Aug. 31 marks International Overdose Awareness Day — the day highlights an issue that is just as local as international.
Scroll spoke with Bonneville County (Idaho Falls) Sheriff Sam Hulse and Health Education Specialist Mallory Johnson at a Fentanyl Town Hall last month hosted by Eastern Idaho Public Health. The two joined recovery coach Michelle Smoley and Idaho Falls Deputy EMS Chief Jon Perry as part of a panel discussion about the nature of fentanyl in Eastern Idaho and solutions to combat the deadly impact of one of the most potent drugs currently on the illicit market.
Opioid addiction has ravaged communities across the country in the last decade and now fentanyl, a synthetic opioid, is worsening overdose rates.
A hundred times more powerful than morphine and fifty times stronger than heroin, fentanyl has become a leading cause of death among Americans 18-45. Though occasionally prescribed by doctors, fentanyl is taking over the illicit drug market. It only takes about 2 milligrams to kill someone. Fentanyl-related overdose deaths doubled between 2020 and 2021 in Idaho.
Idaho had 188 fentanyl overdose deaths in 2022.
Colorless, tasteless, odorless, there is no way for the average person to tell if a drug they are taking is laced with fentanyl, and that is one reason why Mexican drug cartels and illicit manufacturers are spiking drugs like heroin, methamphetamines and even marijuana with it. Fentanyl has become immensely profitable for cartels because it is cheap to make and its potency means a small amount gives the user an extreme high.
“At the end of the day, it’s all about making money for the cartels, and, quite honestly, they don’t care who they harm in the process,” Sheriff Hulse said.
Sheriff Hulse’s biggest concern is “dirty thirties,” pressed fentanyl pills designed to look like the pharmaceutical drug oxycodone.
He urged people to never accept pills, or any drugs for that matter, that are not purchased at a pharmacy.
“If you don’t know where that pill came from, it’s not safe,” Sheriff Hulse said.
Law Enforcement Response
“If you are a drug trafficker, we are going to find you and we are going to prosecute you to the fullest extent of the law.”
Hulse’s sharp words extended to the federal government as well, which he criticized for allowing drugs to pour through the southern border. He called on the government “to do its function” to protect citizens from outside threats.
Calling every sheriff a “border sheriff,” Hulse said his department has been in talks with other sheriffs around the country including Collin County, Texas, to get assistance in drug interdiction strategies.
Though overdose rates continue to rise, the sheriff credits a slight alleviation in deaths with the increased access of naloxone in the state.
Naloxone, often referred to by its brand name Narcan, acts as an antidote to opioid overdoses.
Mallory Johnson, health education specialist senior at Eastern Idaho Public Health, explained that when too many opioids attach to opioid receptors in the brain, it slows and stops. Naloxone has a stronger connection to those receptors than the opioids themselves and detaches them from each other.
Protocol for Administering Naloxone
Note: Those who want to prepare themselves to administer naloxone should seek training offered by community organizations such as Eastern Idaho Public Health as well as study the instructions offered in kits.
Anybody in the state of Idaho may carry and administer naloxone as long as they call EMS immediately after providing it to a victim.
According to Idaho Health and Welfare there are three FDA-approved formulations of naloxone.
— Injectable: Use of this product requires the user to be trained on proper assembly and administration.
— Autoinjectable: EVZIO® is a prefilled auto-injection device that makes it easy for families or emergency personnel to inject naloxone quickly into the outer thigh.
— Prepackaged Nasal Spray: NARCAN® Nasal Spray is a prefilled, needle-free device that requires no assembly and is sprayed into one nostril while patients lay on their back.
A person who suspects another of having undergone an overdose can and should administer naloxone, if available. The reversal drug does no harm to those who have not overdosed, though people should keep in mind that it has no effect on non-opioid drugs.
Signs of an overdose include slow or stopped breathing.
After administering a dose to a victim and calling 911, a responder should watch for signs of recovery. If no improvement is made within two to five minutes, a second dose should be administered.
Local nonprofits such as Center for Hope and Soldiers for Hope provide free packages of two doses. No prescription is needed to purchase it from a pharmacy. Idaho residents with Medicaid can get it for free.
As much as Sheriff Hulse applauds the increased use of naloxone, he reminds users that it only treats the symptoms. He urged all users to seek treatment, especially since continued opioid use can lead to deadlier amounts and increased chances of overdosing.
Free medication lock boxes and drug deactivation pouches are available at Eastern Idaho Public Health’s Rexburg office.