Across the United States, the heroin epidemic continues to worsen in 2017. Cities across the country have reported rising numbers of overdoses in January and the first weeks of February. Last week, Louisville, Kentucky, reported 151 overdoses over four days, 52 of them within a 32-hour period.
City officials attributed the record spike to the introduction of the synthetic opioid fentanyl into the local illicit drug supply. Russ Read, co-founder of Kentucky Harm Reduction Coalition, told local CBS News affiliate WLKY, “What we’re seeing in the streets right now is fentanyl mixed with heroin, as opposed to heroin mixed with fentanyl.”
Heroin overdoses have been rising in Louisville, as across the country, over the past few years. Metro officials report that in January, emergency crews responded to 695 overdose cases—an average of 22 overdose calls a day—33 percent more than the same period last year. Between February 9 and 12, first responders dealt with an average of 38 overdoses per day.
Louisville is a city with a population of around 760,000, a large segment of which lives in or near poverty. Per capita income in 2016 stood at $26,893, according to federal Census data, and 18 percent of residents live in poverty—up from 12.4 percent in 2010. At $41,000, Kentucky is ranked 47 nationwide in terms of median household income.
Fentanyl is a prescription painkiller 50 to 100 times stronger than morphine, and between 30 and 50 times stronger than heroin. Even when taken in tiny amounts, fentanyl can cause respiratory depression or arrest, unconsciousness or coma. Overdoses can be counteracted with opioid blockers like naloxone or its brand-name medication Narcan, but fentanyl overdose victims usually require quick emergency response and multiple doses.
Many addicts are not aware of the composition of the drugs they buy. “I got what I thought was heroin,” Nathan Johnson, a Louisville resident who overdosed on fentanyl, told WLKY. “I went in the bathroom, and dude told me it was strong, so I did just a tiny bit of it and they found me in the bathroom against the door with the needle in my arm. … They threw me in the shower, they did 18 minutes of CPR before the cops got there. Nothing was working, so the cop came in and he had to use two Narcans. It brought me back to life,” Johnson said.
First responders are stretched to the breaking point when multiple overdoses occur in a short period of time. “You hear some of the stories of, ‘Man, we used all our naloxone,’” Louisville Metro Emergency Medical Services supervisor Ben Neal told CNN. “ ’We ran out of our bag valve masks. We’ve had so many overdoses, we had to go back to the station and pick up more.’ It does take a toll.”
The overdoses were reported at homes, parking lots, restaurants, and even in traffic. None were fatal, but one person reportedly died while riding in a car driven by someone under the influence of heroin. Many of the overdose victims required multiple naloxone doses; one patient was administered seven doses before reviving. “That could mean people’s tolerance levels are going up,” Neal told CNN, “or, you know, the heroin itself is becoming more and more potent.”
In Lexington, Kentucky’s second largest city, heroin overdoses are also surging. Last month, emergency personnel responded to nine overdoses in a 24-hour period in Jessamine County. The drugs were laced with carfentanyl, an elephant tranquilizer 10,000 times stronger than morphine.
On January 27, Lexington resident Hillary Moore fatally overdosed shortly after a stint in jail and rehab. “She was 30, she has two little girls,” her cousin told NBC News affiliate LEX 18. “They are young and left without their mother now.” Lexington firefighters told LEX 18 that in January alone, they had administered 150 doses of Narcan.
As the need for Narcan has spiked, so has the price. “It’s gone from $3 to $38 a dose,” Lexington Fire Department Battalion Chief Bryan Wood said. “In 2010 we gave 492 doses at a cost of about $2,000. Last year we gave 1,550 doses at a cost of $59,000.”
Across Kentucky, West Virginia, and the so-called Rustbelt of the US Midwest, heroin is ravaging working class towns and rural areas, exhausting emergency responders, and straining municipal budgets.
In Muncie, Indiana, the Indianapolis Star newspaper reported a “bad batch” of heroin led to at least 13 overdoses and three deaths over the weekend of February 4-5. Last year, Muncie’s Delaware County saw dozens of drug deaths, many of them linked to heroin or fentanyl. Delaware County emergency dispatcher April Buckles described “an overload of people” who were “coming in doubles.” Buckles said the calls came in from panicked family members. “You know, we’ve even had an 8-year-old child who called and tried to do CPR on her mother who had a heroin overdose.”
Lake County, Illinois, in the Chicago area, saw 21 fatal overdoses in the first six weeks of 2017. “Know that we have many people, hundreds and hundreds in our communities who have an addiction,” Lake County Coroner Merrilee Frey told the Post-Tribune. On Monday, February 13, Lake County Jail was treating 42 inmates for “serious addictions,” and the cost of naloxone treatments is creating a serious budget problem for the county.
Cities across Ohio are confronting epidemic levels of overdoses. Cleveland’s Cuyahoga County reported at least 46 deaths in January due to heroin and fentanyl, with 11 other cases pending autopsy reports. In the first week of February, at least 24 other people died of overdoses. In Toledo, 19 heroin overdoses were reported the weekend of February 4-5.
Nationally, heroin overdose deaths have quadrupled in the past decade. According to the federal Centers for Disease Control and Prevention, 61 percent of the 41,055 drug overdoses in 2014 were caused by opioids, up 14 percent from the year before. In 2015, some 52,000 people died of drug overdoses, nearly two-thirds of them caused by prescription or illegal opioids.