Locals find tools to battle overdose deaths
Oct. 19—Fentanyl is a growing problem for law enforcement, but the deadliness of the drug is causing a wider spread of concern.
As overdose deaths in general have increased in Nez Perce County, the number of overdose deaths because of fentanyl is also rising. Of a total of 18 overdose deaths in 2021, six were related to fentanyl. There have already been six fentanyl overdoses this year, according to Nez Perce County Coroner Josh Hall.
According to the Idaho Department of Health and Welfare's drug overdose data, there were 152 deaths related to fentanyl overdose, 241 deaths related to opioid overdose and 353 total drug overdose deaths for the state in 2021. That means out of all the overdose deaths in 2021, around 43% were caused by fentanyl. In the same year, there were 5,058 emergency department visits related to drug overdoses, with 1,076 of those related to opioids.
The National Institute on Drug Abuse reports that synthetic opioids, including fentanyl, are the most common drugs involved in overdose deaths. Fentanyl is 50 to 100 times more powerful than morphine. That's one of the reasons the drug is so dangerous.
"The scariest thing about (fentanyl) is it's obviously very deadly," said Lewiston police detective Tyler Crane.
Crane said 2 milligrams of the drug can be fatal. While people can overdose on other substances, even legal ones like alcohol or nicotine, the risk is much lower because the amount it takes to overdose is significantly higher than with fentanyl. There is also no consistency with fentanyl because different pills can have different amounts of fentanyl, even within the pill itself.
"It's a gamble every time. Every time someone uses," he said.
First responder use of Naloxone
Lewiston Fire Chief Travis Myklebust said the department sees an uptick in overdoses when a bad batch of drugs comes in. People can also overdose on fentanyl when they unknowingly take other drugs laced with fentanyl.
"When we do see (overdoses), it tends to be the fentanyl," Myklebust said. "Back in the day, it was oxycontin."
To help with overdoses, paramedics carry Narcan, a brand of Naloxone nasal spray. Naloxone counteracts an opioid overdose by attaching to opioid receptors, reversing and blocking the effects of the opioid. It can restore breathing if someone is having an overdose from an opioid like fentanyl, according to the National Institute on Drug Abuse. It also has no effect on someone who doesn't have opioids in their system, which makes it safe for paramedics to use if they aren't sure what drug is causing the overdose.
"We've carried (Narcan) long before the fentanyl came around," Myklebust said.
If the Lewiston Fire Department receives an overdose call, they respond to it like any other medical call. Paramedics start eliminating causes to determine what is wrong with the patient. Once they determine the cause is overdose, they can use reversals like Narcan to treat the medical emergency. Sometimes there are witnesses who can tell first responders what drug the person took, Myklebust said, but sometimes "witnesses don't like to say much."
If the fire department receives an overdose call or later determines the cause of a medical issue is an overdose, law enforcement will also respond.
"Sometimes, (law enforcement are) the first ones there and administer the Narcan and have the patient come around by the time we get there," Myklebust said.
Exposure to fentanyl can be dangerous, even just to the inhaling or touching the powder, so first responders take precautions such as wearing gloves, eye protection and facemasks and avoid handling unknown substances to prevent exposure from touching and breathing in fentanyl. Those precautions are reducing the numbers of first responders being exposed to the drug.
That's another reason for first responders to carry Narcan — not only to prevent drug users from overdose deaths, but to protect themselves. Crane said that law enforcement can be exposed to the fentanyl from doing searches on people or of their vehicles.
Public use of Naloxone
First responders aren't the only ones who have caught on to the benefits of Narcan and other Naloxone drugs, it's also being used by drug users or friends and family members of drug users.
"Before we started this fentanyl, I never saw Narcan be carried around," Crane said. Now, he finds it in purses, backpack and vehicles during searches, something he didn't see heroin addicts use. However, with fentanyl being so common and so dangerous, general Narcan use is also increasing.
Crane has talked to drug users who are self-administering Narcan six times a week. "And any of those times that could've been it," he said. "They're brought back from near-death daily."
Many pharmacies carry Naloxone drugs like Narcan. Some community-based distribution programs like local health departments give it out free of charge.
"(It's) the most effective drug that I've ever seen," Crane said. "If it weren't for Narcan, we would be — and this is speculative — we'd be inundated with overdose deaths."
Brett Myers, Whitman County Sheriff, who also is involved with the Quad Cities Drug Task force that partners with agencies in Whitman, Asotin, Nez Perce and Latah counties, said fentanyl is too dangerous to rely on Narcan to stop the problem.
"Narcan is a band aid. If you get there in time, you can stop the bleeding. It's good to have, but it's not the answer," Myers said. "In many cases, if we can get people there soon enough, their lives are saved. In other cases it's still not going to be enough."
Myers credits Narcan with saving people's lives, but very few compared to shutting down fentanyl to prevent it from being used in the first place.
"People aren't sitting around with Narcan in one hand and fentanyl in the other," Myers said.
Legal response
If someone does die of a drug overdose, an autopsy is performed to determine the cause of death. Hall said that for Nez Perce County, toxicology reports are done by a lab that can determine what drug caused the overdose, even if the person has more than one drug in their system. That information is then sent to the prosecutor's office in case the prosecutor wants to pursue charges.
Nez Perce County Prosecutor Justin Coleman said that in order to file charges against someone for an overdose deaths there has to be evidence beyond a reasonable doubt that proves the drug was the cause of death.
That's where the investigation side comes in. Crane said that all overdose deaths are treated as homicide cases. He has worked with the North Idaho Violent Crimes Task Force that has prosecuted fentanyl overdose death cases, and those have gone through the federal system.
Coleman said that evidence can be hard to find because investigators have to trace where the pills came from. It means getting search warrants for Facebook, messaging apps and phone records to see if there's a communication trail that can lead to the drug dealer.
"Sometimes you get the evidence you need and sometimes you just don't quite get there," Coleman said.
Once the evidence is found, those overdose deaths can result in people being charged with manslaughter, either through the state or federal courts. Coleman said the prosecutor's office has to be careful about which cases they go forward with to make sure they have the evidence, but it's another tool the office has to prevent the spread of fentanyl.
"We will go forward on those cases because it's important to make people aware that you are responsible if you are dealing this stuff to people and they end up dying from it, if we have the ability to prosecute on it, we will," Coleman said.
Example case
The Nez Perce County Prosecutor's Office has firsthand experience in pursuing a manslaughter case because of a fentanyl overdose, the office was the first to file a manslaughter case for a fentanyl overdose in Idaho. Kollin D. Mazur, 28, of Clarkston, was charged with involuntary manslaughter for the 2021 overdose death of 26-year-old Zachary Taylor, of Lewiston. The charges were later dismissed because the U.S. Attorney's Office for the Eastern District of Washington indicted Mazur along with Dustin Allen for distribution of fentanyl, which carries a maximum sentence of life in prison, while the manslaughter charge carries a 10 year maximum. The case is still going through the court system.
"We would not have been able to do that here. Not even close," Coleman said about the prison sentence the two men received.
The detectives who investigated the death discovered there was a bigger case based on the evidence, so Coleman filed the manslaughter charges. Then the Nez Perce County Prosecutor's Office gave the case to the federal office to get a longer sentence and charge Allen.
"We had been trying to pay attention to cases coming through of overdose deaths because it became such a big problem," Coleman said.
Brewster may be contacted at kbrewster@lmtribune.com or at (208) 848-2297.
