For the past week, the the city of Cincinnati has been battling an unprecedented spike in heroin overdoses that has left police and emergency responders drained. Per the Cincinnati Enquirer, in a "normal" week, police and healthcare officials indicate that Cincinnati encounters roughly 25-30 heroin-related overdoses. That said, within the past 6 days that number has spiked by over 5.5x as 174 overdose cases have been reported by local emergency rooms.
Given the sudden spike in overdoses, local police authorities speculate that the heroin supply has likely been cut with a potent painkiller called fentanyl or the mega-potent animal opioid Carfentanil. Carfentanil, an analgesic for large animals including elephants, is about 10,000x stronger than morphine and was discovered in July in the region's heroin stream. Police are still working to find the source of the deadly heroin supply. Per Cincinnati Enquirer:
“These people are intentionally putting in drugs they know can kill someone,” Synan told WCPO. “The benefit for them is if the user survives, it is such a powerful high for them, they tend to come back. … If one or two people die, they could care less. They know the supply is so big right now that if you lose some customers, in their eyes, there’s always more in line.”
"We're working very closely to find the source dealer," said Newtown Police Chief Tom Synan, who heads the law enforcement task force for the Hamilton County Heroin Coalition. He said local, state and federal authorities are combining their forces to investigate the source or sources. "We don't have anything solid to go off of."
"This is unprecedented to see as many alerts as we've seen in the last six days," said Hamilton County Health Commissioner Tim Ingram. He was referring to a surveillance system that alerts the public health department when an unusual number of drug-related emergency-room encounters occur.
"We can’t confirm in the short term if someone’s had fentanyl, carfentanil or heroin – the tests flag only as positive or negative for opiates," said Nanette Bentley, spokeswoman for Mercy Health. Tests could be ordered, but results could take days to weeks to come back, she said.
Further complicating matters is that Narcan, the nasal-spray version of the drug Naxolone, which reverses the side effects of an overdose, is not working anymore, at least not as reliably. Usually one or two doses of Narcan will stabilize a patient but doctors say that patients under the influence of Carfentanil can require up to 5x the normal dosage.
While it's still unclear which drug may be causing the spike in overdoses, drug enforcement officials are quite confident the source supply is flowing in from overseas.
There's no telling whether carfentanil is the drug that was sold to the overdose victims, but investigators believe it's a possibility.
If that's a question, the drug could be identified by Drug Enforcement Administration lab tests, however, said Melvin Patterson, a DEA spokesman in Washington, D.C.
The DEA has been on alert for the animal opioid since its appearance in U.S. and at the Canadian border.
There's little doubt that the carfentanil that's showing up in street drugs is from overseas, just as fentanyl is manufactured and brought across the U.S. borders, Patterson said.
"It's such a restricted drug there's only a handful of places in the United States that can have it," he said.
This rising crisis comes as many states across the country are pushing ballot measures to legalize marijuana use. Several studies over the years have linked marijuana use to more dangerous drugs like methamphetamine and heroin earning it the title of the "gateway drug." Robert L. DuPont, President of the Institute for Behavior and Health and the first director of the National Institute on Drug Abuse, recently pointed out the flawed logic of legalizing marijuana use in an article published in the New York Times.
It should come as no surprise that the vast majority of heroin users have used marijuana (and many other drugs) not only long before they used heroin but while they are using heroin. Like nearly all people with substance abuse problems, most heroin users initiated their drug use early in their teens, usually beginning with alcohol and marijuana. There is ample evidence that early initiation of drug useprimes the brain for enhanced later responses to other drugs. These facts underscore the need for effective prevention to reduce adolescent use of alcohol, tobacco and marijuana in order to turn back the heroin and opioid epidemic and to reduce burdens addiction in this country.
People who are addicted to marijuana are three times more likely to be addicted to heroin.
The legalization of marijuana increases availability of the drug and acceptability of its use. This is bad for public health and safety not only because marijuana use increases the risk of heroin use.
The aggressive commercialization of marijuana that is now rampant and still growing is particularly damaging to the public health because it markets marijuana and an array of increasingly potent products in ever more attractive ways that encourage marijuana use and frequent highdose THC use.
We are at a crossroads. Legalizing marijuana will have lasting negative effects on future generations. The currently legal drugs, alcohol and tobacco, are two of the leading causes of preventable illness and death in the country. Establishing marijuana as a third legal drug will increase the national drug abuse problem, including expanding the opioid epidemic.
Of course, DuPont's concerns about the negative health effects of marijuana and opioids doesn't even touch upon the staggering spikes in violent crime that follows the distribution chain of these drugs in our inner cities. One has to look no further than Chicago for evidence of how quickly violent crime in a city can spiral out of control.