Published: October 21, 2016.
Heroin addicts are dying to get their fix. Literally, they are dying.
It starts with shallow breathing, confusion, loss of consciousness. Respiration stops, the lungs stop, the heart stops, then death.
In search of that next euphoric high, heroin users have encountered something they didn’t bargain for when they inject themselves with heroin laced with carfentanil, a synthetic opioid approximately 10,000 times more potent than morphine and 100 times more potent than fentanyl, a strong opioid pain medication. Recently, drug dealers have been cutting heroin and lacing it with carfentanil. Carfentanil – often used to tranquilize large animals such as elephants – is lethal to humans, said Mason Police Lieutenant Jeff Burson.
“It’s everywhere,” Buron said. “It seems to be like the drug of choice right now, and hopefully we will get away from it. It’s a big issue.”
Burson said carfentanil gives the same type of effect as heroin, but is incredibly potent and cheaper to buy.
“It’s only been here for a very short amount of time, but the problem is that it’s thousands of times more potent than heroin,” Burson said. “If a user uses the same amount that they would in heroin, then it’s going to shut down the body. Respiration stops, lungs stop, and then once the lungs stop, the heart stops and it causes death.”
Cincinnati Police Department Public Information Officer Lieutenant Steve Saunders said the introduction of fentanyl and carfentanil has been a fairly new phenomenon to the Cincinnati area and the surrounding suburbs.
“I think drugs being an inner city thing may be more of a myth, especially when it comes to heroin or opioid addiction,” Saunders said. “A lot of people seem to get hooked on opioids through prescription drug medications. When those (prescription medications) are no longer available, people turned to other forms like heroin.”
Death by overdose
Doyle Burke, Chief Investigator for the Warren County Coroner and Medical Examiner, said up until 2015, heroin deaths lagged far behind prescription drug deaths and cocaine deaths. Now with carfentanil added to the mix, Burke said more heroin and carfentanil deaths are expected.
“People are used to taking heroin with a modest degree of fentanyl in it, but then they get (carfentanil) and it’s much more deadly,” Burke said. “We have not seen that much carfentanil in Warren County; we have two cases that are pending. What occurs is when there’s an overdose death like this, we typically bring them in for autopsy – that initially takes a couple hours. But the toxicology report is what is of interest here. That can take eight weeks, sometimes even longer. We have had 42 confirmed overdose deaths this year. By the time we get the toxicology report back on what we have in the lab timeline, we will probably have about 56, which is a lot for Warren County. The vast majority of it is heroin and fentanyl.”
Burke said heroin, fentanyl and carfentanil have a residual effect on Mason, such as increased crime rates and the use of valuable community resources. In order to combat the problem, autopsies of overdose deaths are needed to prosecute the people dealing heroin. An average autopsy costs $1,500, and with 56 deaths expected this year, around $84,000 will be spent on overdose autospies alone in 2016.
“It affects all areas, especially urban areas, in a way people don’t realize,” Burke said. “The average Emergency Medical Services run has four medics that go; they always send a (Halligan bar, an iron tool) out as well in case they have to break down a door to get to the person. That’s not free. That costs a lot of time and resources. There is crime involved with this because the narcotics trafficking is illegal, but I’m talking about the residual effect of theft. Even though heroin is relatively inexpensive, it’s not free. It creates more crime, it creates more loss, it creates a high usage of resources in a community. It costs a lot of money.”
Saunders said the introduction of carfentanil has led to increased overdose runs throughout Cincinnati.
“It’s really brought to the surface how big the heroin addiction in this area really is,” Saunders said. “When we were having an average of four overdose runs per day, we had a period where we were making 20 plus overdose runs a day. When you compound the problem that much, it really identifies a lot of people are using and when they start using something as dangerous as fentanyl or carfentanil, it magnifies the problem because a different mixture of the drugs on the street are now being used.”
Burke said with increased overdoses, the police and fire departments have to allocate their resources in different ways.
“Mason is fairly affluent; Warren County itself is fairly affluent,” Burke said. “But it’s only so much. You get other areas that are not as quite affluent and have two medic units in a township, and one of them is tied up on an overdose, and the other goes out to a traffic accident. Then grandma drops over from a heart attack, and there is no one available. They have to come from another area and take even longer, and those are the things that people don’t think about. It affects everyone.”
Burson said heroin and carfentanil are shipped out of Mexico and South America, then transported to larger cities. From the larger cities, it makes it way to the suburbs where it’s destructive impact is felt throughout the community.
“Carfentanil has been (in Mason) within the last few months,” Burson said. “Its shipments have come out of Dayton and Cincinnati and have been adulterated, or cut, with (heroin). A heroin user doesn’t operate just in a vacuum. A heroin user will do anything it takes to get their drug. If that means stealing from their own family, going out and stealing to get money to buy heroin, (they will); you hear about people who are driving around drug-impaired with their kids in the car; they leave their kids with people they don’t know to go buy heroin. It’s destructive to the community as a whole. We’ve had cases here recently, and a drug-related death yesterday. It’s been one day since we had our last (death). Here in Mason. We’re a relatively small community, but no one is immune from it, and we are definitely suffering our losses from it as well.”
Law enforcement at risk
Police officers are aware of the impact of carfentanil and heroin, Burson said, and take extra precautions when dealing with drugs. All police officers must use gloves for any contact with drugs, and all drugs must be packaged in multiple layers. Carfentanil and heroin could also be spread transdermally, or through the membrane of the skin. This could easily affect an officer just as it would the drug user.
Saunders said that police dogs are also now at risk when brought onto drug scenes, because if a dog sniffs carfentanil, it could die.
“We have received a great deal of training from the Drug Task Force, and then also from the State Attorney Generals Office on handling precautions,” Burson said. “We used to do field testing, where we would take test kits to take a small sample, but we don’t do field testing anymore. Lots and lots of precautions are taken because it can be deadly for us too.”
Police officer and law enforcement are now at threat, Burson said, because sellers will do anything they can to protect their product, and users will do anything they can to get their next high.
“Heroin-impaired people are usually docile and passive, but because they’re willing to do anything to get their drug, it becomes dangerous for us if it is mixed with anything like fentanyl or carfentanil,” Burson said. “It becomes fatal to anyone who comes in contact.”
Time for a change
Burson said that because traditional law enforcement is not working, he believes there should be a change to help users receive treatment.
“We as a law enforcement community are going to have to come up with better ways to enforce this,” Burson said. “The traditional arrest and prosecution isn’t working; it’s not going quickly enough. We’re going to have to come up with a treatment to help people.”
Burke said combating this epidemic is going to take time, and will require help from all forms of law enforcement.
“We’re doing everything we can,” Burke said. “Every year, a third as many people are dying because of this. Look at what the residual effects would be. Something has to be done. We’re offering treatment, but it’s a tough war to fight. This is not going to be an overnight fix – it’s going to take a lot of time. Everyone is used to identifying a problem, targeting it, and dealing with it, and eradicating it and being done. This is not that simple. It’s going to take a lot of work, a lot of time, a lot of effort by a lot of different agencies, not just the police.”
The Drug Policy Alliance said Ohio House Bill 110 is a new law which encourages witnesses to overdoses to call 911 for help and went into effect on September 13. This law, commonly known as the “911 Good Samaritan Law”, exempts witnesses from arrest and prosecution for minor drug charges and alcohol law violations. Good Samaritan Laws, however, do not protect people from arrest for other drug-related charges such as drug-impaired driving or drug trafficking. Twenty states and the District of Columbia currently have policies regarding the protection of drug overdose witnesses.
The real danger
Burson said the law enforcement has hopes to help control the outbreak, but is aware this drug may not go anywhere anytime soon.
“It’s everywhere,” Burson said. “It’s really throughout the entire country right now. It’s a big issue. The danger is obvious because humans cannot handle that kind of synthetic opioid. ”
Saunders said the law enforcement is trying to find the source of incoming illegal drugs, but in the meantime, he said he urges students to be aware and realize the true power of heroin, fentanyl and carfentanil.
“Carfentanil is illegal in the US,” Saunders said. “If we can identify the source of where these drugs are coming in and then shut that off, we can prevent more harm to come this way. It’s a dangerous drug and we hope that anybody, including high school students that might consider using drugs, will see how dangerous and potentially lethal they are (and) that they would not even go down that path.”