Overdose Capital of the U.S.

"Heroin is the devil's drug, man. It is."
"No one wants their family to find them face down with a needle in their arm."
"But no one stops until they're ready."
Cliff Parker, 24, heroin user, Akron, Ohio

"July 5, 2016 -- that's the day carfentanil hit the streets of Akron."
Captain Michael Shearer, commander, Narcotics Unit, Akron Police Department

Drugs seized by Montgomery County (Ohio) Sheriff's officers  (Montgomery Sheriff's Office)

Akron, Ohio got their initiation into the devastating effects of a powerful sedative used to sedate huge beasts like elephants, when it appeared on their streets likely sourced from China through the Internet and being used to adulterate more expensive drugs for higher profitability. People using illicit street drugs looking for a kick, and a high more dramatic than the ones they'd become accustomed to and were dissatisfied with, began to get more than they'd bargained for.

On the day that Captain Shearer was commemorating with huge regret, 17 people overdosed, with one of them dying over a tortuous nine hours. The following six months saw 140 overdose deaths of people testing positive for carfentanil, verified by the county medical examiner. With fentanyl, the still-highly-dangerous but more moderate of the two drugs and carfentanil, overdoses can present as sufficiently severe that even multiple doses of naloxone -- the anti-overdose medication -- can barely rescue people from death.

Fentanyl has been around for awhile. Its legitimate use in the medical community is that of a pain reliever. It is commonly prescribed in amounts carefully judged by those skilled in pain management for people suffering pain. It is also used in hospital settings during surgery and following surgery to help manage the pain that accompanies surgical intervention and its follow-up recovery. As such its use is monitored and carefully gauged and stopped once its work is deemed to have succeeded.

But it is also a drug that has been seen more and more frequently during drug seizures over the past three years across North America. Most frequently fentanyl is sold as heroin on the street. Alternately drug traffickers make use of it to produce cheap counterfeit prescription opioids. Its cousin carfentanil is 5,000 more powerful than heroin, and it is well known that a few grains of the drug can be lethal.

Lisa Roberts gives a naloxone auto-injecter to a group of women who live under a bridge in Portsmouth, Ohio. (Jon Castell/CBC)

So much so that the requirement of multiple applications of naloxone to save a life has become common. Rescue crews (first-responders) "are hitting them with 12, 13, 14 hits of Narcan with no effect", observed Doyle Burke, the chief investigator at the Warren County coroner's office in Ohio. And this situation is only  going to become more common, with overdose deaths continuing to spiral upward, according to Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention.

As Dr. Frieden points out, this represents the sole aspect of American health becoming significantly worse over accelerated time. In excess of two million Americans are thought to be dependent on opioids, with another 95 million who used prescription painkillers in the past year. "This epidemic, it's got no face", commented Chris Eisele, president of the Warren County Fire Chiefs' Association. Lawyers, accountants, young adults and teens from middle-class backgrounds attend Narcotics Anonymous meetings in Deerfield Township.

There has been 312 drug deaths in Summit County in 2016 alone, a 45 percent increase from 2015, and over triple the 99 cases that the medical examiner's office saw just two years earlier. Last year -- according to Gary Guenther, chief investigator of the county medical examiner's office -- saw so many deaths that the county was forced to have refrigerated trailers brought onto site to store bodies when the morgue had run out of space, on three occasions.

"The problem is getting worse every day. We don’t have enough police resources to combat it. We work very hard, it’s changed our jobs."
"We’re trying to be proactive. People say to us: ‘We didn’t know, we don’t understand’ the scope of the crisis."
"I don’t know, with everything that’s out there, how some people still don’t know [about the epidemic]."
"They're overdosing in the jails and in courtrooms."
Montgomery County Sheriff Phil Plummer

Public health nurse Lisa Roberts leads Project DAWN, the first program in Ohio to put the anti-overdose drug naloxone into the hands of users. (Jon Castell/CBC)