Heroin addicts crave it, even though it could kill them.
It’s fentanyl, a drug created for medicine but now manufactured illicitly and mixed with heroin.
Fentanyl was found in the blood of all 14 people who died of overdoses in Janesville last year, police said.
The deaths are a new record and represent more deaths than all of Janesville’s homicides and traffic deaths combined, said Police Chief Dave Moore.
Fentanyl kills because it’s many times more powerful than heroin, said Dr. Jay MacNeal of Mercyhealth, EMS director for Rock County.
Local heroin users are well aware the drug they buy could be laced with fentanyl, said Janesville police officer Chad Woodman, but they use it, anyway.
“When it’s broadcast that there is a strong dose of heroin mixed with fentanyl or a strong batch of heroin going around in the community, people who are actively using are likely to seek that drug out, even though people are dying from it,” said Claire D., a local woman who counts herself clean of drugs for the past two years.
Dealers will even advertise when they have a potent batch of heroin, said Claire, who asked that her full name not be used.
“What it means is, it’s probably going to provide a really good high, and they’re willing to risk that,” Claire said.
Addicts always are chasing the high they got the first time they used heroin, but they eventually don’t get high at all. They just need the drug so they don’t suffer horrible withdrawal symptoms, Claire said.
MacNeal agreed: “Their only thought is how to get the next dosage of the drug so they don’t feel miserable.”
It’s the nature of the disease of addiction, said Mike R., another recovering addict who works in a 12-step recovery program.
“In our meetings, we have discussions about how you can die if you use one more time, and they’re all aware of it,” Mike said. “People say they’ve ‘died’ several times, and they’re tired of it.”
Offer a dose to a group of addicts and tell them it might kill them, and 99 percent would take it, Mike said.
It’s similar to an alcoholic who is told he has cirrhosis of the liver and that if he drinks, he could die.
“Most alcoholics are still going to drink,” Mike said.
Reviving the ‘dead’
Local emergency medical responders often are the ones bringing overdose victims back from near death. They’ve had to change procedures in recent years to combat fentanyl, MacNeal said.
Heroin, fentanyl and similar drugs all slow breathing. If the dose is strong enough, the brain is starved of oxygen, and the person dies, MacNeal said.
Part of the problem is that addicts never know how potent their latest dose might be, MacNeal said.
Naloxone, known commonly by the brand name Narcan, can reverse the effects of an opioid overdose. But fentanyl-laced heroin can be so strong that it may overpower even two doses of naloxone.
Emergency responders have increased their initial dose of naloxone, and they’re inserting an airway sooner to get more oxygen to the brain, MacNeal said.
But waiting for EMTs can be fatal in some cases. Addicts and their loved ones often carry naloxone for emergencies, but time is so critical that MacNeal recommends people also learn CPR to force air into the lungs before help arrives.
People need to call 911 right away, but sometimes they’re afraid to because they could get in trouble with the law, MacNeal said.
Janesville police report 30 overdose deaths in the past three years. Eighteen were male, 12 female. All but one were white.
“It’s very sad, and its not just junkies shooting up behind the Dumpster. It’s people from high-functioning families who totally get hooked on this stuff, and it’s a blight on our society right now,” MacNeal said.
Police made six arrests in those 30 cases. Convicting someone of providing the drug that led to a death is difficult, but there have been few.
It’s hard to prove that the drug was the only contributor to a death. A medical condition might have been involved.
It’s also hard to get a conviction if the person who died had willingly went along with the person who delivered the heroin, Woodman said.
Janesville police reported 65 drug overdoses last year, seven more than in 2016.
Woodman is the police DROP officer. The acronym stands for Death, Rehab or Prison. He contacts addicts, often after they overdose, and offers help, sometimes in the form of peer counselors who are recovering addicts and treatment when available.
He maintains contact, continuing to offer help. Sometimes, they succeed in getting clean; sometimes, they try and relapse.
“If all of a sudden I get a string of overdoses, I have a pretty good idea that probably we had a bad batch that came through, probably higher potency, probably fentanyl out there, and I contact people and say we have fentanyl out there, watch yourself. I tell them to be careful,” Woodman said.
Sometimes they heed the warning, sometimes not, he added.
Fentanyl is used regularly in medicine, but the stuff on the streets until recently could be mail-ordered from China, Woodman said.
Experts say most or all of the illicit fentanyl is made in China and enters the United States from Mexico.
The federal Drug Enforcement Administration announced this month that China is taking steps to control two chemicals used to make fentanyl in addition to previous steps to clamp down on the illicit trade.
The new controls, the result of “ongoing collaboration” between the DEA and China, are scheduled to take effect Feb. 1.
But Woodman believes criminals will always find a way to supply addictive drugs.
“You can’t fight the supply without fighting the demand,” he said. “You cut off one source, it’ll spring up from another one ...
“If we don’t fix the addiction, we’re not going to fix the problem,” he said.
Moore believes the current wave of overdoses will decline in five to 10 years. He notes the road to addiction often starts with young people experimenting with painkilling pills, which contain drugs similar to heroin, or when people get pain pill prescriptions.
When the pills are gone, some people turn to heroin, Moore noted.
Doctors are being more careful about when and how much they prescribe, and the public is being more careful about getting rid of the painkillers in their medicine cabinets, Moore said, so the number of people getting hooked should decline.
At the same time, police are working in Janesville schools to warn about those pills, and “we’re starting to learn what works and does not work (in treating) heroin users,” Moore said.
In the meantime, Dr. MacNeal said: “We’re really trying, and despite everything we do, we know we’re not going to save everyone, and that’s very frustrating.”