By BREEANA LAUGHLIN/YachatsNews.com

Lincoln County health officials and law enforcement are raising the alarm about a spike in overdoses they believe are caused by a highly potent narcotic used in counterfeit prescription pills.

While the recent deaths of two Portland high schoolers and the overdoses of five West Point cadets on spring break in Florida has grabbed headlines, the people on the front lines of the addiction battle in Lincoln County say the same is happening here.

Lincoln County Public Health raised an the alarm a month ago by announcing it had observed a “significant increase in reports of overdoses” from mid-December to mid-February caused by the addition of the cheap and extremely potent synthetic drug fentanyl into the local supply of heroin and methamphetamine.

The agency also said that police in Lincoln County – like law enforcement across Oregon — are seizing more counterfeit pills containing fentanyl manufactured to resemble 30 milligram prescription oxycodone known on the street as ‘Dirty 30s’ or ‘Blues’.

Public health officials believe fentanyl contributed to four Lincoln County overdose deaths during one week in mid-February.

“This last December hit and it became pretty clear fast that there were a lot of people who were overdosing,” said Cedar Derishebourg, an outreach worker in LCPH’s harm reduction program.

The bad pills contain fentanyl, a synthetic opioid that is 80-100 times stronger than morphine. Addicts or people experimenting with drugs think they are taking “blues” — oxycontin or xanax – but instead they are taking a pill laced with fentanyl.

“They look very, very similar but they are not oxycodone. They are extremely lethal,” said Isabelle Cisco, a harm reduction specialist with the health department.

In addition to their regular contacts with treatment centers, Cisco and the Lincoln County Sheriff’s Office are also worried about the counterfeit pills reaching teen-agers experimenting with drugs.

“High school or middle school students might go to a party or hang out with friends and someone takes out a bag of pills that look identical to a prescription pill,” Cisco told YachatsNews. “Not knowing they aren’t prescription, they give it a try – and trying it for the first time could be the last time they do anything.”

Following the death of the two Portland high school students, Portland Public Schools issued a warning asking parents to talk to their children about fentanyl – urging them to never take pills that aren’t directly given to them from a doctor, not even from friends. “This is a conversation that can literally save their lives,” the district said.

Zach Landry, a Lincoln County Sheriff’s deputy who is the resource officer in Waldport and Toledo, said he’s doing everything he can to get the word out to students.

“In this day and age fentanyl is one of the scariest aspects of my job,” said Landry. “I want to be proactive and have an open dialogue about it.”

Landry met with students at Waldport High School before Spring Break to warn them about the increasing dangers of experimenting with drugs.

“I want to have an open discussion about it,” he said. “I like when students come to me and ask questions. I might not be able to save them all but I can make sure students are well-informed.”

Fentanyl from China via Mexico

Fentanyl was originally made to treat patients with chronic severe pain such as cancer or severe pain following surgery. Under the supervision of a licensed medical professional, fentanyl has a legitimate medical use, according to the Drug Enforcement Agency.

But illegal fentanyl is being produced in labs and mixed in with other illicit drugs – or pressed into fake prescription pills. Because there is no official oversight or quality control, these counterfeit pills often contain lethal doses.

According to the U.S. Drug Enforcement Agency, the process begins in China where fentanyl, or the chemical ingredients to make it, are produced. The chemicals are shipped to Mexico, where cartels produce the fentanyl powder in massive amounts. This deadly drug is then mixed with other chemicals and pressed into pharmaceutical-grade pills that appear to be Xanax, OxyContin, Adderall, or other popular drugs. Once made, the Mexican cartels pass it on to dealers who sell these fake pills using social media apps.

In early March, a police operation targeting drug traffickers in the Portland area led to the seizure of approximately 150,000 counterfeit prescriptions pills containing fentanyl and 20 pounds of suspected bulk fentanyl, the largest single fentanyl seizure in Oregon history with an estimated street value of approximately $4 million.

The misuse of fentanyl started out with a “trickle” in the early 2000s and turned into a “flood” by 2016 and is now driving the ‘third wave’ of the U.S. opioid crisis. Fentanyl is also driving a nationwide surge in overdose deaths. Overdose deaths involving opioids rose almost 40 percent in one year – between January 2020 and January 2021, according to the Center for Disease Control.

The Oregon Health Authority tracks unintentional overdose deaths. While data for 2021 overdoses are not complete, the agency reports overdose deaths in Oregon were higher in 2021 than in the corresponding months of 2020 and 2019.

In 2019, there were 280 unintentional opioid overdose deaths, 472 in 2020 and 473 for the first eight months of 2021.

In 2020 there was a 306 percent increase in fentanyl-related overdose deaths and a 131 percent increase in methamphetamine-related deaths compared to 2019, the OHA said.

Agencies hand out antidote

Lincoln County’s harm reduction program aims to reduce the negative consequences of substance abuse. As part of that, Derishebourg visits six locations around the county every week to provide syringe exchange, rapid HIV and Hepatitis C testing, distribute drug testing strips and give out Narcan – a tool proven to save lives in the event of a fentanyl overdose.

Derishebourg said several of her clients were able to reverse a possible death by overdose by administering Narcan.

Narcan, or Naloxone, is being distributed free of cost to community members who think they, or someone they know, may be at risk of a fentanyl, or other opioid, overdose. It is also carried by police and first responders who are the usually the first to respond to possible opioid overdoses.

Pacific West Ambulance, which provides ambulance service to most of Lincoln County, keeps track of the number of times it administers Narcan. PacWest general manager Jeff Mathia said his paramedics administered Narcan eight times in January, a slightly higher rate than normal. It administered Narcan 88 times in 2021, the highest number since 2019.

“When the paramedics arrive we can start an IV and administer Narcan. We can give it as a shot somewhere on the body or we can also inject it in the nose,” Mathia said. “Narcan takes the opioid effect and temporarily stops it.”

While Narcan is not harmful to the body, sometimes it takes several doses to revive a patient – especially if fentanyl is involved. Sometimes the patient has gone beyond a state of resuscitation. If a patient survives an overdose, they can still suffer dire consequences.

“You can end up with an anoxic brain injury where your brain does not get enough oxygen and you have brain damage. That can be crippling,” Mathia said.

Fentanyl overdoses are not only dangerous for the person who took the drug – it also poses danger to paramedics and law enforcement officers who respond to the incident. Anyone who comes in contact with the substance can be exposed to the drug by inhaling it or absorbing it through their skin.

Paramedics, law enforcement, hospital and clinical personnel must follow strict protocols to keep themselves safe. That was the case in the recent overdose of West Point cadets in Florida – three of whom suffered overdoses while administering CPR.

Lincoln County school resource officer Landry says the idea of fentanyl poisoning spreading to a larger group scares him.

“From my perspective working in the schools, if someone gets a hold of it and it gets in the classroom, I now potentially have an entire classroom that is potentially overdosed and I don’t carry enough Narcan for 15-20 students,” he said.

Landry said he hopes if students come in contact with a “Dirty 30” pill that they don’t take it and will contact him or a medical provider to confiscate it.

Officials said it’s important to keep an open line of communication with young people, and anyone who is struggling with drugs.

“People who get into it don’t want to come out because they don’t want to be judged,” Landry said.

Derischbourg said it’s important that everyone have the opportunity to be “seen and heard.”

“I really believe in the saying that the opposite of addiction is connection. It’s important to reach out to our friends and neighbors and family members who are struggling, while maintaining healthy boundaries, and say ‘I care about you and I want to support you.’”

• Breeana Laughlin is a Waldport-area freelance writer who can be reached at Breeana4@Yahoo.com

 

To read a national story (it might be behind a paywall) this week on the fentanyl epidemic, go here

Some basic questions and answers about fentanyl

What is fentanyl?

Doctors use the powerful synthetic opioid to treat patients with chronic severe pain or extreme pain following surgery. It’s a schedule II controlled substance that is 100 times stronger than morphine and 50 times stronger than heroin.

Illicit fentanyl has now overtaken the illegal drug market, sold on the street because it’s cheaper and more potent that many other drugs. Pills made to mimic prescription pills are now filled with fentanyl and pose a serious threat to unsuspecting buyers because people can’t smell, taste or see it. Fake prescription pills are nearly impossible to distinguish from real ones. They’re often referred to as “Blues,” “M30s” and “Perc-30s.”

What are the effects of fentanyl?

Euphoria, drowsiness, nausea, confusion, sedation, constipation, problems breathing, unconsciousness.

What is a lethal dose of fentanyl?

The U.S. Drug Enforcement Administration estimates 2 milligrams to be a lethal dose. That’s similar to a couple grains of salt.

Where is illicit fentanyl coming from?

It’s primarily manufactured in foreign clandestine labs, mainly in China, Mexico and India and smuggled into the United States through drug cartels from Mexico, then distributed across the country and sold in the illegal drug market. An increasing number of pills laced with fentanyl are being made in the United States, according to the U.S. Drug Enforcement Administration.

How to prevent overdoses?

Only consume pills and other drugs obtained from a pharmacy and prescribed to you, not to a friend or anyone else. It’s not safe to consume anyone else’s prescription drugs or anything bought or ordered online or on the street.

What are fentanyl test strips?

Fentanyl test strips can identify the presence of fentanyl in unregulated drugs. They can be used to test injectable drugs, powders and pills. But they don’t provide any information on the amount of fentanyl in a drug or detect the presence of any other drug.

A test strip that shows no fentanyl in one pill doesn’t mean the other pills in a batch are also free of fentanyl. People can get free fentanyl test strips and naloxone kits through local health departments.

What can parents do?

Talk with teens about risk of substance abuse, about the danger of buying drugs on the internet, through social media or from anyone who isn’t a licensed health care provider.

Look for changes in behavior, such as irregular eating or sleeping patterns, loss of interest in usual activities or signs of depression or anxiety. If parents are aware their child is taking counterfeit pills or illicit drugs, they can carry multiple doses of naloxone, an opioid reversal drug.

What is naloxone?

It’s a medicine that can rapidly reverse an opioid overdose when given the right way. It works rapidly binding to opioid receptors to block the effects of the drug. But fentanyl is stronger than other opioid drugs and typically requires at least two doses of naloxone, experts say.

Naloxone can be given as a nasal spray or injected into the muscle, under the skin or into veins. People given naloxone must be monitored for at least two hours after their last dose to make sure their breathing doesn’t slow or stop. Naloxone is available at pharmacies in Oregon without a prescription.

Families with loved ones who struggle with opioid addiction should have naloxone nearby. Families should ask their loved one to carry naloxone and let friends know where it is. People should still call 911 immediately if someone has overdosed. Naloxone works to reverse opioid overdoses for only 30 to 90 minutes after the drug is taken.

What are signs of an overdose?

Check for small, “pinpoint” pupils; pale, bluish, cold and clammy skin; vomiting or foaming at the mouth; slow, shallow breathing; sluggish, sleepy behavior; or loss of consciousness.

What to do if you suspect someone has overdosed?

Call 911 for immediate medical attention.

— By The Oregonian/OregonLive