Justin Herdman/YouTube screengrab
Socrates Kokkalis came to Cleveland last year for several business meetings. When the meetings were over, Kokkalis ate dinner with colleagues then visited the casino downtown. He also made a series of quick phone calls seeking cocaine, which he ultimately purchased from a dealer.
Kokkalis then went to his room on the hotel’s 24th floor, but he never came out. He died on his hotel room floor, apparently unaware the cocaine he bought actually included fentanyl, a lethal opioid that is up to 40 times more potent than heroin.
The story of Socrates Kokkalis has a sad ending that is becoming all too common in Northeast Ohio. Kokkalis, the son of a Greek billionaire, is not the typical drug overdose victim in Cleveland. But the method of his death – ingestion of cocaine laced with fentanyl – is now the signature killer for an overdose crisis that has entered a new phase.
Ohio has been on the front lines of the nation’s opioid epidemic for more than a decade, going back to pill mills flooding our streets with prescription painkillers. Pills gave way to heroin, which was cheaper and became more easily available, and heroin was eventually cut with fentanyl, a more powerful, and still cheaper, synthetic opioid made not from poppies but from chemicals in labs in China and Mexico.
At each stage of this crisis, deaths have risen precipitously as the substances became more potent and easily available. Now this epidemic has changed again. Heroin is now hard to find. Instead, we are in the midst of a surge in deaths from cocaine, either alone or mixed with fentanyl. Among cocaine’s effects on the body is to speed the heart. When mixed with fentanyl, which depresses breathing, the result is life threatening stress on the body. Even a very small dose of fentanyl can kill a human being.
Last year was the first time since the start of this crisis that Cuyahoga County saw more people die from cocaine than heroin. So far in 2019, more than 60 percent of overdose deaths in Cuyahoga County are associated with cocaine, either as a stand-alone narcotic or mixed with fentanyl.
This trend is changing the demographics of who is dying. Victims from cocaine-associated overdoses span several generations, from ages 19 to 71. Many of those dying, however, are in their 50s and 60s. And we are on pace to have 134 African-American people die from a drug overdose in Cuyahoga County this year. In 2015, that number was 25.
So why is this happening? And what can we do about it?
There are a number of reasons why fentanyl may be mixed with cocaine. Some believe dealers are intentionally mixing fentanyl with cocaine to create a new market of opioid addicts. Another possibility is the narcotic effect of combining cocaine and fentanyl drives user demand. We also cannot discount instances where neighborhood drug dealers simply sell whatever is available that will turn a profit, or may be working in an unsanitary environment with multiple drugs.
We do know the cocaine being intercepted at our borders typically arrives unmixed with fentanyl, so this cross-contamination is likely happening closer to the street level.
This month, the community group Greater Than Heroin, advertising agency Marcus Thomas, our office and others are launching a public awareness campaign to warn everyone that they should operate under the assumption that the drugs they buy on the street contain fentanyl. Separate efforts continue to make free fentanyl test strips and the opioid antidote Narcan more readily available.
Let’s be clear: nobody should be using drugs like cocaine or heroin. There is no safe amount to try recreationally. In fact, our office filed a record number of indictments last year against the people who bring drugs into Ohio and seek to profit from this wave of death and broken lives, including bringing federal charges against the man who sold Socrates Kokkalis the fentanyl-laced cocaine.
Yet we also have to acknowledge the opioid crisis has set its sights on a new group of victims, those who use cocaine and crack-cocaine, with absolutely no idea that the mistake they are making may be the last mistake they ever make. The scourge of addiction in our communities presents many problems for families, law enforcement and the criminal justice system. In the age of fentanyl, it may also be an automatic death sentence.
Justin Herdman is the U.S. Attorney for the Northern District of Ohio.
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