Rachel Ramirez was dead hours before police discovered her body in the bedroom of a Cary home, said her mother, Sarah Peters.
On May 14 – the day after Mother’s Day – 19-year-old Ramirez and her boyfriend were in bed playing video games before Ramirez overdosed, according to a police report. Earlier that same day, a man overdosed in the home where Ramirez was found. He survived, but Ramirez did not.
“She was supposed to come home Sunday,” Peters said. “And she didn’t.”
Ramirez is one of 46 people to die of an overdose death in McHenry County this year, and her mother has questions about how and when her daughter ingested the lethal amount of Xanax and fentanyl found in her system.
McHenry County is experiencing a reduction in the rate of overdose deaths so far this year compared with 2017, McHenry County Coroner Anne Majewski said, but the number of fentanyl and heroin-fentanyl combination overdoses are on the rise, along with the number of drug-induced homicide cases in the county.
Prosecutors have charged 11 people with drug-induced homicide since January – more than the nine people who were charged with the offense in 2017. In several cases, multiple defendants were charged in connection with one person’s death.
“Everybody along that delivery chain faces charges,” McHenry County State’s Attorney Patrick Kenneally said.
Currently facing Class X drug-induced homicide charges in McHenry County are Nicole Free, Christopher Crimaldi, Christopher Birong, Timothy Colby, Jermal Johnson, Tiera Tracy, Sara Peters, Keith Lang, Patrick Milton and Paige Hoover.
Sheriff’s deputies are on the lookout for another man, Rahim Conda, who is wanted on a warrant for drug-induced homicide in connection with a McHenry man’s overdose death.
As the cases begin to stack, the number of fentanyl-related deaths also has begun to climb, despite a reduction of overall opioid deaths in the county.
The coroner’s office is working on an additional suspected overdose death that is pending toxicology results, she said.
Of those 46 confirmed overdoses, 39 can be attributed to opioids, specifically, with heroin leading to 21 deaths and fentanyl leading to 25, Majewski said.
Fentanyl is a synthetic opioid. Dealers sometimes combine unregulated amounts of fentanyl with other drugs such as heroin to exaggerate the other drug’s side effects.
The emergence of fentanyl and similar synthetic opioids, has ushered McHenry County into what Kenneally has called the “third wave of the opioid epidemic.” The crisis, he said, began with pills, then moved on to heroin, and now fentanyl has presented its own challenges.
“That’s been a major problem that we’re seeing not just in McHenry County but across the state and across the country,” Kenneally said.
This year alone, 15 people in the county have overdosed on a combination of heroin and fentanyl, Majewski said.
At least three people overdosed on what’s called a fentanyl analog, or a substance that has a nearly identical chemical makeup as fentanyl.
The overall number of overdose deaths is down significantly from 2017, which saw 78 total overdoses.
Although the number of opioid-specific overdoses also is down, there has been a greater proportion of deaths contributed to fentanyl overdoses than heroin alone, and a greater number of combined heroin and fentanyl deaths in 2018 so far, Majewski said.
Some have criticized the McHenry County State’s Attorney’s Office for shifting accountability away from the person who overdosed, while others see prosecution as their closest chance at justice.
The victims and alleged dealers vary in age and relationship to one another.
While some cases involve close friends who family say got high together, others involve people who seem to have hardly known each other.
In every case, prosecutors only charge people who can be linked by evidence to a specific sale or delivery of the same drug found in the victim’s system.
In regard to Ramirez, who weighed only 100 pounds, a blood test showed the presence of Xanax, marijuana, fentanyl and opioids in her system, according to a Cary police report.
Two people, 22-year-old Jacob Reis – Ramirez’s boyfriend of one week at the time – and 19-year-old Reanna Salas are charged with delivering Xanax to Ramirez that day. Neither Salas nor Reis face drug-induced homicide charges in connection with Ramirez’s death.
Reis’ attorney declined to comment on the matter, and Salas’ attorney could not be reached for comment.
The McHenry County State’s Attorney’s Office is continuing to investigate the matter and reviews each overdose death in the area on a weekly basis to determine whether prosecutors can file charges, Kenneally said.
“For people like Rachel who don’t do this type of thing, just because you’re taking a drug that is normally prescribed does not mean it is safe and it comes from a pharmacy,” Peters said. “There are people out there that are sick and pressing and making their own drugs at their own potencies for their own benefit. And one time will kill you.”