Recent heroin spike raises alarms

Manatee County EMS will host a town hall meeting at 2 p.m. Tuesday on the recent spike in heroin overdoses and how medical officials should treat patients.

The meeting will be held at the Public Safety Center, 2101 47th Terrace E., Bradenton.

“We received information from the sheriff’s office, they believe the heroin is being cut with Carfentanil (different than before),” county public safety official James Crutchfield wrote in a July 15 email to Melissa Larkin-Skinner, chief clinical officer of Centerstone Florida. “Prehospital treatment modalities are going to change due to this new information, and there is a high chance that the hospital treatment plans will need to change, too.”

Paul DiCicco, acting Manatee EMS chief, said the meeting will touch on upcoming changes in medical protocol that correlate with the county’s heroin issue. Representatives from local hospitals will be present.

“We may have a couple varieties (of heroin) that are out there right now based on the responses that we get from our patients,” DiCicco said. “Some patients take up to 2 milligrams of Narcan and some take up to 8 grams.”

Narcan nasal spray is a life-saving medication that can stop or reverse the effects of an opioid overdose.

“From our side, it seems like the overdoses have increased,” DiCicco said. “I wouldn’t quite say it’s at a crisis level, but we’re working very closely with the Manatee County Sheriff’s Office, Bradenton Police Department, cooperatively to try to do best for our patients.”

Last year, Larkin-Skinner said Manatee County has become the epicenter of the heroin problem in Florida.

July 2015 had been the worst month of the epidemic the sheriff’s office had seen, said Manatee County Sheriff’s Office Capt. Todd Shear. Emergency Medical Services administered 281 doses of Narcan, the opioid overdose antidote that Shear said can last up to 90 minutes.

But this month, with almost two weeks to go, the count has already surpassed last July’s: 289, as of July 13.

Controlled substances are divided into five categories, in order of most to least likely to be abused, according to the DEA. Heroin is a Schedule 1 narcotic since there is no accepted medical purpose for it and it’s highly addictive. Other Schedule 1 narcotics include LSD, marijuana and ecstasy.

But fentanyl, with which dealers are cutting heroin, is a Schedule 2 narcotic; dangerous and a high potential of abuse, but has an accepted medical purpose. In the same category as cocaine, Vicodin and Oxycontin, fentanyl is a synthetic opioid used for patients suffering from severe pain. It’s 100 times more potent than morphine.

Carfentanil is something the sheriff’s office is starting to see as well. The opioid, typically used in veterinary situations, is an analog to fentanyl and, according to Shear, it’s 100 times more potent than fentanyl and 10,000 times more potent than morphine.

“If you breathe it, you’re going to find yourself in some serious trouble,” he said.

Manatee County Sheriff’s Office spokesman Dave Bristow said the sheriff’s office found a very small amount of Carfentanil in some heroin recently.

“That’s the only sign of it that we know of. It’s much stronger than just regular fentanyl,” Bristow said, adding that it’s primarily used in the veterinarian field for large animals. “We’re concerned about people overdosing because, all of a sudden, we’ve had this recent trend. We’re concerned whether they are taking heroin, or heroin mixed with fentanyl, or heroin mixed with Carfentanil or whatever, people need to know if they take these drugs, they can die. We’ve put that out continuously in the last year and a half to two years... it’s not like it’s a big secret.”

This story was originally published July 18, 2016 at 5:34 PM with the headline "Recent heroin spike raises alarms."