An ambulance driver is overcome by drowsiness while transporting an overdose victim to the hospital. Two police detectives lose consciousness while handling evidence during a drug investigation. A policeman collapses after brushing what he believes to be a crumb off the front of his uniform, only to learn later, following emergency resuscitation efforts by his colleagues, the “crumb” was a powerful synthetic opioid.
These are the horrific but true tales from the front lines of an ongoing battle across the country by police, firefighters and EMS professionals representing the first response to victims of what has been described as one of the deadliest drug crisis in the United States history.
The crisis is due to opioids, the drugs largely blamed for a 2016 90-per-day death rate — statistics worse than deaths from the H.I.V. epidemic and automobile accidents at their respective peaks in 1995 and 1972.
President Donald Trump, in late October, declared the crisis a “health-care emergency,” saying “No part of our society — not young or old, rich or poor, urban or rural — has been spared this plague of drug addiction and this horrible, horrible situation that’s taken place with opioids.”
A main culprit in this modern plague is the synthetic opioid known as fentanyl and its derivatives called analogs. Fentanyl was first developed almost 60 years ago, the drug in recent years has been increasingly used by doctors and veterinarians as a highly effective “anesthetic during surgery, to manage pain after surgery and to treat chronic pain in patients physically tolerant to other pain killers,” according to the U.S. Justice Department’s Drug Enforcement Agency.
Since 2014, the drug’s availability and use as filler for heroin and other illicit drugs has increased exponentially, in part due to illegal manufacturers across the globe.
Fentanyl is much more powerful than heroin, and its burgeoning presence in illicit drug supplies across the U.S. led to made it a common cause of overdose deaths.
“Illicitly manufactured fentanyl is a key factor driving opioid overdose deaths,” CDC researchers wrote in a report released earlier this year. “Fentanyl analogs are increasingly contributing to a complex illicit opioid market with significant public health implications,” because of the drug’s use an added ingredient to heroin as well as cocaine and methamphetamine, the report said.
Sauk County’s first overdose death officially linked to fentanyl occurred during the past year, according to Public Health Educator Sara Jesse of the Sauk County Health Department.
As dangerous as fentanyl may be for those who ingest it as part of illicit drug use, its dangers have also emerged as a health risk for the first responders who may encounter it.
Such has been the case during several highly publicized incidents since 2015 when police or paramedics encountered the drug when responding to drug-related emergencies.
“There is a significant threat to law enforcement personnel and other first responders, who may come in contact with fentanyl and other fentanyl-related substances through routine law-enforcement, emergency or life-saving activities,” indicated the DEA in its recently distributed publication “Fentanyl — A Briefing Guide for First Responders.”
The briefing guide goes on to warn that “any substance suspected to contain fentanyl should be treated with extreme caution, as exposure to a small amount can lead to significant health-related complications, respiratory depression or death.”
First responders across the region are well aware of this warning, due to efforts like the DEA’s. With the state’s first overdose death linked to carfentanil occurring in March of this year in Milwaukee and the first Dane County overdose linked to carfentanil occurring in April, the powerful synthetic opiate likely can be found in the region’s drug supply.
“If it’s already north of the Mexican border or south of the Canadian border, it could be here,” said Lake Delton Sgt. Steve Smith, a member of the Sauk County Drug Task Force.
Although no fentanyl-related ingestions have been reported regarding the region’s first responders, they are well aware of the dangers and have added fentanyl-proof equipment and an increased awareness overall.
“There’s been a big push to train not just us in EMS field but also fire departments and police,” confirmed Damian Kruse of Mauston Area Ambulance. “It’s always a concern — any kind of medication or drug can affect us, potentially.”
The region’s firefighters also have access to the full-bodied protective gear and oxygen tanks and masks as part of their routine first-response equipment.
Deputy Chief James Bowen recently demonstrated the full-bodied tyvek suit Delton firefighters wear if they encounter hazardous materials during an emergency, and he tried on various pairs of gloves, including a new pair whose label indicated it would effectively protect the wearer from the dangers of skin contact with fentanyl.
Police have long been aware of the toxic dangers of drugs when pursuing suspects, and they know to take proper precautions, said Lake Delton Police Chief Daniel Hardman.
“You’re never going to mess around with any unknown substance, no matter what it is,” Hardman said, noting that an officer he knew was once exposed to methamphetamine “oil” during a drug raid, with a DEA hazmat team summoned immediately.
A multi-year grant from the Wisconsin Prescription Drug/Opioid Overdose-Related Death Prevention Project has enabled the Sauk County Health Department get the word out about the dangers of opioids as well as training interested citizens in the use of a nasal spray antidote to overdoses.
That nasal spray, Naloxone, can revive someone unconscious from an overdose, giving first responders a chance to arrive on the scene and continue the much-needed emergency help.
The department has scheduled one such information and training session for Dec. 4 at UW-Baraboo’s Giese Lecture Hall, and a similar session at Reedsburg Area Medical Center is expected to be scheduled soon, according to the department.
“It’s definitely scary,” Jesse said regarding the possibility of contact with such powerful drugs. “We definitely want all first responders and community members to be safe when responding to these types of situations.”
Of course, the dangers to the user are inherent with the ingestion of any illicit substance, due to its unknown ingredients — whether they be carfentanil or talcum powder.
“Who knows what they’re cutting it with,” she said. “They’re not chemists and they’re not trustworthy — you can’t trust your local drug dealer is what I’m getting at.”