, more dangerous opioids and making huge profits.
Last July, the DEA released the report on this new lethal trend in drug trafficking seen months later in the overdose in Hamden.
"The drug trafficking organizations will take the powders and press ... and they will create them to exactly mimic an oxycodone," Desmond said. "It could be mimicking any prescription drug even the color and the stamp."
D'Onofrio said with this trend "we aren't even going to see these people. They are going to take the pill and die."
The report highlighted that agents in the New England office had turned up thousands of these 30-milligram counterfeits from 2014 to 2015. Similar reports of seizures have cropped up in Tennessee and New Jersey. In Los Angeles, federal authorities say they raided a counterfeit pill operation with presses and other necessary materials to create the fakes.
Despite the DEA's warning about the prevalence of these pills, state police, which teams up with police departments across Connecticut through a statewide narcotics task force, has yet to have reports of counterfeits, a department spokeswoman said.
These pills, federal authorities contend, can make drug traffickers a sustainable amount of money for a small investment especially if they use fentanyl.
The organizations can buy a kilogram of the drug from China for as little as several thousand dollars. For as much as $995, traffickers get an oxycodone press and turn that fentanyl into hundreds of thousands of pills that would later sell for totals in the millions of dollars, the DEA outlined in the report.
Given the demand and the profit potential, the DEA warned that they only saw this problem growing in the "near term."
"Overdoses and deaths from counterfeit drugs containing fentanyls will increase as users continue to inaccurately dose themselves with imitation medications," the DEA wrote.