A coroner raised the alarm over fentanyl for years – then it took her son

In every death there is a story, and it is Alfarena McGinty’s job to tell it. For more than two decades she has worked in the Marion County coroner’s office in Indianapolis, a job that requires her to carefully investigate and document the final moments of the city’s dead. There is not much she hasn’t seen.

But about six years ago she started to notice something strange. The opioid crisis was already raging across the country and fatal overdoses were common, and yet she saw a shift taking place. At more and more death scenes she discovered the presence of fentanyl — a powerful synthetic opioid that is 50 times more potent than morphine.

“I started trying to figure it out,” she said. “I sent alerts to the health department, to the police department, to mental health and public health agencies to let them know that we’re seeing this increase in fentanyl deaths.”

She went even further, starting an agency taskforce to look at the phenomenon and implementing investigative practices to discover why it was causing so many deaths.

Things continued to get worse. Fatal overdoses rose dramatically in the subsequent years and fentanyl became the primary killer. The number of deaths was “simply ridiculous”, she says.

McGinty signed countless death certificates of other people’s sons and daughters with fentanyl as the cause as it spread across the city of Indianapolis like a virus. Then one day she received a call from one of her own employees.

“She asked me if I knew someone named James Williams,” she says. “Immediately I asked how old he was. She said he was 27. I said, ‘Yes, that’s my son.’

“I asked her, ‘Is he dead?’”

James Williams, known to his friends and family as Jimmy, died from fentanyl poisoning on 24 July last year, becoming a victim of an spiralling epidemic that has grown more deadly during the coronavirus pandemic.

More than 100,000 Americans lost their lives from overdoses in the 12 months ending in April 2021, the highest annual number ever recorded and an increase of nearly 30 per cent on the same period in the previous year.

America’s opioid crisis began more than two decades ago when pharmaceutical companies created powerful painkilling drugs they falsely claimed were not addictive. That transformed into a deadly heroin addiction crisis. Today, fentanyl is taking over. Last year it was responsible for two-thirds of overdose deaths. Williams was one of them.

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When her son died, Alfarena McGinty set out to find answers about his death in much the same way she had done with thousands of strangers before him in her professional life. Who was he with? What did he take? What did he think he was taking? What drugs were found at the scene?

As a coroner, there was an immediate and reflexive need for her to know the answers to these questions — to tell the story of his death. But as a mother, that story would be much harder to tell, and harder still to deal with.

Jimmy was her firstborn son. It was clear early on that he was bright; he started talking before most other children and at three years old he went to a private school where he learned Spanish. By the time he was in elementary school, Jimmy was bilingual.

Alfarena McGinty with a picture of her son, Jimmy

In those early years, Jimmy’s father — McGinty’s first husband — became addicted to drugs. They were living in Indianapolis in a difficult neighbourhood. She says it was “not where I wanted to raise my boys”, so when Jimmy was nine, McGinty took him and his brother to the suburbs and away from the trouble.

“After I saw his father and what he went through, I wanted them out of that whole neighbourhood. I wanted them out of that environment,” she says.

Their household grew. McGinty’s second husband had three girls and they all moved in together. Jimmy thrived out there, watched closely by his mother and stepfather, who was a deputy sheriff.

“I was very strict. Like, you couldn’t hang out, you had to be in before dark. I was just a strict mother because I was raised by my strict dad. There were no issues. He didn’t smoke weed in high school. He wasn’t trying to do all the gang-banging stuff,” she says.

I took him to the morgue and I said ‘Look, this is where you’re gonna be if you don’t stop this.’

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