The autopsy suite at the coroner's office in Cincinnati has all the necessary equipment for disassembling a corpse, from an array of scalpels and blades to a pair of pruning shears. Determining a person's cause of death is a grisly but essential business, especially when the bodies start piling up like they did this past summer.
Surrounded by the tools of her trade, Dr. Lakshmi Sammarco recalls the stretch in August when Cincinnati and surrounding Hamilton County experienced an unprecedented 174 drug overdoses in a six-day span. At least three of the cases were fatal, and Sammarco was mystified — and alarmed — when autopsies revealed that something other than heroin was the culprit.
"There was a lot of scratching of the head going on," she said. "It was like, now what? What are we going to do? We need to find this stuff."
Sammarco eventually linked at least 21 of the deaths in the area to carfentanil, a synthetic opioid that zookeepers use to tranquilize elephants, rhinos, and other large animals. As a physician trained on humans, she'd never heard of carfentanil, but she was already very familiar with its chemical cousin fentanyl, the ultra-powerful opioid that caused 238 of Cincinnati's 414 fatal overdoses in 2015. Carfentanil is roughly 100 times stronger than fentanyl, which is about 50 times more potent than heroin.
"I was looking at my staff and going, 'Are you kidding me?'" she said. "Like, fentanyl wasn't bad enough? They have to go out and get something that's 100 times as potent as fentanyl? Why would anyone even put that poison in their bodies?"
Carfentanil fits with an unsettling trend in the country's opioid crisis. As more and more Americans have switched to heroin from prescription painkillers, drug dealers have turned to synthetic opioids to meet the skyrocketing demand.
Watch the segment on carfentanil in the Monday, October 18, edition of VICE News Tonight on HBO.