After years of battling a seemingly unending heroin epidemic, Fentanyl has taken over as the area’s drug-of-choice and experts find that many overdose victims have such a range of drugs in their system it’s often unclear which one killed them.
Fifty times stronger than heroin and 100 times stronger than hospital opiates, Fentanyl is responsible for over half of the overdose deaths this year.
It attacks without warning and kills its victims so fast that first responders often find the needle still in their arm, according to Lycoming County Coroner Charles Kiessling Jr.
Kiessling’s 20-year run as coroner has brought him face to face with every category of death, but he remembers when the county would face no more than two or three overdose deaths a year.
“In 20 years this is one of the biggest problems that we’ve had,” Kiessling said. “It doesn’t seem to be going away.”
In 2019 overdose deaths have reached 38, tying it with 2017’s record-breaking tally. While the county saw a brief respite in 2018, at just 27 overdose deaths, 20 of those deaths were due to Fentanyl – a synthetic opioid only sold on the street and meant to enhance the effect of heroin or morphine.
Getting a stronger high
As addiction rates grew, so did the search for a strong high.
Shay Madden, executive director at West Branch Drug and Alcohol, has been helping people who struggle with drug abuse for years.
For her clients, the search for a stronger high means mixing prescription and street drugs, often meaning that the addicts don’t know what is in what they are taking.
“People do not know what they are using,” Madden said, adding that many go in search of Fentanyl because it’s cheaper and easier to get.
A nightmare two-week stretch in 2017 saw over 50 overdoses rack the county. It was blamed on a bad batch of heroin, but while it should be seen as a cautionary tail, instead many addicts went looking for the very batch that took so many lives and sent many more to the hospital.
It’s hard “when you have a rash of overdoses and want people to be informed, but then people will seek out that specific drug,” Madden said.
As Kiessling looks through reports of this year’s deaths, he finds that some have as high as 13 drugs in their system, ranging from marijuana to prescription drugs to morphine or Fentynal.
This is an all-too-common trend with drug users, Kiessling said, adding that it often makes it impossible to prosecute after an overdose death as doctors are unable to say which drug was actually responsible for the death.
Naloxone – Not always a ‘magic drug‘
State Surgeon General Dr. Rachel Levine’s standing order for Naloxone has provided a way to reverse many overdoses in the state, putting a large dent in the epidemic at large.
While the drug should still be used on overdose victims, Kiessling cautioned people from thinking of Naloxone as a ‘magic drug,’ especially with the plethora of overdoses caused by mixing prescription drugs and cocaine and methamphetamine. Naloxone can only be used to reverse the affects of opiates.
In 2019, of the 39 overdose deaths in Lycoming County, 10% showed Naloxone was administered and ineffective, according to the coroner.
“This can be for several reasons but the toxicology reports don’t lie,” Kiessling said.
Naloxone may still work and should be used in an attempt to reverse the overdose, but Kiessling added that other life-saving efforts should also be used, such as CPR to help the individual continue to breath and process the drugs.
The drug is ineffective on prescription overdoses and not always strong enough to combat the strength of Fentanyl, Kiessling said. “People will think they have this magic drug in their pocket that they can use.”
“When Heroin was being sold on the streets persons were more readily revived with Narcan (Naloxone),” Kiessling said. “Now, with most of the drugs being sold on the streets being Fentanyl and cut with other substances there is no guarantee that the Narcan will work. 911 must always be called and persons must be prepared to administer CPR to give the person the greatest chance of survival.”
Lycoming County’s drugs through the years
In 2005, a community survey showed that 11% of residents thought drugs and alcohol were an important issue and 17.3% saw crime and gangs as a major problem. Surveyed again in 2018, the percentage of the community who saw drugs and alcohol as a major problem rose to 58% and those who thought crime was a major problem dropped to 7%.
Despite the continual rise in overdose deaths, Williamsport Bureau of Police Chief Damon Hagan has seen the crime and drug epidemic rise and fall over the years.
Declining to comment on the current state of dealing in the city, Hagan said one of the worst gang-related crime era’s in the city was in 2005 when a sect of the popular street gang The Bloods – Sex, Money Murder – were prominant in the city.
Since then he’s seen streams of drugs come in from “non-traditional” groups out of Philadelphia, often dressed in every-day clothes and very organized.
“We’ve seen three man groups be more effective than 10-man groups and 10-man groups be more effective than three-man groups,” he said. “We’ve seen it all.”
The most effective group is the one that is harder to detect – “generally experience plays out.”
“The level of organization has varied overtime,” Hagan said. “It really depends on who’s out of jail.”
Recovery must be a choice
The current epidemic is like nothing local experts have seen. While cocaine was the drug of choice years ago it was eventually taken over by heroin. Now cocaine overdose rates are on the rise again, as well as Fentanyl.
“It’s not surprising to me, but it is disheartening, of course it is,” Madden said. “There’s so many folks in recovery.”
As the problem grew, so have the recovery options. County treatment court was launched in the 90s and a number of heroin and drug task forces have cropped up over the years. In addition, Madden said West Branch Drug and Alcohol implements a “warm handoff” method in emergency rooms, having someone available to guide overdose survivors to support and programmining immediately.
But even with all of these options, recovery must always be a choice the addict makes for themself, she said.
In one way or another, the problem will always persist, Madden said. Those in the thick of it every day agree that if there is a way to fix it for good, they haven’t found it yet.
Even prevention efforts and more education aren’t complete remedies, as many youth simply opt to do drugs out of choice, not due to their economic status or upbringing, according to Hagan.
West Branch is beginning to work closer with law enforcement and the hospital, and Madden hopes this trend will continue.
For the coroner, he plans to build more collaboration between his office and the county District Attorney’s office to begin prosecuting more dealers.
“We have to just keep plugging away,” Kiessling said.