Police in York County using more Narcan as fentanyl makes heroin even deadlier
As opioid overdose deaths are rising in York County, so is the amount of naloxone required to save victims, according to local officials.
The drug, also called Narcan, reverses the effects of narcotics and revives people who have overdosed.
"The (COVID-19) pandemic has not been kind to heroin users," said Chief Dave Lash of Northern York County Regional Police. "We’ve been seeing increased heroin use. As a result, we’re using more and more naloxone to save people’s lives."
But it's not just that the number of overdoses is rising, he said — it's also that street heroin has become more potent, meaning deadlier.
"This is an ongoing crisis, no matter what else is going on in the world," Lash said.
Police departments in York County started carrying naloxone nasal spray in 2 milligram doses in 2015, because officers are often the first to respond to a reported overdose.
"Back then ... one of those was effective to bring back someone who overdosed on heroin," Lash said.
But because fentanyl has made street heroin so much stronger, officers are now carrying naloxone nasal spray in 4 milligram doses, he said.
"Now we're using two, three, four (doses) to bring someone back," Lash said, despite them being double the strength of what police carried five years ago. "Fentanyl is much deadlier than pure heroin. It takes us much more naloxone to counteract the effects of fentanyl."
And those dosing numbers don't account for whatever amounts of naloxone EMTs and paramedics administer to a victim after they arrive on scene and take over treatment from officers, he said.
The fentanyl problem: Nearly all of the illegal "heroin" being sold that has killed people in York County has at least some fentanyl in it, according to York County Coroner Pam Gay — and sometimes has no heroin in it at all, just fentanyl and filler.
"While they may think it's 'just heroin,' deep down in their hearts I think most users would know there is a risk there's fentanyl in it," she said. "But I don't think it stops them. That's really why a lot of (police departments) went to 4 milligram. Because the 2 milligram was not doing it."
Lash said that in 2019, Northern Regional Police administered 52 doses of naloxone to 30 people.
"As of Aug. 13, we’ve administered 69 doses of naloxone to 47 people (this year)," the chief said. "Our overdose deaths this year are also through the roof."
He said that in 2019, officers were dispatched to a fatal opioid overdose every couple of months. So far this year, it's not uncommon to have three or four in a month, Lash said.
Between April 2015 and Aug. 13 of this year, Northern Regional officers have revived victims of overdoses 205 times, according to the chief.
Fairview Township Police Chief Jason Loper, who is president of the York County Chiefs of Police Association, shares Lash's concerns.
"What we are seeing is that even with the increased dosage, in almost every incident the officers have to use more than one dose of naloxone," Loper said, adding that once an ambulance arrives on scene, EMTs often provide even more doses.
Saving lives: Since April 2015, 17 people died of opioid overdoses in cases where Northern Regional officers either administered naloxone or where the overdose victim was beyond medical intervention, according to Sgt. J.C. Asper.
"We're doing what we can to save lives," Lash said.
The deaths of overdose victims are investigated as homicides by the department's criminal investigative division, which has taken on a dozen new fatal overdose cases since the coronavirus pandemic began, according to the chief.
"It takes a lot of investigative resources and a lot of time ... to do these investigations," Lash said. "They're important investigations to do."
Gay said her office had been investigating about 20 to 22 confirmed and suspected drug overdose deaths each month so far this year, although it's slowed a bit in August, in which the coroner's office responded to 11 such deaths as of Wednesday.
Prior to the COVID-19 pandemic, there was a trend for two years in a row in York County in which overdose deaths decreased slightly, but that reversed itself around March and April, the coroner said.
Countywide: As of Wednesday, there were 133 confirmed and pending drug overdose deaths in York County, according to Gay, compared with 94 in all of 2019.
Gay said she believes the stress and anxiety caused by COVID-19 has led users to relapse, especially those who lost their jobs, are isolated and who feel depressed. Those in recovery are also finding that pandemic restrictions mean they can't attend Narcotics Anonymous and Alcoholics Anonymous meetings in person, she said.
The coroner's office is also seeing an increase in alcohol-related deaths amid the COVID-19 pandemic, Gay said — a few from alcohol toxicity, but most from long-term complications of alcoholism, such as malnutrition and internal bleeding.
Some of those people are in their 40s and 50s, she said.
Tolerance levels: Audrey Gladfelter is administrator of the York/Adams Drug & Alcohol Commission, which provides naloxone to police departments and other first responders.
"When people stop using, their tolerance goes down," she said.
Despite that, relapsing users will typically use the same amount of drugs they did prior to quitting, even though their bodies have lower tolerance, and they are more susceptible to overdosing, according to Gladfelter.
To help combat that, the commission recently began supplying take-home doses of naloxone to York County Prison and to WellSpan, she said, "so clients have it in hand upon leaving the prison or the hospital."
The sooner naloxone is administered to an overdose victim, the more effective it is, Gladfelter said.
— Reach senior crime reporter Liz Evans Scolforo at firstname.lastname@example.org or on Twitter at @LizScolforoYD.