MANATEE -- More than 150 people will have died from a heroin overdose in 2015 in Manatee-Sarasota, doubling heroin overdose deaths in 2014, officials estimate. But those numbers don't surprise anyone familiar with the area's heroin epidemic.
There were 81 confirmed deaths from heroin and fentanyl through August 2015 in Manatee, said Dr. Richard Vega, medical examiner of the 12th Judicial District. There were 30 deaths in Sarasota County, and another 134 pending drug overdose cases through mid-December in both counties. Though it's difficult to make predictions on how much of that is heroin and fentanyl, Vega said it's at least 50 percent.
"It's almost a certainty that it will be more than 150 deaths in 2015," Vega said.
That's up from 63 overdose deaths in 2014, 19 in 2013 and eight in 2012. The heroin epidemic in Manatee County started in spring 2014, when law enforcement first started seeing fentanyl, a painkiller about 80 to 100 times more potent than morphine, enter the local supply.
But community advocates warily hope that the heroin epidemic's grip on Manatee is loosening. Since July, fatalities have been decreasing -- and officials say public awareness, community efforts and law enforcement are working together to drive those numbers down.
Brandilyn Karnehm, a recovering opioid addict who has been clean for almost three years, warns that it could just be temporary luck. She remembers the quality of street drugs was always changing, strong for a few weeks and weak the next.
"The batches change all the time," Karnehm said. "A month straight it would be really good, then next month it could be garbage."
The record-breaking statistics have medical, law enforcement and addiction treatment officials on edge, hoping the decline in deaths continues. Other statistics reflecting the fallout of the heroin crisis continue to plague the area.
Overdose calls in Manatee County increased to 1,299 through November 2015, up from 700 in 2014 and 325 in 2013.
Child protective services removed 568 children in Manatee through November 2015, and half of those were due to substance abuse. There were 387 children sheltered in 2014 and 179 in 2013.
The Manatee County Sheriff's Office seized 2,328.7 grams of heroin through November 2015. They seized 296.6 grams in 2014 and 25.7 grams in 2013.
The Manatee County Sheriff's Office has arrested 70 people in 2015 on charges related to selling heroin, half of those trafficking charges. The Palmetto Police Department made four heroin-related arrests and the Bradenton Police Department made several as well.
And it isn't just Manatee and Sarasota. Nationwide, heroin-related deaths increased 286 percent between 2002 and 2013, from about 70,000 deaths to about 270,000, according to the Centers for Disease Control.
But after more than a year of bad news, there's reason for optimism in Manatee: Deaths and overdose calls have been decreasing since July, with a significant dropoff in October and November. The spike of overdose calls hit 281 in July, according to figures from emergency medical services, and dropped to 41 in October and 64 in November. Those numbers are even lower than overdose calls in 2014, when there were 77 calls in October and 113 in November.
"It's still a problem -- we've gone from having about 12 a day to two a day," said Steve Krivjanik, chief of Manatee County EMS. "We're not seeing as much fentanyl, and that's from the hospitals, and I really believe law enforcement had a big impact on that."
Though he doesn't have specific numbers yet for October and November, Vega said he believes fatalities decreased in those months as well.
"Our overall caseload in October and November has gone down," Vega said. "And thank God, because we needed a slowdown. And a decrease in suspected drug overdose deaths has definitely played into that."
Capt. Todd Shear, of the Manatee County Sheriff's Office, said public awareness, community efforts and law enforcement have worked together to drive those numbers down. The sheriff's office received 171 tips from the community this year regarding fentanyl and heroin activity.
Detectives put months, sometimes more than a year, of work into operations designed to hit suspected dealers with effective charges that would result in a high bond, keeping dealers off the streets. They especially prioritized heroin mixed with fentanyl.
"If we have intelligence that a dealer is one of those automatically mixing fentanyl in to the heroin, then they're going to be high on our priority," Shear said. "So as you see some of the arrests we've made, there's fentanyl there, those folks are being put in jail. And coincidentally you're not seeing as much fentanyl-laced heroin."
High demand for help
But while targeting fentanyl seems to have resulted in a decreasing number of deaths and overdoses, it hasn't meant that other problems associated with drug use have evaporated. Maj. Connie Shingledecker, of the Manatee County Sheriff's Office, said they haven't seen the same decrease in the number of children they've had to shelter because of parents' substance abuse.
October was the second-highest month for the number of children sheltered in 2015, at 75. It trailed only behind July, when Child Protective Services sheltered a record 77 children. November saw 67 children sheltered.
"I think we've controlled the fentanyl, but not heroin," Shingledecker said.
Melissa Larkin-Skinner, chief clinical officer at Centerstone, a mental health and addiction treatment center formerly known as Manatee Glens, agrees that the problem still plagues the community. Demand for Centerstone's addiction services has continued to increase.
That could be a good thing, Larkin-Skinner said, because it could mean that more existing addicts are willing to seek treatment, rather than more people becoming addicted.
"We should be referring to them as people who have an addiction, like people who have diabetes or have cancer. It will go a long way towards changing the attitudes, because I think if you change your language, it changes your attitude over time," Larkin-Skinner said. "And that's what we need, because people are afraid to get treatment because they're afraid people will think poorly of them, when what we should be doing is encouraging them when they seek treatment. We should be telling them, 'That's a really great decision, I'm 100 percent behind you.'"
Demand in the past six months compared to last year has doubled for medication-assisted treatment, which provides certain medications to addicts to reduce drug cravings; increased 13 percent for residential treatment, which houses addicts at Centerstone for about a month to teach them life skills to stay clean; increased 9 percent for outpatient services, which provides therapy and group classes to addicts who live outside the campus; and increased 44 percent for partial hospitalization, which has addicts come to Centerstone for five hours per day as a less intense form of residential treatment. Larkin-Skinner said other addiction treatment centers in the area have seen increases as well.
Making change happen
Public awareness and a community that cares about each other are propelling a major change in the heroin landscape in Manatee County, officials say. The Bradenton Herald published a comprehensive series on the heroin epidemic in June; task forces have been formed to discuss ways to combat the problem; a group called No Longer Silent was created to support family members of those lost to addiction; and Drug Free Manatee, formerly known as the Manatee County Substance Abuse Prevention Coalition, is working to remove the stigma against addicts so they'll be more inclined to seek help.
Not even counting its impact on deaths, lifting the stigma is significantly helping families. Every overdose death leaves behind numerous family and friends in grief, some too ashamed to admit that their loved one died of a drug addiction. But more and more people, such as Kristen Vollick, a Manatee native who lost her cousin Bobby Lee to a fentanyl overdose, have come forward as the public recognizes addiction as a disease.
"I didn't know how large of a scale it really was, how many people are affected. It's all kinds of people, whether you're white, black, Chinese, no matter what race, religion or what background you come from -- you can be the wealthiest family or the poorest family -- it doesn't play favorites. And it's ruining families," Vollick said. "And I think if one person could be saved, then I think it's worth it.
"It's hard to talk about Bobby, it's hard to think about it," she said. "But I really believe if his story could save somebody else or bring national attention to this problem, then maybe it could get something done."
Efforts by Drug Free Manatee have included the Your Life Matters cards, which encourage addicts to seek treatment, and the Good Samaritan cards, which explain that Florida law states that people who call 9-1-1 for an overdose will not be charged with a crime if drugs are found on the scene.
"We've been partnering with the substance abuse coalition and the information we've put out through them ... has been working," Manatee County Sheriff Brad Steube said. "I know for a fact that those cards have prevented at least one overdose death."
Steube, who has years of experience in the narcotics unit and used to be its commander, believes their key strategies -- targeting dealers and avoiding arresting addicts, instead encouraging them to seek treatment -- have been working.
"I think we're doing everything that we need to be doing. We had a terrible, terrible problem here. We'd have three or four calls a day and we're not seeing it anymore, thank goodness," Steube said. "We still have some, but we've made significant progress."
Kate Irby, Herald online/political reporter, can be reached at 941-745-7055. You can follow her on Twitter@KateIrby