Heroin overdoses on rise

The number of probable heroin overdoses in Thurston County has risen sharply, and public health officials and police are at a loss to explain why.

Detectives have information “that a batch of heroin has been distributed that has not been cut down as much, making it a stronger dose, but we’re not sure,” Thurston County Narcotics Task Force Lt. Loreli Thompson said.

Dealers typically cut, or dilute, heroin with another substance to decrease its potency and improve profitability by creating a larger quantity of the product to sell.

Pete Suver, the advanced life support coordinator for Thurston County Medic One, the county’s emergency ambulance service, offered statistics showing that local emergency medical service providers have responded to eight probable heroin overdoses this month.

From January to May, EMS providers in the county responded to no heroin overdoses, according to Suver’s data. In June, local paramedics responded to one likely heroin overdose, and in July, they responded to two.

“It’s been noticeable to the crews,” Suver said.

THREE IN ONE DAY

Capital Medical Center doctor Bill Hurley said he treated three people for heroin overdoses Aug. 4. Although two of those people entered the hospital together, “it’s pretty unusual that we would see three in one day,” Hurley said.

Police are treating two local deaths this month as possible heroin overdoses.

A 30-year-old man who died Aug. 8 at The Salvation Army in downtown Olympia had a substance thought to be “black tar” heroin, Olympia Police detective Dan Smith said.

An overdose might have killed the man, but it is too early to tell until a toxicology screen is complete and the official cause of death is determined, Thurston County Coroner Gary Warnock said.

He said the other suspected overdose resulting in death occurred Aug. 17, killing a 46-year-old man in Olympia.

Olympia assistant fire chief Greg Wright reported that the number of overdoses Olympia paramedics responded to in late July and early August rose sharply. He did not have data on what might have caused them.

The Olympia paramedics who responded to those calls are part of Thurston County Medic One.

Wright said that between July 22 and Aug. 8, “we had 10 possible overdose calls, eight of them that were very clearly overdoses.” Eight is unusually high for such a short period, Wright said.

Suver said that in August, Thurston County Medic One EMS providers have administered nine doses of naloxone, or “narcan” – a drug that counters the effects of opiate overdoses and reverses respiratory depression. Suver noted that paramedics sometimes use Narcan during medical emergencies that are not caused by opiate overdoses. For example, he said, Narcan often is used when paramedics respond to an unconscious patient and aren’t sure of the cause, because Narcan has no negative side effects and can be liberally administered.

Wright said Narcan is a remarkable drug and long has been a staple in helping paramedics revive overdose victims.

“It’s a lifesaver,” he said.

Overdoses have a variety of causes. Excess amounts of alcohol, heroin or prescription drugs that contain opiates can cause respiratory depression, which can lead to death. A mixture of different types of drugs, or of alcohol and drugs, also can result in an overdose.

Hurley, who also is the medical director of the Washington Poison Center, said that overdoses by opiates – a class of drugs that includes heroin, OxyContin and other prescription painkillers – are the No. 1 cause of accidental deaths in Washington.

There have been 21 confirmed overdose deaths in Thurston County in 2009, Warnock said. There were 35 overdose deaths in Thurston County in 2007 and another 35 in 2008, he said.

Opinions differ about why the number of overdoses in Thurston County has risen so dramatically. Thompson and Thurston County Health Officer Diana Yu are investigating possible connections.

Thomas Lalonde, a volunteer at the Thurston County Syringe Exchange, said an increase in heroin overdoses usually indicates that a stronger, more potent batch of the drug is being distributed among local users.

Wright warned against reading too much into the August increase.

“It’s an on-again, off-again problem that never completely goes away in this community,” he said.

Yu said there were several theories about why the number of overdoses has spiked. She said someone could overdose after stopping use of a drug for a while, then resuming use at the same dose. The old dose could be too strong because the user has lost tolerance for the drug, she said.

Overdoses also can be caused when a user starts getting drugs from a new source – someone who might sell the substance at a higher potency than the user is accustomed to, Yu said.

Hurley said that when he dealt with three heroin overdoses in one day this month, two of the patients were recent, inexperienced users, and one had recently begun using again after being released from jail.

Another possible cause for the overdoses is that more users are mixing drugs in dangerous drug cocktails or with alcohol.

Hurley said drugs such as heroin and cocaine sometimes are cut with dangerous substances. In July, all of Washington’s emergency departments received a warning that the local cocaine supply might have been cut with levamisole, a deworming agent used by veterinarians. The warning was issued after a cocaine and heroin overdose victim at Harborview Medical Center in Seattle tested positive for levamisole.

Later tests confirmed that 80 percent of people who tested positive for cocaine at Harborview also tested positive for Levamisole, which is dangerous for humans to ingest because it causes the body to stop producing white blood cells.

One death in Spokane was attributed to the contaminant, according to a copy of the Levamisole alert that was shared with The Olympian.

Yu and Thompson both said drug contamination is just one of many dangers that cocaine and heroin users face.

“That’s one of the inherent dangers: You have no idea what’s in these drugs,” Yu said.

Jeremy Pawloski: 360-754-5465

jpawloski@theolympian.com