Authorities predict there could be more than 160 overdose deaths by the end of the year.
TOMS RIVER -- The number of overdose deaths in Ocean County is outpacing last year's figures at an alarming rate, officials said.
"The bottom line is we do have a problem in Ocean County that continues to spiral out of control," Ocean County Prosecutor Joseph Coronato said in a recent interview. "Clearly, we are going to be in the range of 150 to 160 (overdose deaths) by the end of the year, which is totally unacceptable."
Ocean County has had 141 overdose deaths as of Monday, according to figures provided by the prosecutor's office. That's up from 118 in 2015 and more than double the amount in 2012. At a panel discussion on Monday night, Coronato said he believes overdose deaths could top 200 in 2017.
Coronato points to fentanyl, a synthetic prescription opioid up to 50 times more powerful than heroin, as a contributing factor to the increase in overdose deaths. Fentanyl, cut with or substituted for heroin, is hard to identify and packs a powerful punch to unsuspecting users.
It's become such a prevalent issue in Ocean County, and in the state, that Coronato dubs it the "synthetic storm." Overdose deaths related to the synthetic opioid in New Jersey tripled from 2013 to 2014.
In Ocean County, Coronato and his team of investigators found that 17 of the 20 people who died of a drug overdose in March had a mix of fentanyl and heroin in his or her system.
"All you need is a small grain of it and it can be lethal," he said. "We definitely have fentanyl in Ocean County. I'm not saying it's in every single heroin pack, but it looks like more and more it's certainly there."
Coronato said the Drug Enforcement Agency has indicated that fentanyl, which is manmade, is coming from China and Mexico. However, it's also prescribed to people with chronic pain, such as end-stage cancer patients.
The heroin problem in Ocean County is all over the map, the prosecutor said.
In Brick Township, the third most populated municipality in the county, police Chief James Riccio said as of Monday there have been 155 overdoses in 2016, including 21 fatal overdoses. Ninety-seven of the overdoses in Brick were heroin-related, Riccio said.
"It effects everyone," Riccio said. "We see people of all ages. We actually had someone in their 70s overdose. But not only in different age groups but all different levels of income. It doesn't matter what class you're in, it's pretty much across the board."
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He said fentanyl is contributing to overdose deaths because its effects are immediate.
"We don't have that window to get to them as quickly as we need to," Riccio said of overdose victims.
Fighting the heroin epidemic in Ocean County continues to be an uphill battle, Coronato concedes. But it's one his office has been at the forefront for years.
In April 2014, the Ocean County Prosecutor's Office was part of a pilot program to equip first responders with naloxone kits. Naloxone, commonly known by the brand name Narcan, is an antidote that reverses the effects of an opioid-induced overdose.
As a result, Coronato said, the number of overdose deaths dipped from 112 in 2013 to 101 in 2014. Still, there's more that needs to be done, Coronato said.
"Law enforcement itself is not going to turn the tide," he said.
Earlier this year, the Ocean County Prosecutor's Office rolled out its Recovery Coach Program. The program, which was praised by Gov. Chris Christie in his State of the State address, offers overdose victims revived by Narcan treatment options while they're still in a hospital bed.
Connie Greene, vice president of the RWJBarnabas Health Behavioral Health Network Institute for Prevention, said of the 200 Narcan-reversal patients health officials tracked from 2014 to 2016, none had been moved into treatment.
"Everyone was well aware that Narcan was saving lives, but that was only the beginning of this story," Greene said.
The improvements in getting overdose victims into treatment were immediate, she said. In January, 50 percent of the 300 Narcan-reversal patients in Monmouth and Ocean counties were given treatment. Still, it's hard to track whether those people remained in recovery or relapsed.
"Getting them into treatment, we realized very early on, is not the end of the story," Greene said.
Trained recovery coaches, many of whom have battled addiction themselves, now take phone numbers of the patients they see and continue to call them for at least eight weeks after they leave the hospital.
But fentanyl has added a new layer to the state's fight against heroin and opioid addiction. It's led to more overdoses and Narcan is not as effective.
Coronato said first responders are administering Narcan to fentanyl victims multiple times. The effect fentanyl has on the body is essentially outlasting the Narcan, he said.
Riccio, the Brick police chief, said his EMS personnel and patrolmen constantly monitor Narcan patients because they can relapse and go back into the overdose.
Coronato said he's heard cases in which law enforcement officers overdose on fentanyl after they've touched it.
"Fentanyl is creating and enhancing the overdose," he said. "That's why we need to certainly address the synthetic storm that's coming down the pipe."
Alex Napoliello may be reached at anapoliello@njadvancemedia.com. Follow him on Twitter @alexnapoNJ. Find NJ.com on Facebook.