The head of the Lebanon County Commission on Drug and Alcohol abuse is worried.
“Through May 5, we’ve had 14 fatal overdoses. We had 29 in all of 2022,” said Jim Donmoyer.
That puts the county on pace for 42 in 2023, which would top the previous record of 39.
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Fentanyl was also the main culprit in overdose deaths in Lebanon County for 2022, and was present in 16 of the 29 deaths.
Donmoyer pointed to one culprit above all others as the cause of the increase: fentanyl, the powerful synthetic opioid ー 50 to 100 times more potent than morphine ー that is intended to be used as a painkiller.
The drug has legitimate medical use as a painkiller, but dealers combine fentanyl with other illegal opioids popular with addicts to increase potency and profit margins.
Even small doses of fentanyl can depress the respiratory system, leading to a reduced rate of breathing. Left untreated, a fentanyl overdose can deprive the brain of oxygen and cause death.
That became evident as Donmoyer thumbed through records from county coroner Dr. Jeffrey Yocum.
“Out of the 14 people who died, Dr. Yocum considers 12 to be ‘mixed toxicology,’ meaning a lot of different drugs in their system,” Donmoyer said. “But what is consistent are 12 out of 14 involve fentanyl mixed with other drugs.”
The “other drugs” are familiar. “Here we have a fatal with fentanyl and cocaine, here we have oxycontin, here we have heroin,” Donmoyer said.
Only one of the 14 fatal overdoses this year was solely due to fentanyl, Donmoyer noted. “It’s normally a drug that they’re taking where they’re unaware there’s fentanyl mixed in.”
While not ruling out the possibility, Donmoyer said he was unaware of any cases in the county where marijuana had been laced with fentanyl.
“Tranq,” or xylazine, is another drug being illicitly mixed with heroin and fentanyl, and has contributed to rising overdose deaths nationwide, including numerous cases in Philadelphia. Donmoyer previously told LebTown that xylazine has not yet been detected in any county overdose deaths, but added that based on past experience, what happens in Philadelphia usually spreads to other parts of the state eventually.
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FASP sees modest overall jump in all ODs
Lebanon’s First Aid & Safety Patrol is the county’s largest provider of ambulance and EMT services. FASP director Gregg Smith told LebTown that his organization is seeing a more modest jump in overdose calls of all types, fatal and non-fatal, illegal and prescription drugs.
“For the last 12 months we have responded to 251 overdoses of all types,” Smith said on May 16. “That includes everything. Opiates and other illegal drugs, medically prescribed opiates, over-the-counter drugs, and alcohol.”
“For the 12 months before that, we responded to 243 overdose calls. That’s about a 1.3% increase. That’s what our data are showing.”
That may be a modest increase, but opiates are still a big contributor. “Of those 251, 55 are known to be opiates, which could include medically prescribed (opiates),” Smith said.
Smith emphasized that those are only FASP’s statistics, and that he couldn’t speak to other first responders’ experiences.
Opiate overdoses can be reversed and prevented
Donmoyer emphasized that naloxone, a drug that can rapidly reverse opiate overdoses if administered in time, is now widely and cheaply available to anyone, including the general public. It is marketed under the brand name Narcan.
“We distribute Narcan for the county,” he said. “We give it to EMTs, cops, first responders, all the school districts, and county agencies.”
Donmoyer added that the general public can get Narcan and that minimal training is needed to administer it properly.
“If someone calls us and asks for Narcan, we’ll give it, no strings attached. There are online training videos. If you give someone Narcan who doesn’t need it, it’s not going to hurt them.”
Narcan is also sold at pharmacies, including Rite Aid and CVS, “but you can get it from us for free,” Donmoyer said.
The county gets its Narcan through a grant from the Pennsylvania Commission on Crime and Delinquency. “They supply us with as much as we want, Donmoyer said. “The idea is to flood Narcan out there.”
Fentanyl in its raw form is a white powder, making it easy for dealers to hide it in cocaine and heroin. Pennsylvania has legalized fentanyl test strips, which allow drug users to know they’re using drugs laced with the lethal opioid.
Donmoyer said the county is in the process of getting a supply of fentanyl test strips. Local CVS and Rite Aid stores told LebTown on May 26 that they did not yet have the strips.
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