An anesthetic commonly used for surgery has surpassed heroin to become the deadliest drug on Long Island, killing at least 220 people there in 2016, according to medical examiners’ records.
The drug, fentanyl, is a synthetic opioid, which can be 100 times more potent than morphine.
The numbers from Long Island are part of a national pattern, as fentanyl fatalities have already surpassed those from heroin in other parts of the country, including New England, as its use has skyrocketed. Part of the reason for the increase is economic — because fentanyl can be manufactured in the lab, it is much cheaper and easier than cultivating heroin.
In New York City, more than 1,000 people are expected to die from drug overdoses this year — the first recorded four-digit death total in city history, according to statistics compiled by the Department of Health and Mental Hygiene. Nearly half of all unintentional drug overdose deaths in the city since July have involved fentanyl, the health department said.
The medical examiners of Long Island’s two counties, Nassau and Suffolk, compiled the new numbers. “Fentanyl has surpassed heroin as the most commonly detected drug in fatal opioid overdoses,” Dr. Michael J. Caplan, the Suffolk County medical examiner, said in a written statement about the statistics, which were obtained by The New York Times ahead of their release. “The influx of illicitly manufactured fentanyl from overseas is a nationwide issue that requires a multidisciplinary intervention from all levels of government.”
Nationwide, recorded deaths from opioids surpassed 30,000 in 2015, according to data compiled by the Centers for Disease Control and Prevention. And overdoses caused by synthetic opioids like fentanyl increased by 72.2 percent in 2015 over 2014 — one of the deadliest year-over-year surges for any drug in United States history, the same data shows.
As recently as three years ago, few people outside the medical profession or law enforcement had even heard of fentanyl, which is legally prescribed in the form of transdermal patches or lozenges. But drug dealers have been lacing heroin with fentanyl for years, just to fill out the packets and save on the heroin — with or without the user’s knowledge.
At the same time, many drug users seek out fentanyl because it gives them a higher high and the thrill of using something so risky, although often they do not know exactly what they are shooting up.
In a statement responding to the overdose data, James J. Hunt, special agent in charge of the Drug Enforcement Administration’s New York Division, said that seizures of fentanyl had increased drastically in the last five years. “Not only are drug traffickers mixing it with heroin for street distribution,” he said, “but drug suppliers are sending it in bulk form for resellers to sell in pill form or in bulk powder.”
Prescription fentanyl is used to treat cancer pain and as an anesthetic for surgery. Even small amounts of it can be deadly. The drug is so powerful that law enforcement officers have to wear gloves when searching for it, as just a tiny bit can get into the skin and, depending on the amount, can be fatal.
“We’ve never seen as much of a drug this strong on the black market before,” said Jeffrey Sheridan, an Oyster Bay, N.Y., resident and addiction counselor whose 34-year-old nephew died from a fentanyl overdose on Staten Island in 2015. “It’s essentially the serial killer of drugs. It’s not something you can use for any kind of duration and survive.”
Fentanyl was the drug that killed Prince in April.
On Long Island, America’s most densely populated suburban region, opioids of all kinds killed at least 464 people in 2016, the medical examiners’ records show. Hundreds of additional drug overdose analyses are pending.
“Too many young people have fallen victim,” the Nassau County executive, Edward Mangano, said of the new data in a written statement. The Nassau County medical examiner, Dr. Tamara Bloom, did not comment on the new numbers.
In New York City, as of June, there were 184 fentanyl-related overdose deaths recorded — more than in all of 2015, health department records show. Since then, the number of fatal 2016 overdoses involving fentanyl has surged to about 500, according to the department data.
Fentanyl is increasingly being manufactured by Mexican drug cartels, according to the D.E.A., or is cooked up in labs in the United States. It is being sold by dealers in New York City and on Long Island, according to Mr. Hunt, the D.E.A. special agent.
Some users who purchase it believe they are actually buying prescription pain pills like oxycodone or hydrocodone, or heroin alone — drugs far less potent than fentanyl.
A user can fatally overdose within moments of snorting, injecting or swallowing the drug, authorities said.
One recovering addict said the drug is so powerful, he can no longer get high from heroin alone.
“Without the fentanyl, shooting heroin’s like shooting water — you build up a tolerance,” said Andrew Giordano, 26, of Prospect Heights, Brooklyn, who overdosed on a fentanyl-heroin mixture in February and is now in a treatment program.
Paramedics used a double dose of the lifesaving opioid antidote naloxone to revive him, he said.
Because the drug is so strong, they need to use about twice as much naloxone to save you, Mr. Giordano said. “Sometimes, it doesn’t work at all.”
Mr. Sheridan, the Long Island addiction counselor who lost his nephew to fentanyl, said the number of addicts using the drug in the city and suburbs was “astonishing.”
“It’s the scariest thing any of us who work in addiction recovery has seen,” he said.
An earlier version of this article referred incorrectly to the proportion of drug overdose deaths in New York City that could be attributed to fentanyl. It is nearly half since July, not over half the number this year.