# Deadly chew: New drug takes toll



## kwflatbed (Dec 29, 2004)

_By Maureen Boyle,_
Enterprise staff writer

Lying in a bed on the seventh floor at Lemuel Shattuck Hospital, Michael J. Welch Jr. of Raynham made a few odd movements with his jaw.

Then he took his last breath.

It was 2 p.m., June 2.

But his parents say the 24-year-old son they knew died four months earlier, the night he chewed on a time-release patch of fentanyl, a synthetic opiate used by cancer patients to control pain, and overdosed.

Welch was one of what experts say is a small but growing number of young adults illegally getting the transdermal fentanyl patches, then chewing them to get high.

By chewing the patches, users are getting a potentially deadly three-day dose of fentanyl in one shot.

"They don't think they are doing drugs because all they are doing is chewing it," Raynham Detective William J. Donnelly said.

Donnelly said he knows of about a half dozen young adults - aged 18 to 25 - in town who have chewed on the fentanyl patch to get high.

Welch is the only one he knows in town who chewed the patch and died.

In the past 2-1/2 years, at least 10 people have died of fentanyl overdoses in the area, according to a review by The Enterprise of death certificates in 10 communities, including Brockton and Taunton.

At least one case was considered a suicide; others - like Welch - were listed as accidental. Some combined the drug - in some form - with cocaine. How many of those involved deaths related to people chewing on the patch was not clear. Nationally, there were 8,000 emergency room visits due to overdoses of fentanyl or fentanyl combined with another drug in 2004.

F. Craig Sylvester, interim chief of the emergency department at Brockton Hospital, said the fentanyl patches were designed to provide a slow release delivery system for those with chronic pain.

"When you bypass that and digest it, it is a much faster rate of delivery which makes it very dangerous," Sylvester said. "For anyone who is opiate naive to ingest that, it is very dangerous."

Fentanyl, first created in Belgium in the late 1950s and about 80 times more potent than morphine, began being used in the 1960s by doctors as an anesthetic.

It is now used both as an anesthetic and a high potent pain reliever. One brand of fentanyl by Actiq is used for opiate tolerate patients and pain relief for cancer patients.

Drug dealers are also making fentanyl in clandestine labs in Mexico and elsewhere then mixing it with heroin. More than 100 deaths in the country have been reported this year in the country among drug addicts who overdosed on heroin mixed with fentanyl.

Debra and Mike Welch never heard of fentanyl until Feb. 25, the day Raynham Police Sgt. Robert Pohl came to their front door around 9 a.m..

"Through the curtain, I could see the uniform," Mrs. Welch said. "Michael hadn't been home all night but he was 24. I wasn't worried. Of all the times that I didn't know where he was, that morning, I didn't have a care in the world when I saw that uniform. We thought, Oh, where's the checkbook, they're collecting for their association. I opened the door and it was Bobby Pohl."

Pohl broke the news.

Their son was at Morton Hospital. He was in critical condition. Get down there.

"I just held onto the doorway," she said.

She called the hospital immediately. "I called to let them know we would be right there. That's when the nurse who handled my call just said, 'You need to get here right away. He's critical.' I lost it. I just lost it. All the way there, my husband kept saying prayers under his breath."

The Welchs - who rushed to the hospital with daughter Colleen, 22, - would learn that paramedics were called at 7:31 that morning to a raised ranch on Elm Street East, less than a mile from their home. There, the paramedics found Michael, unresponsive, on a couch.

They believe he had been that way for up to four hours before help was called. Mrs. Welch said by that time her son's brain had been deprived of oxygen too long.

"When we got to the emergency room around 9:30 in the morning, he was hooked up to tubes. He was shaking and shivering. I told the nurse he was cold. The nurse said, 'He is not cold, he is in seizure activity," Mrs. Welch said.

Welch was brought to New England Medical Center where he remained, in a coma-like state.

"When we followed the ambulance to New England Medical and we stood at the foot of his bed, we said to each other, 'That is not him laying there. .... the essence of our son is gone. We didn't understand how he could come out of that," Debra Welch said.

Debra and Mike Welch stayed by their son's side. They read to him. They talked. They rubbed his arms, his feet. They moved his limbs.

"I would give him a daily report. I would say, 'Michael, this is mom. It is sunny outside. The dogs are all fine.' I would tell him all the current events. I always recited what happened to him and where he was. I told him, 'All you have to do is heal.' "

In the beginning of March, he was weaned off the ventilator. A week later, a feeding tube was put in his stomach.

Then, showing no improvement, he was transferred to Shattuck, a state-run hospital. Welch worked part-time jobs and had no medical insurance.

Debra and Mike Welch and their daughter, Colleen, stayed hopeful.

"We were hoping because we hadn't been told at that point there wasn't hope yet," Debra Welch said.

Mike Welch sat by his son's bed, making a simple plea. "My husband said to him, 'Michael, all I want to do is to be able to feed you. If you could just wake up and I could feed you that would be enough,'" Mrs. Welch said.

The family tried to find somewhere closer to home that would accept their son as a patient. "We kept getting turned down because the facility wouldn't get the proper funding," Mrs. Welch said. "I kept telling them I just wanted him closer. I just want to bring him home to die. Just give him a bed closer to home. I promise he won't take up a space very long."

But in the back of their minds, the Welchs still held out hope that one day Michael would improve.

Then one of the neurologists sat down with Mrs. Welch.

"That was the defining moment, when this nice doctor sat down with me. He put his chair face to face with me. He said, 'I'm going to be perfectly honest. There is nothing except minimal function in his brain. He is not in a coma now. He is vegetative. I don't want you to have these hopes any more.' "

Debra and Mike Welch would then make a heart-wrenching decision. They decided in mid-May to remove their son's feeding tube.

And then they waited for him to die.

The couple sat by his bedside, remembering their child. They sat and waited.

They waited 16 days.

On June 2, Debra Welch left the hospital, went home to wash up and put on clean clothes.

She was on Route 24, heading back to Boston when she called her husband. "He said, 'I'll probably head home when you get here,' " she recalled. "When I pulled into the parking lot at Shattuck, he was standing out in the parking lot. The parking lot is usually always crowded. I thought he was going to show me where he parked so I could take his spot. When I stopped, I saw another spot and took it. He just came over to me and hugged me."

Michael had died.

The official cause of death was anoxic brain injury due to the combined effects of fentanyl, cocaine and alcohol.

Michael Welch, who once played forward and center on his high school basketball team, was 6 feet 4 inches tall and between 200 and 210 pounds when he overdosed on fentanyl in February.

When he died in June, he was about 160 pounds. "I could put my fingers around his wrist," his mother said.

His father said he wonders why help wasn't called sooner - and wonders how things would have turned out if it was. "I didn't have to happen," he said.

At his funeral at St. Ann's Church in Raynham, Debra Welch addressed the mourners.

"Never underestimate the power of outside influences on your child," she said. "This is a tragedy that didn't have to happen, shouldn't have happened. Not to us and not to you."


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