July 16, 2017, 08:28 AM
wcb6092I feel really sorry for the father but this death would have happened at some point. This makes you realize that any family can go through this nightmare. There is also a good video interview of the father but I can not embed it.
http://www.heraldcourier.com/n...5e-bdfffb6f0d9f.htmlHours after Fred A. Renfro received a package from China that contained a notoriously deadly drug, his father found him lifeless at his home in the Colonial Heights section of Sullivan County, Tennessee.
Renfro, a 46-year-old former cardiovascular perfusionist, who operated heart machines during surgeries, died of an overdose of a lethal combination of the powerful painkiller fentanyl and U-47700, a synthetic opioid drug. It was one of six deaths attributed to fentanyl or heroin so far this year in Sullivan County, according to Deputy District Attorney Gene Perrin.
“I went out to check on him,” Renfro’s father, Dr. C.A. Renfro, told the Bristol Herald Courier. “We hadn’t heard from him that day. He didn’t come by and eat, which he normally did.”
It was March 22. Dr. Renfro, a retired physician, said he was worried about his son’s safety because he had a drug problem.
“I went out and looked in the window, and I saw him sitting on the sofa,” Dr. Renfro recalled. “The door was locked.”
He then retrieved a key from his home and returned.
“I went in, and he was sitting on the sofa, leaning forwards,” said Dr. Renfro, describing how his son’s arm was leaning on a nearby table. “I moved him back on the sofa, and that arm stayed up. He wasn’t moving or breathing or anything. I realized he was dead.”
The overdose was the third in four months. In the first two, Dr. Renfro was able to get his son help in time to save his life.
Dr. Renfro called authorities, and Sullivan County Sheriff’s Office deputies began investigating. Perrin, the deputy district attorney and chief narcotics prosecutor in Sullivan County, said officers were already familiar with Renfro due to a previous overdose call.
Perrin said he suspected Renfro had taken heroin.
A toxicology report, however, revealed that Renfro had a deadly combination of fentanyl and U-47700 in his system. Perrin said he’s only seen that combination of drugs — known as gray death — on a toxicology report two times. U-47700 is simply known as “pink.”
Fentanyl, which is 50 to 100 times more powerful than morphine, is prescribed legally to manage intense pain. It is being used by drug dealers to create counterfeit versions of well-known opioid and benzodiazepine pills such as Percocet, Xanax, oxycodone and others, according to a public health alert issued by the state of Tennessee earlier this year.
A bag of 4-fluoro isobutyryl fentanyl, which was seized in a drug raid, is displayed at the Drug Enforcement Administration (DEA) Special Testing and Research Laboratory in Sterling, Va. Fentanyl is a narcotic typically administered to people with chronic pain, including end-stage cancer patients. It is considered 50 to 100 times more powerful than morphine.
AP Photo
Fentanyl and its derivatives can be swallowed, inhaled, injected or absorbed through the skin, and an amount as small as a few grains of salt or a few drops of liquid can incapacitate or even kill a person, Tennessee Department of Health Commissioner John Dreyzehner said in a written statement.
Renfro injected the fentanyl and U-47700, Perrin said, and syringes were found at the scene.
“This is a new and different threat, so please don’t use these drugs,” Dreyzehner said. “Don’t even touch them.”
Fentanyl is also mixed with other drugs such as heroin or marijuana, and, in some cases, criminals are even counterfeiting illegal heroin with fentanyl and its derivatives, the commissioner added.
Authorities say fentanyl-related substances have been identified in several forms, including powders, pills, capsules, liquids and on blotter paper.
The drug carfentanil, which Perrin said drug dealers talk about in Sullivan County, is estimated to be 100 times stronger than fentanyl, according to the public alert. The drug is intended for use as an anesthetic on large animals in veterinary practices and is not appropriate for use in humans.
“Unfortunately, the amount of fentanyl and its derivatives being imported into the U.S. and Tennessee is increasing, with law enforcement agencies working 24/7 to stem the flow and to assist in responding to those who have overdosed from fentanyl and other deadly substances,” Tennessee Bureau of Investigation Director Mark Gwyn said.
Gwyn added that the drugs can kill anyone who comes in contact with them.
In drug overdose cases, investigators typically work to determine where the victim obtained the narcotics. In Renfro’s case, they learned he ordered the fentanyl and U-47700 online from China. The drugs were then shipped by mail to a box at a business in Colonial Heights.
The man’s father, Dr. Renfro, said after his son died, he found the package and receipt.
“We have no idea how potent the stuff that killed Fred was,” Perrin said. “He picked it up that day. He rented out one of these mailboxes. It had been delivered. We tracked it all the way back, and he went home with it. Dr. Renfro found him later that same day.”
Renfro ordered the drugs through the “dark side of the web,” said Sgt. Richard Frazier of the Sheriff’s Office. Renfro was able to buy drugs online without a trace, which keeps small-town investigators from stopping them, he said.
“It’s behind a veil in this world of darkness,” Perrin said. “They know how to get there, but us trying to trace them through that is almost impossible.”
The receipt Dr. Renfro found revealed his son had purchased 5 ounces of the drugs for $200. Frazier said an ounce of crystal methamphetamine can be purchased on the street locally for $1,000.
“If Fred had received those drugs from somebody else, as opposed to somebody in China, Richard and his agents would be building a case, trying to prosecute the person who sent Fred the drugs,” Perrin said.
The practice of ordering illegal drugs online, especially fentanyl and heroin, is not uncommon. Perrin and Frazier said they regularly learn of Sullivan County residents receiving illegal drugs by mail.
Stopping the mailing of drugs to citizens is difficult, Perrin said.
“[Delivery personnel] drop a package off at a house and look in their rearview mirror, and they won’t make a block before a car pulls up and someone gets out and gets the package,” Perrin said. “Or they’re delivered to abandoned homes. [In] one case with the U.S. Postal Service, we told them this was synthetic drugs, and they still delivered it. This goes way beyond what we can do.”
In one case, Perrin said someone had the package delivered to their neighbor’s home. A woman received the suspicious package, opened it and discovered it contained synthetic drugs from China.
“They’ll have it sent to the house across the street, and they’ll go check the neighbor’s mail,” Perrin said.
Narcotics officers and prosecutors attempt to remove packages from distribution when information is available, Perrin said.
“We’re taking off packages when we can, we’re dealing with human tragedies, like his son, but who’s looking at the manufacturers and distributors?” Perrin asked.
USPS spokeswoman Susan Wright said the Postal Service “shares the concerns about America's opioid crisis and works actively with Customs and Border Protection to help interdict the flow of illegal drugs entering the U.S.”
The Postal Service collaborates with other federal agencies and foreign postal operators to secure Advanced Electronic Data [AED] for inbound packages to enhance interdiction efforts, she said.
“We are committed to the goal of working with international partners to expand AED globally,” Wright said. “Through dedication of resources along with negotiation and advocacy, the Postal Service now collects AED for more than 90 percent of its outbound international packages and receives AED for 40 to 50 percent of inbound packages. As we have done throughout our history, the Postal Service is committed to taking all practicable measures to ensure our nation's mail security and provide the American public the best, most efficient service possible.”
Renfro put the order in for the drugs that killed him and knew the day it would be delivered.
“He met the delivery boy in the parking lot and picked it up there,” Dr. Renfro said.
Perrin said Renfro went to the business to check on the package a number of times that day until it arrived.
“With our law enforcement, we are trying to aggressively investigate these cases because it’s so important that we identify the sources of these drugs that are killing our citizens and ruining lives,” Perrin said. “In many incidents, we don’t even know about them. … The magnitude of this problem far exceeds what we know about on paper.”
The level of fentanyl in Renfro’s system “was off the charts,” Perrin said.
Of the 13 drug overdose deaths in Sullivan County so far in 2017, Perrin said six have involved fentanyl or heroin. Earlier this year, four people died of overdoses in one four-day period in the city of Bristol, Perrin said.
He noted that for every death caused by a drug overdose, there are 15 other drug overdoses that don’t result in death.
“What we have right here is the tip of the iceberg,” Perrin said. “This crosses all economic and social lines.”
Police began seeing fentanyl in the area about 12 months ago. The departments of health in Tennessee and Virginia track the number of drug overdoses in each county, but it’s hard to arrive at the number of deaths because 2015 is the latest available official year for fentanyl overdose deaths. Perrin noted that the number of fentanyl overdose deaths has increased every year and there has already been a steep increase in 2017 in Sullivan County.
Tennessee Department of Health spokeswoman Shelley Walker said the number of fentanyl overdose deaths in the state has increased dramatically in recent years.
“You see law enforcement accidentally overdosing on this stuff because they brush up on it,” said Frazier, referring to reports of police officers encountering fentanyl during investigations and overdosing.
In May, an East Liverpool, Ohio, police officer brushed fentanyl powder off his uniform during a traffic stop and overdosed, according to the Washington Post. Nearby paramedics likely saved the officer’s life, the police chief told the newspaper.
“We’re having to take secondary precautions just in case it was, and when we started getting this stuff back from the autopsies and the labs, it was confirmed with what in fact was fentanyl,” Frazier said. “We have to treat everything that we come across that it’s possibly going to be fentanyl or fentanyl-related.”
Renfro, a University of Tennessee graduate and former Johnson City Medical Center employee, had been addicted to drugs for many years, his father said.
“I think probably about that time [when he worked at the JCMC], he may have gotten into drugs for a little bit,” Dr. Renfro said. “It just kept going after that. It got worse, and he did some traveling profusionist work for a year or two.”
For the last several years, Renfro, who liked to hunt and fish, did not work.
“He also experienced a lot of depression and probably a whole lot more than I recognized,” his father said.
Last fall, Renfro’s drug problems worsened.
“The first time, I came out and found him on the floor, and another person was in the room on the floor,” Dr. Renfro recalled. “He was unresponsive, and I called 911.”
Paramedics responded and Renfro was breathing on his own.
“There was no dire emergency at that time,” Renfro recalled of finding his son in November. “A few days before Christmas, I went out to check on him and went in, and he was upside down in the floor, breathing two times a minute. He was black. I opened his mouth and his tongue was black and the roof of his mouth was black.”
Dr. Renfro said he placed his son, who had a pulse, on the floor.
“This was hard to do on your own kid,” Dr. Renfro said. “I breathed for him. He was black and blue. He started responding a little bit, and I called 911.”
Paramedics once again responded to the residence and gave Renfro a dose of Narcan, an opioid overdose antidote.
Renfro was taken to Holston Valley Medical Center in Kingsport for a few days and then Woodridge Hospital, an 84-bed inpatient behavioral health hospital in Johnson City, Tennessee.
“He went there for about five days and came back home,” Dr. Renfro said. “After that, I bought me some Narcan and carried it with me in the car, but this last time that I found him, rigor mortis had already set in. There was nothing to do for him at that point.”
Perrin said Dr. Renfro is committed as a father and a doctor to share his son’s story and hopefully help others.
“We’ve got to do more about this,” Perrin said. “There’s so much unknown about this — and yet, our children and our grandchildren, they’re finding this stuff on the internet. You never know what is actually being sold. They are buying heroin, and it could come back fentanyl. There’s no controls. There’s no idea what’s in this package.”
Dr. Renfro said there’s a great need in the area for help and treatment for drug addicts.
“I couldn’t find really good help in the area,” Dr. Renfro said as he tried to hold back the tears. “Drug help is not available out there for folks. We have a facility in Johnson City. My son was there over Christmas for three or four days, and they turned him loose. They sent him back home to fight the demons himself. … Places out of town are booked up, and there’s a wait. I was trying desperately to find help for him.”
Dr. Renfro also found fault in the Health Insurance Portability and Accountability Act of 1996, or HIPAA, because the law made it difficult for him to learn about his son’s problems. HIPAA laws kept Dr. Renfro from speaking with those helping his son, he said.
While Sullivan County has seen an increase in cases, other local law enforcement, including the Washington County Virginia Sheriff’s Office, said they’ve not yet seen an increase in fentanyl or heroin usage.
“We have not had any known problems with fentanyl or U-47700,” said Wise County Sheriff’s Office Maj. Grant Kilgore. “Our biggest problems in our county are prescription drugs, synthetic drugs, such as K-2, bath salts and gravel, and meth.”
Wise County does have a high rate of overdoses, but Kilgore said none have been attributed to fentanyl or U-47700. Wise County ranks 25th in the nation in the number of reported overdoses, but prescription drugs, synthetic drugs and meth are the root cause.
Those with the drug task force in the coalfields also said they’ve not seen fentanyl or U-47700, Kilgore said.
“If the availability of these drugs were to decrease, the possibility of heroin laced with fentanyl would most likely increase,” Kilgore said.
Maj. Harold Heatley, chief deputy at the Tazewell County Sheriff’s Office, where there were two fentanyl or heroin overdoses in 2016, said the agency has instituted some new policies for deputies regarding fentanyl and heroin. The policies are in regard to searching people and vehicles, and anything believed to be involved in the distribution of heroin or fentanyl, Heatley said.
In Washington County, Virginia, Maj. Byron Ashbrook said, “Our officers are definitely more aware due to the potential dangers that exposure to fentanyl can pose to them.”
