By Ivan Flores
On a rainy Friday afternoon, Corporal Jeff Gontarski, a Washtenaw County deputy sheriff, drove his patrol car down an empty neighborhood street in Ypsilanti Township. Within a block, he pointed to three houses where someone had overdosed. One of the houses had burned down. The third one he had been called to three times in 15 months. All of them were fatalities.
“I’ve never seen anything like it,” Gontarski said. “People die of opioid overdoses before you can get to them. Even if you get someone to a hospital, they’ll be out the next day, and they’ll overdose again.”
Gontarski has been a Washtenaw deputy sheriff for almost 21 years. Adreanne Waller started working as an epidemiologist for Washtenaw County in 1988. Commander Marlene Radzik joined the Washtenaw County Sheriff’s office a year after that. She spent two years in the late ’90s working to get drugs off the street as an undercover officer. All of them say the same thing: Washtenaw County is in the middle of an unprecedented and deadly epidemic.
And there are fears that it’s about to get worse.
The new killer
Carfentanil is one of the most powerful synthetic opioids in the world. It’s lethal to humans. The drug was designed to sedate large animals like elephants and giraffes, but carfentanil has found its way into the veins of heroin addicts across the country. Cincinnati was hit by a wave of overdoses linked to carfentanil in August. National Public Radio reported that 174 people overdosed in six days, with subsequent incidents of up to 25 ODs every day becoming the norm. Michigan has been spared from such havoc, but not from the opioid epidemic.
Washtenaw County in particular has been hit hard. The number of deaths from opioid overdoses has increased by 1,525 percent since 2000 — more than three times the state average. More people die in Washtenaw County from opioid overdoses than from alcohol-related incidents or car crashes. Washtenaw County Medical Examiner Jeffrey Jentzen said there were no documented cases involving carfentanil in Washtenaw as of Oct. 2. However, Wayne County has at least 19 cases involving carfentanil dating back to mid-July. Wayne County Medical Examiner Carl Schmidt said the drug was present along with heroin and/or fentanyl, and even cocaine in many samples.
“It is hard to discern the contribution of carfentanil in these cases because the other drugs were present in sufficient amounts to cause death,” Schmidt said. “Because this drug is so recent, many toxicology laboratories that do postmortem testing have methods to detect it, but not to quantify it. Most likely, the carfentanil in most of these cases is a contaminant or manufacturing by product, but you can never be certain what is going on with street drugs.”
Schedule II and III prescriptions
How do people end up on the path of addiction? According to Ashton Marr, it’s a slippery slope. She is an outreach worker for the Washtenaw County Sheriff’s Department. She’s also the executive director of the Washtenaw Recovery Advocacy Program, and a recovered opioid addict.
“Something like 75 percent of people who end up using heroin start with prescription drugs,” Marr said. “They seem safe because they come from a doctor. One of the things with heroin is that you don’t know what it’s cut with and it’s more dangerous. But here you have this nice little bottle that came from a pharmacy and it must be safe. That’s just not the case. Within two weeks someone becomes physically dependent on it.”
Epidemiologist Adreanne Waller said that among the things contributing to the epidemic, schedule ii and iii drugs are among the most significant.
These are substances that are highly addictive, like oxycodone, morphine, and fentanyl.
Pain used to be treated with medications that were not necessarily addictive, Waller said.
However, pain has become “a fifth vital sign.” Narcotics are used liberally to treat pain from sports injuries and surgeries. Their widespread use and presence in homes means that many people are vulnerable to addiction.
The idea that drug addiction is something that happens on the fringes of society is a myth. The national advocacy group Facing Addiction estimates that 1 in 3 American households are impacted by addiction. While that statistic includes drugs besides opiates, it shows the breadth of the problem.
Marr had experimented with drug use in high school, but the path to addiction started with a surgery.
“In my early 20s, I had an emergency appendectomy,” she said. “That’s when I was introduced to narcotic painkillers. It seemed like salvation. For whatever reason, something clicked. When my tolerance built up and it became prohibitively expensive, somebody showed me something that was cheaper and relatively easy to access.”
Marr’s story is not unique. According to Waller’s Washtenaw County statistics, every week through 2015 there were three opioid overdoses; two survived, one died. There were four opioid overdose deaths in 2000. In 2014, there were 64.
Commander Marlene Radzik saw the rise of epidemic firsthand.
“Back in 1998 until 2000 I was an undercover narcotics officer,” Radzik said. “Back then, the majority of the stuff we saw was powder cocaine, crack cocaine, marijuana, a little bit of meth. Heroin was very rare.”
“Fast forward now. Probably about eight years ago, I started seeing very young people overdosing on heroin. It was very disturbing… I would see these tenagers. I think the youngest was 15… I finally got the courage to ask the parents, how did it start? Every single story was the same. Well, they were in a car accident, or they had a football injury. They went to the doctor and they were prescribed an opiate. They went through physical therapy, they got off their opiates, but by that point they were addicted.”
“We’ve gone to overdoses where people thought they were buying heroin and it’s pure fentanyl. If you get pure fentanyl, the minute it hits your veins, you’re dead. That’s what we’re dealing with now.”
The survivors and the way forward
By the point someone becomes addicted to opioids, it’s no longer about getting high, but taking the drug not to get sick.
“Withdrawal is not something like a bad flu,” Marr said. “It felt like my bones were glass. As soon as I would get the sniffles, feel that horror creeping in… there was no choice. You’re a slave to it. Opioids are cough suppressants, they constipate you, they make you fall asleep… Whatever they do, the opposite occurs. I would cough so hard that I would throw up. You get diarrhea and shakes and chills, I still can’t figure out how someone can be hot and cold at the same time but it’s incredibly uncomfortable. It’s hell.”
There is so much stigma around being an addict that it makes it difficult to reach out for help. While Washtenaw County has more resources than other places to treat addiction, it’s still not enough to cope with the epidemic.
Marr said that the decriminalization of addiction would go a long way in helping to curb the epidemic. Treating addiction as a chronic health problem instead of a criminal one would open up more resources for treatment and recovery. It would also reduce the shame attached to addiction, encouraging more people to look for help.
Education is also key. Radzik said that the youth drug education campaign D.A.R.E failed because it had no substance behind it. It taught children the effects of drugs on the human body, but not the nature of addiction. Radzik would like to see comprehensive education about addiction begin in middle school. However, education administrators have largely ignored the problem. She recalled one instance where superintendents and principals were invited to see a film about addiction in schools. Only one came, and he suggested that the film be shown to seniors in high school.
“By the time they’re seniors,” Radzik said, “they’re already addicted.”
One key component of subsiding the epidemic will involve education among healthcare professionals about how to manage the prescription of synthetic opioids. Individuals can mitigate the risks by talking with their doctors about the dangers of addiction when they are prescribed narcotics. Getting rid of leftover medications safely is another way of reducing risk. Several law enforcement agencies around Washtenaw County have programs to take back narcotics.
There are also resources for people already struggling with addiction:
- Washtenaw County Sheriff’s Office
2201 Hogback Road, Ann Arbor MI, 48105
Accessible 8:00a.m. – 5:00p.m., Monday – Friday
- Dawn Farm (Recovery Center)
6633 Stony Creek Road, Ypsilanti MI, 48197
- Ashton Marr (Washtenaw Recovery Advocacy Program)