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August 28, 2016

Flood of overdoses takes toll on Ohio first responders

By Lauren Lindstrom
The Blade

LUCAS COUNTY, Ohio — They happen in the middle of day and the dead of night; in January and July; in quiet suburban homes and on busy street corners.

In a two-year period, from June, 2014, through June, 2016, first responders were called out to nearly 3,000 drug overdoses in Lucas County. 

That works out to an average of four per day. Four calls a day for patients whom police, firefighters, and medics try to revive after they cross the invisible threshold from their coveted high to the brink of death.

The frequency in overdoses is in large part because of the heroin and opioid epidemic that has overwhelmed Ohio and much of the nation.

Often cited is the number of Ohioans who fatally overdose, including the 113 people who died in Lucas County of heroin or other opioid overdoses in 2015. Less explored is the damage left by nonfatal overdoses, incidents that leave survivors to either navigate a path to sobriety or continue using at the risk of overdosing again, and have increased the workload for police, firefighters, and paramedics.

Adding to the 3,000-some reported overdoses are ones unreported by addicts who are revived by others or wake up on their own, those who don’t call 911, or who show up at hospitals through private transportation. Additionally, calls to 911 for an unresponsive person or unknown illness can also turn out to be an overdose, though they are not always recorded that way.

The overdose logs do show calls to every corner of the county. People overdose in Whitehouse, North Toledo, and Sylvania.

Heavily represented in the data are the 43605 and 43612 ZIP codes in East Toledo and North Toledo. More overdoses are reported in those two ZIP codes than anywhere else in Lucas County, though West Toledo’s 43615 is not far behind.

In East Toledo’s 43605, more than 400 overdoses were reported over that two-year period for an area that census estimates say is home to a little more than 28,000 people.

Many locations with frequent calls occur where people are already struggling with a host of other issues. Cherry Street Mission, the city’s largest homeless shelter, was the source of 20 calls for overdoses. Likewise, the YWCA downtown and the Lucas County Jail have multiple calls on the list.

Also represented are calls to McDonald’s, Rite Aids, library branches, and Franklin Park Mall — public, and perhaps the source of a warm, free place to shoot up or sleep.

The calls track where victims overdose, not where they reside, so not all north side overdoses are from north side residents.

“Some do, a majority don’t,” said Lt. Robert Chromik, who heads up the Lucas County Sheriff’s Office’s Drug Abuse Response Team, or DART. “A majority come from ZIP codes that are low [on the list].” The overdose locations are a better indicator of where they are buying drugs, he said.

“We know statistically that people are going and purchasing heroin in these areas because they use within a block radius [of where they buy],” he said. “But we’re pretty sure just from the people we’ve met that have been displaced by their families, these are kids from Maumee, Oregon, Springfield, Sylvania. ... These are kids going from house to house, getting high from one place to another, but they are not from these areas.”

Peak yet to come
Lieutenant Chromik said one factor driving up overdoses is synthetic opioids such as fentanyl. It’s why he said he believes northwest Ohio has not yet seen the peak of the epidemic.

He worries about the rashes of overdoses reported recently in places like Akron, when 21 people were hospitalized and four died of suspected overdoses in three days in June, or this month in Huntington, W.V., where officials reported 26 overdoses in four hours. Nearly 80 people overdosed in Cincinnati over a two-day period last week. 

Investigators believe the culprit was heroin cut with carfentanil, which is used as an elephant tranquilizer and is 100 times more potent than fentanyl.

“I can’t imagine a night like that,” Lieutenant Chromik said. He worried this summer when the on-call DART officer responded to six overdoses in one night.

“My first question was: Are they from the same place and do they all know each other?” he recalled, though it turned out they didn’t. “They overdosed separately, but we were still asking where they got it.”

The DART unit has put policies in place to try to prepare for a dreaded “bad batch” that causes a mass overdose. In addition to rotating an on-call officer who handles calls from 10 p.m. to 8 a.m. weekdays and around the clock on weekends, there are now two officers from the unit on standby in case there’s a need to call in reinforcements.

In May, DART officers said they documented their first known overdose because of U-47700, a powerful synthetic opioid that until recently had been legal. Just days before, Gov. John Kasich had signed an emergency order to make it illegal as a Schedule I substance. But the race to identify and rout out the next big drug has put law enforcement on edge.

The DART unit watches national trends, because of Toledo’s access to the turnpike and close proximity to Detroit, Chicago, and Cleveland, Lieutenant Chromik said.

“Everything is coming through here,” he said. “We’re going to get it.”

Overdosing people survive often because of Narcan, the brand name of naloxone, which can rapidly reverse the effects of an opioid overdose.

“What we’re finding is, when they cut their heroin with synthetics, or they are using the synthetic itself, it’s not just a shot of Narcan to bring them back, it’s eight or nine shots because the stuff is so powerful,” Lieutenant Chromik said. “These are serial killers in powdered form that are added to everything.”

Tim Haynes, a firefighter and paramedic at Toledo Fire’s Station 6 on Oak Street in East Toledo, said he’s seen overdoses come in waves that fluctuate with whatever variation of heroin or synthetic opioid is popular.

Walking into a possible overdose, Mr. Haynes said he looks for shallow or slow breathing and pinpoint pupils — both classic signs of opioid overdose — and starts oxygen and naloxone.

If successful, patients can be alert in a matter of minutes. Despite the frequency of these calls, particularly in the neighborhoods where he works, responding to an overdose hasn’t become routine, he said.

“The fire and the police are empathetic to these people’s struggles,” he said. “When I go in there, I don’t look at a person as another drug addict. It hurts me to see these families in pain because their loved one is struggling.”

First responders’ work prevents adding to the number of fatal overdoses, a number that has steadily increased as the heroin and opioid epidemic continues to ravage Ohio.

In 2015, 2,590 people in Ohio died of opioid overdoses, which includes heroin, fentanyl, and other prescription overdoses, according to the Ohio Department of Health.

The Lucas County Coroner’s Office, which serves a 19-county area in northwest Ohio, as well as two in southeast Michigan, reported 211 heroin or fentanyl-related deaths in 2015, including 17 in Wood County.

Michigan has not been spared either. The Michigan Department of Health and Human Services reported 1,745 people fatally overdosed on heroin and other opioids in 2014, the most recent year available.

Getting help
DART officers, who are alerted to opioid overdose patients identified in Lucas County, are often juggling upward of 100 cases at a time. After meeting overdose patients, DART officers try to convince addicts to seek treatment, help connect them with services, and check in with them in the days, weeks, and months after opening a case.

“I would love to have three, four at a time,” said Deputy Charles Johnson, who currently has about 45 open cases. “If something happens to them I feel like it’s on my shoulders. I shouldn’t, but I do.”

The constant flow of new clients means frequent requests to expand the unit and resources available. Since the unit was formed in 2014, it has added officers from Toledo police, Mercy Health System, Oregon police, and several counselors. They want more.

This week, peace officers from the Toledo-Lucas County Library system are beginning their training to offer part-time help. The officers bring a unique perspective and valuable information about the epidemic, Lieutenant Chromik said.

At least four overdose calls to library branches, including at Main Library downtown and Mott in the central city, appear on the logs in the last two years.

DART is also bringing a cadre of volunteers into the fold — nurses, mental health professionals, and parents of addicts in recovery to provide support to families whose children overdose. 

In addition to meeting the overdose patient at the hospital, DART officers often encounter parents, grandparents, and siblings.

Katie Heltman overdosed four years ago and has witnessed several of her friends do so too. 

Ms. Heltman, 28, is a recovering heroin addict who marks 10 months clean this week. Only in sobriety does she understand how close she and other addicts come to death on a regular basis, she said.

“That’s the risk that a heroin addict takes every time they shoot up because we don’t know what the heroin is mixed with,” she said. “The drug dealers don’t know what mixed with before they got it.”

McClatchy-Tribune News Service
Copyright 2016 The Blade