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Spike in overdose deaths in Stamford points at fentanyl

March 25, 2018 GMT

STAMFORD — Jessica Anderson became an emergency medical technician because she wanted to help people.

But as drug overdoses continue to rise locally, and across the nation, Anderson said it can feel like working in a “revolving door.”

“It can be very frustrating, especially when you’re responding to the same person and the same situation over and over again,” said Anderson, a Stamford EMS paramedic. “You bring this person back, you hope they’ll get help and maybe they do, but a month or two later, we’re right back where we started and we’re trying to save that person again.”

Then there were times Anderson arrived at a scene only to find it was too late — nothing could be done.

“I feel for the family because they are left with all these unanswered questions,” she said. “And there are times when maybe I’ve questioned myself — did I do enough? Was there something I missed? But in the end, all I can do is clean up and get ready for the next call.”

With the rise of opioid abuse, and especially synthetic opioids such as fentanyl, recently released data from the Office of the Chief Medical Examiner shows fatal overdoses have steadily increased in Connecticut. The data shows many of those deaths are occurring in Connecticut’s bigger cities, including Stamford.

The data showed there were 16 fatal overdoses in Stamford in 2017. Two more Stamford residents died of overdoses in Bridgeport last year. Almost all who died, had multiple drugs in their systems.

Of those 18 deaths, 13 involved fentanyl, eight involved heroin and six involved a mixture of opiates and benzodiazepines — medications often used to treat anxiety.

The youngest victim was a 20-year-old Stamford woman who overdosed on a mixture of fentanyl, heroin and other drugs at a friend’s house in Bridgeport. The oldest victim was a 60-year-old New Haven man who died at a Stamford residence after mixing alcohol, fentanyl and morphine with other drugs. A majority of those who died were white males between the ages of 35 and 55.

“A lot of the people that are overdosing lead very transient sort of lives,” said Capt. Richard Conklin, commander of the Stamford Police Bureau of Criminal Investigations. “When you become addicted to heroin or opiates, it becomes your life. So, you go where the drugs are more available, and unfortunately, we have an ample supply here in Stamford, just like Bridgeport or Norwalk or New Haven and all the other larger cities.”

By the numbers

Data from the Centers for Disease Control and Prevention show that from 2015 to 2016 there were significant increases in overdose death rates in the Northeast, Midwest and South. Connecticut was among those 26 states that saw an increase.

In 2016, the most recent year for which data was available, the CDC said, the five states with the highest fatal overdose rates were West Virginia, Ohio, New Hampshire, Pennsylvania and Kentucky.

Per 100,000 people, West Virginia’s 2016 rate was 52, Ohio was 39.1, New Hampshire was 39, Pennsylvania was 37.9 and Kentucky was 33.5.

The rate for Connecticut, based on the 2017 data, was 28.93 per 100,000 people.

With numbers dating back to 2012, when there were 357 fatal overdoses in Connecticut, the medical examiner’s data shows a steady increase each year.

Population a factor

John DeCarlo, an associate professor of criminal justice at the University of New Haven and former Branford police chief, said population is only one piece of the puzzle.

“There are socioeconomic factors that exist in these cities and towns,” he said. “Crime and drug use are usually centered in higher populations and poorer areas, which is what we often see in cities.”

“Where there are more people, it follows that there would be more accidental deaths,” he added. “Basically, the higher the population density, the more things you’re going to have — whether you’re talking about cars, crime or overdoses.”

Though more overdoses may occur in bigger cities, Dr. Ofer Wellisch, chief of Pain Medicine at Stamford Hospital, said the opioid epidemic is also hurting rural areas.

“This has not been just an urban type of phenomenon,” he said. “Really, where overdoses have been most prevalent has been in the more rural areas like the Midwest. But it’s obviously also an issue here, and there’s been an even greater issue with opioids here now that there’s been an influx of fentanyl-type products on the streets.”

Fentanyl, benzos add to problem

Fentanyl is a highly potent synthetic opioid that is typically used to treat chronic discomfort and advanced cancer pain. According to the Centers for Disease Control and Prevention, fentanyl is up to 100 times more potent than morphine and many times that of heroin.

Made in clandestine labs in China, fentanyl’s increasing prevalence has sent overdose numbers skyrocketing in recent years.

Drug users generally don’t know when their heroin is laced with fentanyl, Conklin said. So when they inject their usual quantity of heroin, they can inadvertently take a deadly dose of the substance.

Dealers add fentanyl to their heroin to improve potency. However, the fentanyl sold on the street is not controlled, making its potency and purity unpredictable. And, because heroin and fentanyl look identical, Conklin said “you don’t know what you’re taking,” when purchasing these drugs on the street.

But fentanyl isn’t the only problem.

Conklin said benzodiazepines — or benzos — have increasingly contributed to overdose deaths in Stamford. Benzodiazepines, such as Xanax or Ativan, are typically prescribed to treat anxiety.

“A lot of these deaths that we’re seeing now are associated with using opioids and other types of drugs together,” Dr. Wellisch said. “And, many of these overdoses involve mixing opioids with benzodiazepines. The mixture of benzodiazepines and opioids makes the respiratory suppression and the sedation more significant, which is why mixing the two can become more of an issue.”

Conklin said the potent mixture of fentanyl and benzodiazipines is hampering first responders’ efforts to save overdosing patients.

Narcan: A miracle and crutch

Opioid overdoses have become so prevalent across the country that most first responders are now armed with kits containing Narcan, a brand name of the opioid overdose antidote.

“Narcan is a marvelous, miracle-type drug, that has saved countless people,” Conklin said. “But unfortunately, it has also been a curse.

“What we’re now seeing is that addicts are using Narcan as a crutch,” he said.

Too many times when talking to addicts, encouraging them to get help and warning them of eminent overdose and death, Conklin said the response has been “no, they’ll just give me ‘the can.’”

“‘The can’ — that’s what they call Narcan,” he said. “They think the Narcan will save them, but it’s not guaranteed.”

Narcan is limited in what it can do, Conklin said. The drug has proven less effective in overdoses involving fentanyl, which often require EMS to administer multiple Narcan doses to revive a patient. Additionally, Narcan was designed to treat opioid overdoses, making it ineffective when dealing with benzodiazepine toxicity.

Conklin said many addicts are now carrying their own Narcan, “but they are still dying.”

“We’ve seen so many overdoses who have died and their Narcan was maybe 10 feet away from them, but they were so high or so incapacitated, they couldn’t get to it or they couldn’t administer it to themselves,” he said. “And a number of those we’ve seen brought back by Narcan have already been brought back two or three times before. It’s really sad to see.”

Staff writer Tara O’Neill contributed to this story.