EMS service says synthetic opioids a growing problem

Published 9:55 am Tuesday, August 1, 2017

DALTON, Ga.— Opioid overdoses in Whitfield County are on the rise this year, says Scott Radeker, director of Hamilton Emergency Medical Services.

So far this year, Hamilton paramedics have administered Narcan, a drug that blocks the effects of opioids, 70 times. By comparison, they used Narcan 85 times in all of 2016 and 95 times in 2015. There have been individuals who have received the drug on more than one occasion but that number is not tracked.

“We are on a pace to almost double last year,” Radeker said.

And while prescription painkillers account for some of those overdoses, Radeker says they aren’t the biggest culprit.

“The big things are a drug we haven’t seen for a long time, heroin. That’s making a comeback. And the other thing is fentanyl,” he said.

Fentanyl is an opioid painkiller 50 to 100 times more potent than morphine used to manage chronic pain.

Worse, Radeker says, they are also seeing carfentanil, an even more potent derivative of fentanyl typically used as a tranquilizer for large animals.

“That’s coming out of China, and it’s cheap, cheaper than heroin, so what the dealers are doing is cutting the heroin with fentanyl or carfentanil,” said Greg Stinnett, director of the pharmacy at Hamilton Medical Center. “It saves them money and makes the heroin even more potent.”

The federal Centers for Disease Control and Prevention (CDC) says about 9,500 people died from overdoses involving synthetic opioids other than methadone — including fentanyl and carfentanil — in 2015, the latest year in which complete statistics are available. The CDC says overdose deaths involving synthetic opioids other than methadone increased by 72 percent from 2014 to 2015.

“This is a problem everywhere, and Dalton isn’t immune,” said state Rep. Bruce Broadrick, R-Dalton, himself a pharmacist.

Broadrick, a member of the House Health and Human Services Committee, notes that several people in middle Georgia died earlier this year after taking pills they believed to be Percocet, a mixture of hydrocodone and acetaminophen, but were actually a more potent drug that authorities believe to have been fentanyl or a fentanyl derivative.

Radeker says increasing use of fentanyl is something first responders have to be cautious about.

“If we get to the scene and see powder, we do have to take precautions,” he said. “If it become airborne and someone inhales it, it can be quite toxic. We haven’t had to deal with that yet, but I’m afraid it’s just a matter of time.”

He said all ambulances are equipped with protective equipment for paramedics, but he says they would also have to call the fire department and treat the powder as a hazardous material.

In May, a police officer in East Liverpool, Ohio, took part in a drug bust. After returning to the police station, he noticed powder on his uniform and brushed it off. Within minutes, his body began shutting down. Fortunately, other officers realized what was happening and gave him Narcan. He was taken to the hospital and made a full recovery, according to press reports.

All Hamilton EMS ambulances carry a bag with Narcan, which Radeker says is very effective in countering the effects of opioids, even powerful ones such as fentanyl. They can administer the drug by injection, through the nose or through a tube placed down the throat. Each dose costs about $36, and paramedics can give multiple doses if necessary. The patient is responsible for the cost.

“We aren’t trying to wake them up. We just want to stabilize them, get them breathing and get them to the (emergency room),” Radeker said.

Radeker says it’s important to control the dose because Narcan is so powerful it can cause instant opioid withdrawal in some patients, which can lead to seizures.

Dalton Police Department officers began carrying Narcan in the form of a nasal spray in June. Police spokesman Bruce Frazier says the department has used Narcan once since officers started carrying it.

Whitfield County Sheriff’s Office deputies also carry Narcan.

“All of our patrol cars have it. We have it at the jail, and the officers are trained to use it,” said Capt. Rick Swiney.

Narcan is also sold over the counter in pharmacies in Georgia.

“The recommendation is that if someone has overdosed once they keep it on hand and make sure their family and friends know where it is and how to administer it,” said Broadrick.

Georgia’s 911 Medical Amnesty Law allows people to call 911 for help with overdoses without fear of arrest for drug or alcohol possession.