The autopsy does not make clear if the Halyes knew the cocaine they were taking contained carfentanil — a synthetic opioid 100 times stronger than fentanyl and 1,000 times more powerful than morphine.
It does indicate, however, that both Halyes took the drug by injection. Courtney Halye had needle puncture marks on her right thigh and left wrist, the report shows, while Brian Halye had a single needle puncture mark on his right arm.
Intentionally injecting cocaine into the body with morphine, heroin or other drugs is known as a "speedball."
The powerful concoction has killed celebrities, including former Saturday Night Live star John Belushi more than three decades ago.
Earlier this month, Hamilton County Coroner Dr. Lakshmi Sammarco warned Cincinnati-area cocaine users that their stashes could be cut with fentanyl or heroin without their knowledge, the Cincinnati Enquirer reported.
Cuyahoga County Medical Examiner Dr. Thomas Gilson last week told a U.S. Senate subcommittee that he believed drug dealers may be mixing cocaine and fentanyl as a way to increase opioid addiction in the black community, according to The (Cleveland) Plain Dealer.
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