26 overdoses in just hours: Inside a community on the front lines of the opioid epidemic

Huntington, West Virginia – Official Sean Brinegar came home first – “people come here and die, “the 911 caller had said – and found a man and a woman in panic. Two people died inside, they said.

Brinegar, 25, has been on the force of the Appalachians in this city for less than three years, but as heroin has increased, has seen more than its fair part of overdose . So on Monday, he grabbed a double pack of naloxone his equipment bag and headed inside.

A man was on the floor of the room, her slender body abscesses bluish purple skin and a strong history of drug use. He was dead, he thought Brinegar, so the officer turned his attention to the woman in a bed. I could see his chest rising, but did not get an answer when the knuckle is dug in his sternum.

Brinegar gave women injected a dose of naloxone, an antidote that can boost the breath of someone who has taken an overdose of opioids, and returned to the man. The man sat in response to Brinegar knuckles on the breastbone – that was alive after all – but it started to happen again. Brinegar gave the second dose of naloxone.

Maybe on an average day, when this Ohio River town of about 50,000 people seen two or three overdoses, which would have been the same. But on this day, the calls kept coming.

Two other heroin overdose in that house, three people found in the surrounding courtyards. Three overdose in nearby public housing complex, two on the hill from the resort.

From about 15: 30-19: 00, 26 people overdosed in Huntington, half of them in and around the apartment complex Marcum terrace. The barrage busy all ambulances in the city and more than worthy of a shift of police officers.

At the end of it, however, all 26 people were alive. Authorities attributed the successful cooperation between local authorities and the sad reality that are well practiced, to respond to overdoses. Many officials did not seem surprised by the concentrated peak.

“It was like any other day, just more of the same,” said Dr. Clay Young, a doctor of emergency medicine at the Cabell Huntington Hospital.

But tragic news came. Around 8 p.m. paramedics responded to a report of a cardiac arrest. The man died later in the hospital and only then were officials said he had overdosed. On Wednesday, authorities found one person dead of an overdose in Cabell County and elsewhere think that death could have happened on Monday. They are investigating whether those overdoses are linked to the other, making them potentially Nos. 27 and 28.

Perhaps the rash of overdose was caused by a particularly powerful batch of heroin or a shortage of the drug in the days beforehand weakened tolerance of people.

However, police suspect that heroin was here mixed with fentanyl , a synthetic opioid that is many times more potent than heroin. A wave of fatal overdose of fentanyl marked the arrival in Huntington in early 2015, and now some stashes of heroin laced with fentanyl is not, but “heroin mixed with fentanyl,” said Police Chief Joe Ciccarelli.

Another possibility is I carfentanil , another synthetic opioid, it is used to sedate elephants. Police drugs either do not recover overdose, but toxicology tests could provide answers deaths.

Heroin Huntington WV
A home in the area where 13 people overdosed last Monday.

A city with battle scars

In a way, what happened in Huntington was as nondescript as the jets in overdoses that have occurred in other cities. This year, I carfentanil fentanyl or killed a dozen people Sacramento nine in Florida, and 23 people in about a month in Akron, Ohio. The list of cities follows: New Haven , Conn;. Columbus , Ohio; Barre , Vt.

But what happened in Huntington stands out in other ways. a mysterious potential to release large-scale trauma and overwhelm emergency response substance of a city stresses. And it suggests that a community that is doing all the right things to combat a scourge worse still can get knocked back by it.

“From a policy perspective, we’re throwing everything we know about the problem,” said Dr. James Becker, Vice Dean of government affairs and policies of health care in the medical school University Marshall here. “And yet, the problem is one that takes a long time to change, and probably will not change for a while.”

surrounded by hills full of lush trees, Huntington is one of many fronts in the fight against an epidemic that is opioid killing nearly 30,000 Americans one year. But this city, the state and the region are among the most battle scars.

West Virginia has higher rate fatal overdose of any state and higher rate of babies born dependent s of opioids among the 28 states that report data. But even compared to other communities in West Virginia, Huntington sees above-average rates of heroin, overdose deaths and newborns dependent on drugs. Local authorities estimate that up to 10 percent of residents use opioids improperly.

The heroin problem came about five years ago, when authorities across the country cracked down on the “pill mills” that send pain medication in communities; officials here specifically point to a Florida law 2011 that stopped the flow of pills in the area of ​​Huntington.

As the pills became more difficult to obtain and more difficult to abuse, people turned to heroin. It has devoured many communities in Appalachia and beyond.

In Huntington, law enforcement initially took the lead, with police arresting hundreds of people. They seized thousands of grams of heroin. But he was not making a dent. Thus, in November 2014, local leaders established an office of drug control policy.

“As far as number of arrests and seizures, which were before the game, but our problem was getting worse,” said Jim Johnson, director of the office and a former police Huntington. “It became very clear that if we do not work on the demand side as hard as the supply side, which is never going to see any success.”

The office brought together police, health officials, community and religious leaders, and experts from Marshall to try to address the program together.

Changes in state laws have opened naloxone distribution for public and protected persons who report overdoses. But the city and its partners have gone further, deploying programs through the municipal court system to encourage people to seek treatment. A program is designed to help women working as prostitutes to feed their addiction. Huntington has eight 28-bed detoxification medical assistance from the state, and it’s always busy.

In addition, in 2014, a call center Lily Huntington Place opened to wean babies from drugs. Last year, the local health department first launched needle exchange this conservative state. The county health officials know, is at risk of outbreaks of HIV and hepatitis C because of shared needles, so they are trying to get ahead of the crisis seen in other communities affected by addiction .

“Huntington just happens to have assumed the responsibility for the problem, and very brave … initiated some programs that have been models for the rest of the state,” said Kenneth burner, the coordinator of West Virginia Areas for High Intensity Drug Trafficking Appalachians program.

‘A revolving door “

As paramedics in the area have it carried naloxone for years, was this spring that police officers Huntington were equipped with it. Only a few officers have it administered, but Monday was the third time Brinegar reactivation of overdose victims with naloxone.

paramedics who try to revive first victims by pumping air with a bag through a mask, had to administer another dose of naloxone 10 Monday. Three doses were a person, said Gordon Merry, director of Cabell County Emergency Services. During the response, ambulance stations outside Huntington were called to the city to attend eight or more response teams already deployed.

Feliz was clearly proud of the response but also frustrated. I was tired, he said, people to emergency teams revived going back to drugs. Due to the power of their disease, saving his life did not get to the root of their addiction.

“It’s a revolving door. we’re not solving the problem beyond reviving them,” he said. “We took 26 people another chance in life, and hopefully one of the 26 going to seek help.”

Part of the city where he spent half of overdoses, some homes are well kept, with gardens, bird feeders, and waving American flags. “Home Sweet Home”, read an article wood engraving above a door; on another front yard, a wooden sculpture presents a bear with a fish with “Welcome” written across his body.

However, many structures are decrepit and have their windows covered with cardboard and sheets. In a sealed house, metal slats that once formed a projection for the porch separated and deformed as it collapsed like crooked teeth. In the plywood covering a window frame had a message written in green dots: GIRL SCOUTS RULE

in and around the public housing complex, which consists of squat brick buildings of two floors tilted up. a hill, people either said they did not know what had happened Monday or the “underworld” in another part of the complex caused the problem. Although paramedics were responding to overdoses, police began to raid homes as part of their research, including apartments in the complex, the chief said.

Just up the hill, a man named Bill was sitting in a recliner on her porch with her cat. He said he saw police outside the area on Monday, but does not pay much attention to more overdoses. They are so frequent.

Bill, who retired, asked to be identified only by his first name because he said he has a son in law enforcement. He has lived in this house for five decades and began blocking its door only in recent years. the house of his neighbors had broken, and had seen people who use drugs in cars on the street of your home. Called police sometimes said, but users always gone by the time police arrived.

“I hate to say this, but I know, I would die,” Bill said. “If they knew that nobody was going to revive them, maybe they would not have an overdose.”

Even in this case, where addiction had touched so many lives, is not an uncommon feeling. Addiction is still seen by some as a poor personal choice made by bad people.

“Some people in the community not simply care” that 26 of his fellow residents to death, said Matt Boggs, executive director of the recovery point.

Point Recovery is a program of long-term recovery that teaches “clients” to live a life without drugs or alcohol. Boggs himself is a graduate of the program, funded by the State and donations and grants.

Customers living in rooms with bunk beds at the facility for an average of more than seven months before graduation. The program says that about two-thirds of graduates stay sober in the first year after graduation, and about 85 percent of those people are sober after two years.

Local authorities laud recovery point, but like many other recovery programs, is limited in what it can do. It has 100 beds for men in their location in Huntington, and is expanding to other sites in the state, but Boggs said there is a waiting list of a couple hundred people.

Mike Thomas, 30, graduated from the main part of the program a month ago and is working as a peer mentor there as you transition out of the installation. Thomas has been clean since October 15, 2015, but has dreams of getting high or surprises himself thinking that could save $ 100 from his bank account to drugs.

Thomas hopes to find a full time job to help addicts. Their own recovery will be a lifelong process, one that can be torn by a single bad decision, he said. He will always be in recovery, never recovered.

“I’m not cured,” he said.

Heroin Huntington WV
Mike Thomas, 30, is a recent graduate of recovery point program and is now working as a mentor there.

A murderer does not discriminate

As heroin has bleeding in communities across the country, has spread beyond the spotlight common drug in cities. On a map of Huntington drug in 2004 – at the time, most crack cocaine – a few blocks from the city glow red. Almost the whole city is lit in yellow and red on the map of 2014.

In 2015, there were more than 700 drugs called overdose in Huntington, ranging from children in their early teens to seniors in their late 70s in 2014, it was 272 calls; in 2012, 146. A positive point :. fatal overdoses, which stood at 58 in 2015, has scored so far this year

“I used to be able to say, ‘We need to focus here,'” said Scott Lemley, an analyst with criminal intelligence the police department. “I can not do this.”

Heroin has not only geographical barriers dismantled. It has infiltrated every demographic.

“It does not discriminate. Prominent businessmen, his son. The police, his son. Doctors, their children,” Feliz said. “The businessman and officer did not have his child.”

The employer is Teddy Johnson. His son, Adam, died in 2007 when he was 22, one of a dozen people killed in five months due to an influx of black tar heroin. The drug had not done all his resurgence in the region yet, but now, Johnson sees the drug that killed her son everywhere.

Heroin Huntington WV

Heroin Huntington WV
Teddy Johnson lost his son, Adam, in 2007 to a heroin overdose. It has several tattoos dedicated to the memory of Adam.

He has a plumbing business, heating and kitchen accessory and remodeling. From his window, which has seen offers through the street.

Adam, who was a student at Marshall, was a musician and artist who organized radio programs. It was the life of any party, his father said.

Johnson was to describe Adam as he sat on the marble top of a kitchen model in its business last week. With photos of their children on the counter, it felt like a family home. Johnson explained how he still had Adam’s bed did, how your child’s room remained the same, and then began to mourn.

“The biggest star in the sky that we say is the star of Adam” he said. “When we’re in the car – and can not be this way – but always seems to be in front of us and guide us.”

tomb of Adam is on top of a hill near the monument to the 75 people – soccer players Marshall, staff and fans – who died in a plane crash 1970 . It is a beautiful place that Johnson visits a few times each week, bringing flowers and cutting the grass around the grave of her son. a note that there are a couple of Johnson knows that just lost her son to an overdose recently left; they were asking Adam to look out for her son in heaven.

But even here, in what should be a respite, Johnson can not escape what took her son. He said he has seen happen in the cemetery offers, and recently found a burned spoon no more than 20 feet from the grave of her son.

Heroin Huntington WV
Johnson keeps fresh flowers on the grave of his son and cut the grass around the same grave.

“I’ve just seen too much of it,” he said.

If Huntington does not have a handle on heroin, at least, initiatives are helping officials understand the magnitude of the problem. More than 1,700 people have come through the exchange of syringes since it opened, where they receive a medical evaluation and learn about recovery options. The exchange is open one day a week, and in less than a year, has distributed 150,000 125,000 clean needles and syringes received.

But to grow and maintain their programs, Huntington needs money, authorities said. The community has received federal, state subsidies and officials know they have a problem. However, economic losses and the collapse of the coal industry that fed the drug epidemic have also depleted state coffers.

“We are ready to launch programs and do not have the resources to implement them,” said Dr. Michael Kilkenny, medical director of the Department of Cabell-Huntington Health. “We’re throwing without resources, because our people are dying, and we can not tolerate that.”

In a way, it is a kind of Huntington. Has a university faculties of medicine and pharmacy enlisted to help, and office and police department a mayor collaborating with public health officials. But what makes then advertise for other communities?

“If I feel worried about what happens in Huntington and in Cabell County, I can not imagine what it must be like to live in one of these other counties at risk in the United States, where not all people have resources, they do not have people thinking about it, “said Dr. Kevin Yingling, the dean of the Faculty of Pharmacy at the University of Marshall.

Yingling, Kilkenny, and others gathered on Friday afternoon to discuss the situation in Huntington, including the eruption of overdose. But by then, already it existed a different incident to discuss.

A car had hit a tree before the evening in Huntington. A man in the driver’s seat and a woman in the passenger seat had both an overdose and naloxone is needed to be reactivated. A preschooler girl was in the back seat.

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