FORT LAUDERDALE, Fla. — The number of Floridians who died from drugs last year decreased across the state, but one synthetic drug was noticeably on the rise and fentanyl is still the deadliest drug of all, according to a statewide report released this summer.

Both occurrences of and deaths caused by synthetic cathinones increased by over 100% last year, an interim report from the Florida Medical Examiner’s Commission released in July said. The drugs are man-made stimulants that have effects similar to cocaine, methamphetamine or ecstasy, according to the U.S. Drug Enforcement Administration.

The synthetic cathinone most commonly identified in drug-related deaths throughout the state in the first six months of 2023 was N,N-Dimethylpentylone and Pentylone, which is a metabolite of the former, the FMEC report said.

Other examples of synthetic cathinones are bath salts, commonly known as flakka. Use of bath salts in the mid-to-late 2010s was rampant in South Florida, causing people to act out bizarrely and often violently in public.

U.S. Drug Enforcement Administration Special Agent in Charge of the Miami Field Division Deanne L. Reuter told the South Florida Sun Sentinel there’s recently been “a dramatic increase” in the number of seizures of the drug N,N-Dimethylpentylone.

Reuter said when it is seized, the DEA is often seeing it packaged similarly to methamphetamine or in capsules or pills, resembling MDMA or ecstasy. The drug is a stimulant that can cause hallucinations, increased heart rate, seizures, chest pains and violent behavior, similar to other stimulants, Reuter said.

“We don’t know for sure whether they’re actually seeking this out … Most are seeking out molly or MDMA, and this is the substance that they’re getting or mixed in with other things,” Reuter said.

Florida topped the country in where it was found in toxicology tests between August 2021 to March 2022, according to a 2022 report by the Center for Forensic Science Research and Education.

In 2020 and 2021, a different type of synthetic cathinone called eutylone, also marketed as MDMA, ecstasy or molly, was most often seen. But in 2021 came international efforts to control it, possibly causing the more recent rise in N,N-Dimethylpentylone, according to a 2023 briefing on the drug by United Way of Broward County Commission on Behavioral Health & Drug Prevention.

Hundreds of local cases in recent years

In South Florida alone, at least 118 people died in 2023 from or with the drug in their system, with the majority of those occurring in Miami-Dade County, according to statewide data obtained from the Florida Department of Law Enforcement.

The drug was included in the primary cause of death for at least 34 people in Broward County between 2021 and mid-July. In Palm Beach County, it was included in the cause of death in at least 82 people since 2021 and in more than 200 people in Miami-Dade County, the three medical examiner offices’ data shows.

Most people across South Florida died from a combination of the cathinone and other drugs, largely cocaine and the opioid fentanyl.

“If the medical examiners say the cause of death is a mixed toxicity with fentanyl being involved, likely they were seeking out something else and fentanyl was mixed in,” Reuter said. “And they didn’t know it.”

DEA Southeast Laboratory Director Allen Catterton said he has recognized the synthetic cathinone, generally white and crystalline, coming into the agency’s lab for about the last five years, not regularly but consistently enough that chemists “would recognize it pretty readily.” In some cases when it has been brought into the lab, it was initially thought to be meth, molly or flakka, he said.

“You just don’t know what you’re going to get,” he said. “We get samples and samples and samples and they’re just loaded with so many things and they’re poisoned with so many different things.”

Occurrences of and deaths caused by cathinones also increased throughout 2022, but the rise reported in the first half of 2023 was significantly higher, according to the FMEC reports. In 2022, those deaths increased by about 35 percent, or 95 more deaths, while they rose by 101 percent, or 148 more deaths, in the first half of 2023.

“When we talk about the dangers of fentanyl … there’s dangers in this too,” Reuter said.

Fentanyl ‘still our deadliest drug’

The number of people who died from drugs overall in the first half of 2023 decreased by 7 percent. But fentanyl is still the deadliest drug, the data shows.

Attorney General Ashley Moody said at a July news conference about the FMEC data in Tampa that Florida has the largest amount of fentanyl seizures in the country.

More than 2,500 people died from fentanyl in the first half of 2023, the FMEC data showed, about 200 less deaths than the same time period in the 2022 report.

More than 580 of those who died were in South Florida. Palm Beach County had the third-highest number of fentanyl deaths statewide, while Broward County had the fourth highest.

“Fentanyl is still our deadliest drug threat facing the communities today, but I do believe that the outreach and education of the community has a lot to do with the decrease,” Reuter said.

Catterton said recently the lab has seen large packages of drugs that contain noticeably purer fentanyl or higher potencies than they have seen in the past. He said that could be an indication that the DEA is seizing the drug from “from the higher levels” of sources.

Fentanyl deaths began rising about five years ago, Reuter said, and federal and state law enforcement have taken “an aggressive approach” to target dealers. More dealers across the country but particularly in Florida are being prosecuted for selling deadly doses, she said.

Florida in 2018 passed a law allowing dealers to face murder charges if they sell fentanyl to someone who then overdoses and dies.

Reuter gave an often-repeated warning: “What you think you’re buying may not be exactly what you’re buying, and there’s inherent dangers with that,” she said.

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