Heroin Epidemic

Manatee is drug death capital of Florida

This map shows the fentanyl deaths per county per 100,000 people in 2015.
This map shows the fentanyl deaths per county per 100,000 people in 2015. 2015 Medical Examiners Commission Drug Report

While local law enforcement, health agencies and residents try to combat the epidemic of deaths caused by heroin and other opioids that has plagued the county for the past few years, a new Florida Department of Law Enforcement report shows that the war still isn’t over and that it continues to take a heavy toll.

According to the Medical Examiners Commission annual report, in 2015 Manatee County had the highest number of deaths per capita among Florida’s 67 counties in which the medical examiner found a presence of heroin, fentanyl, morphine or cocaine.

Last year, heroin was found at least partially responsible for 45 deaths in Manatee. Fentanyl was found in 77 cases.

Manatee was the only county last year that had between 20 and 24.99 deaths per 100,000 population involving fentanyl, a powerful pain medication that often is either cut with heroin or passed by drug dealers as being heroin. Sarasota County was the only county that had between 10 and 14.99 deaths. Twelve other counties had between 5 and 9.99 deaths, and the rest of Florida’s counties had between 0 and 4.99 deaths.

Through death investigations, Dr. Russell Vega, the medical examiner for District 12 including Manatee, Sarasota and Desoto, found that last year the three counties had the highest number of fentanyl-related deaths in the state. Fourteen were fentanyl-only deaths and 108 were deaths caused by fentanyl combined with other drugs.

Manatee in 2014 earned the ignoble designation of being the epicenter of the heroin epidemic when the medical examiners report showed it was the only county within the range of the highest numbers of deaths per 100,000.

This year, the county was joined in the grouping by Palm Beach County.

In Manatee and Palm Beach, there were between 10 and 14.99 heroin-related deaths per 100,000 population. Six other counties had between 5 and 9.99 deaths, and each of the rest of the state’s counties had between 0 and 4.99 deaths.

District 12 has seen a huge spike in heroin-related deaths since 2013, when there were 19 deaths. The next year, there were 55, and in 2015 there were 68.

Morphine also took a heavy toll in Manatee in 2015. The county had the highest death rate, between 20 and 24.99 per 100,000 population. Only two other counties had rates as high as between 15 and 19.99.

Vega said the presence of morphine actually indicates possible heroin use.

“Many instances of morphine that are found represent heroin abuse that has had the chance to mature in the body,” Vega said.

Medical examiners are able to tell real morphine from heroin-metabolized morphine by testing for an intermediate component in the urine, but Vega said he suspects a lot of the morphine found in bodies in the district is actually metabolized heroin.

Local law enforcement are not reporting finding morphine in any of their investigations.

“Our still biggest concern is fentanyl and carfentanil,” Bradenton Police Lt. James Racky said.

Carfentanil is a synthetic form of fentanyl that officials are starting to find in local drug cases. Carfentanil — which is 10,000 times more powerful than morphine — is a large animal tranquilizer that is generally used to subdue exotic animals such as rhinos, elephants and hippos.

While deaths as a result of morphine are also concerning, fentanyl’s and carfentanil’s potency make them a top priority.

“We are pursuing the traffickers, but you have to have the education for it and you have to the treatment for it,” Manatee County Sheriff’s Office spokesman Dave Bristow said. “It had to get better after this summer, and it has gotten better. Hopefully, it will continue a downward spiral.”

As for cocaine, Manatee County was the only one in Florida that recorded more than 25 deaths per 100,000 population. Only four other counties had rates as high as between 15 and 19.99 per 100,000 population. District 12 also saw a 62.7 percent increase in cocaine-related deaths, half of which were in Manatee.

The re-emergence of cocaine is no surprise to local law enforcement.

“Cocaine has always been on the radar. Cocaine never went away,” Bristow said. “We have been seeing cocaine in this community since the mid-80s, since the rise of crack cocaine hit the streets and hit it with the vengeance.”

Vega said his office has been investigating cocaine-related deaths for a while.

“Even though heroin and fentanyl have really grabbed the headlines because of their meteoric rise ... cocaine has not gone away,” Vega said.

With the rise of the heroin and fentanyl epidemic, however, law enforcement has found that drug dealers are willing to cut anything into the supply in order to boost their profits

“Whatever they can get their hands on, they are cutting into the heroin supply,” Racky said.

Statewide, drug-related deaths rose by 13.9 percent and heroin-related deaths overall increased by a staggering 79.7 percent.

The drug-related deaths don’t seem to be going down. The Bradenton Herald reported that the District 12 medical examiner’s office has performed a record number of autopsies in part due to the spike on heroin- and fentanyl-related overdoses. Last year, the District 12 office performed a total 820 autopsies for the three counties, where 397 of those were in Manatee County. The average is from 625 to 650 per year.

So far this year, the medical examiner’s office has performed 310 autopsies for Manatee.

“It’s not something we want to be proud of,” said Manatee County Commissioner Carol Whitmore, a nurse who also is a member of the Medical Examiners Commission.

Whitmore thinks part of the problem is with the current method of treating addiction and overdose patients.

She said she has heard emergency room horror stories of patients needing to be revived from overdoses with three doses of Narcan, an opioid antidote. While the Baker Act allows an authoritative eye on patients who seem to want to harm themselves, Whitmore said most overdose patients aren’t able to be considered for it because it was an accident.

Many times, patients come right back to the hospital after another overdose.

“I think there’s a loophole there,” she said.

Hannah Morse: 941-745-7055, @mannahhorse

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