Health Care

It’s ‘Sept. 11 every 3 weeks.’ How fentanyl is killing Beaufort County, America

So far this year, Beaufort County has recorded 18 drug overdose deaths — nearly triple the number of such deaths in both 2015 and 2016, and more than the past two years combined.

County records show that 15 of those deaths were related to fentanyl, a synthetic opioid 100 times more powerful than morphine and 50 times more potent than heroin; or carfentanil, an elephant tranquilizer that had not been tracked before 2016.

In contrast, there were three deaths last year in the county related to fentanyl or carfentanil.

Most of this year’s fatal overdoses have occurred on Hilton Head Island or in the Bluffton area, according to records.

The county’s skyrocketing overdose cases mirror nationwide trends. More than 142 Americans die of overdoses every day — over 60 percent of which involve opioids, according to the National Institute on Drug Abuse.

“The issue with fentanyl and carfentanil is that I don’t think a lot of people realize it’s designed to stop a charging rhino in its tracks,” Beaufort County Sheriff P.J. Tanner told The Island Packet and The Beaufort Gazette recently. “It’s not intended for humans.”

By comparison, the Jasper County Coroner’s Office has seen three overdose deaths in the last 18 months, records there show.

In Beaufort County, the Sheriff’s Office forensic laboratory so far in 2017 has investigated 32 cases that involved fentanyl, up from seven cases in 2016 and two in 2015, according to records.

Fentanyl is often — without the user’s knowledge — mixed with heroin, OxyContin or other opioids because it’s cheaper than those and much stronger, law enforcement officials say.

“When you’re buying drugs off the street, you don’t know what compounds they consist of,” Tanner said. “When you have potential exposure as a user to something as powerful as fentanyl, then you could lose your life. And that’s kind of where we’re at.”

About two years ago, a person in Beaufort County died of the first fentanyl-based drug overdose in the state, according to county Coroner Ed Allen. Since then, his office has seen the number of those deaths escalate at an alarming rate.

The 15 victims to date this year ranged in age from 24 to 62, according to the Coroner’s Office.

“Some are repeat users,” Allen told the Packet and Gazette. “They had an overdose, and EMS may have gotten there in time to give them Narcan (a drug used to treat overdoses), only for them to go back a week or so later and have a recurrence.”

In some U.S. cities, first responders have run out of Narcan in a day, while in others, mobile morgues have been used to accommodate an influx of overdose deaths. Asked if he feared a similar situation occurring in Beaufort County, Allen gave this response:

“It’s going to tax our system. We’re fortunate that we haven’t experienced that yet — and I hope that we will not experience it — but it’s still taxing to the entire system.”

On Aug. 9, President Donald Trump said during a news conference that the country’s opioid crisis “is an emergency,” though he hasn’t formally declared it as such. That process would come with specific legal authority and could eliminate barriers and waive some federal rules governing how states and localities respond to the drug epidemic. It would also put pressure on Congress to provide more funding.

Several weeks ago, the President’s Commission on Combating Drug Addiction and the Opioid Crisis, which was charged with studying ways to combat and treat drug abuse, addiction and the opioid crisis, issued a preliminary report that described the nation’s overdose death toll as “September 11th every three weeks.” The report urged Trump to immediately “declare a national emergency.”

On Tuesday, S.C. Attorney General Alan Wilson announced that the state had filed a lawsuit against OxyContin maker Purdue Pharma, joining a growing list of states suing opioid manufacturers for alleged deceptive marketing practices that critics contend have contributed to the national crisis. Since a 2007 settlement with South Carolina, Purdue Pharma has continued to downplay the addictiveness of its opioid products and overstated the benefits, the latest suit alleges.

A South Carolina House committee was recently formed to study opioid abuse prevention. The committee is chaired by Rep. Eric Bedingfield, R-Greenville, who lost his son to an opioid overdose last year.

In 2015 — the most recent statewide statistics available — 565 people died of opioid-related overdoses in South Carolina, up from 508 in 2014. Deaths involving prescription opioids accounted for 512 deaths in 2015, according to the S.C. Department of Health and Environmental Control.

In 2015, the number of deaths from heroin and opioid overdoses in South Carolina surpassed the number of homicides by more than 100, according to DHEC.

Street opioids ‘way stronger’

Treatment for a suspected overdose has not changed in recent years, said Eric Lainhart, the Town of Hilton Head Island Fire and Rescue’s training captain. But the number of times the department responds to a scene and administers naloxone, the drug commonly referred to by the brand name Narcan and which can reverse the effects of opioids, has increased dramatically in recent years.

In the first half of 2017, Hilton Head Fire and Rescue administered naloxone for a suspected overdose on 50 occasions, which exceeded the number of times in all of 2016, according to records.

Similarly, Beaufort County EMS has administered naloxone 63 times so far this year, compared to 27 occasions during the same period last year, county records show.

The increased potency of drugs found in the suspected overdose patients has forced first responders to carry more doses of the lifesaving drug and therefore spend more money.

In May, Hilton Head Fire and Rescue increased the amount of naloxone carried on each truck from two doses to four, Lainhart said. In fiscal year 2017, the department spent a total of $5,080 on naloxone, up from $1,880 in fiscal year 2016.

“The opioids are way stronger, so we’re having to give more of the medication in order to reverse the effects,” Lainhart said. “Previously we may have given a dose and that would bring the patient around, whereas now we might need two or three doses.”

On fentanyl’s front lines

Beaufort County Sheriff’s deputies also are seeing the opioid crisis firsthand.

As a part of a five-year, $3.1 million federal grant, the Sheriff’s Office recently attended training and received 158 kits of Narcan, which each include two doses of the drug.

Deputies have used Narcan on two occasions since the training in May, according to Tanner.

“It’s obvious that it’s become a problem when you’re starting to equip law enforcement officers with drugs such as Narcan to help people in a situation of an overdose,” Tanner said. “It’s something the EMTs have used for number of years. But you can see that this has evolved and has rolled over to law enforcement acting as first responders as well.”

Fentanyl is not only dangerous to the user but also for anyone nearby, including emergency responders, who come into contact with the drug. Second-hand exposure can cause disorientation, coughing or cardiac arrest, according to the U.S. Drug Enforcement Administration.

Tanner said his department, like law enforcement agencies around the nation, has taken extra measures when dealing with overdose calls that could potentially expose an officer to fentanyl. In June, the department started equipping deputies with safety masks, goggles, gloves and coveralls to protect them from accidental exposure to dangerous opioids.

When it comes to stopping the distribution of opioids, Tanner said the task is harder than handling drug crimes in the past.

“We don’t have enough answers for the fentanyl issue yet,” he said. “We know it’s a problem and we know it’s deadly, but we haven’t got our arms around the distribution side.”

Tanner said his department is focused on investigating the issue, attempting to identify different compounds found with the drugs, and treating every overdose like a crime scene. But dealers are harder to identify in those situations, he said.

“It’s different than drug cases we’ve worked in the past,” he said. “With fentanyl and other compounds, your dealers are a dime a dozen. These drug dealers could be friends or relatives. It’s not like tracking that distribution to certain kingpins, if you will, like back in the ’80s. ”

Meanwhile, overdose deaths in Beaufort County continue to rise.

“When you think about our little area of Beaufort County, South Carolina, and compare our numbers to others like Chicago, Detroit or Philadelphia, it may look like we don’t have the problem they have,” Tanner said. “But if you look at population numbers, it’s some pretty alarming numbers.”

“And those are just the known numbers,” he added. “The unknown part — how many overdoses are not reported — within itself would be alarming.”

Maggie Angst: 843-706-8137, @maggieangst

Key terms

Fentanyl: A synthetic opioid approximately 100 times more potent than morphine and 50 times more potent than heroin. It can be injected, snorted, smoked or taken orally by pill or tablet. Similar to other commonly used opioids, it produces effects such as relaxation, euphoria, pain relief, sedation, confusion, drowsiness, nausea, vomiting and respiratory depression.

Naloxone: A medication used to block the effects of opioids, especially in the event of an overdose. The drug is commonly sold under the brand name Narcan.

Source: U.S. Drug Enforcement Administration

International Overdose Awareness Day

On Thursday, Aug. 31, the Beaufort County Sheriff's Office and the Beaufort County Alcohol and Drug Abuse Department are hosting an event from 6:30 to 8 p.m. at the Buckwalter Recreation Center (PALS) at 905 Buckwalter Parkway in Bluffton.

The event will include the distribution of overdose-awareness materials and information, a “take-back-the-meds” drop-off site, and a candlelight vigil to remember the “everyday people we’ve lost everywhere,” according to a release.

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