A rash of drug overdoses has plagued Cape Cod since the beginning of the year and sent local officials and outreach workers scrambling to respond to the surge in heroin and other opiate use.
Yarmouth has recorded 13 overdoses since Jan. 1, including two fatalities, police said. The Barnstable villages of Centerville, Osterville, and Marstons Mills have counted nine overdoses, including one death. And Falmouth has been hit with six overdoses, including two fatalities, authorities said.
“The ODs have become almost an epidemic problem down here,” said Detective Sergeant Chuck Peterson, who has worked in narcotics for 20 years with the Yarmouth police.
But Cape Cod is an example of a place afflicted by what many police and health officials are calling a crisis that is rapidly cutting across racial, income, and geographic lines.
It is a crisis in which drug users, many in their teens and 20s, are turning to heroin as a much cheaper alternative to once-popular prescription opiates such as OxyContin and Percocet, authorities said.
“It’s not unique to any specific area of the state,” said Hilary Jacobs, director of the Bureau of Substance Abuse Services for the state Department of Public Health. “It’s coming from all over.”
Fire Chief Michael Winn, who commands the station that serves Centerville, Osterville, and Marstons Mills, said the overdose problem has even reached the front door of the firehouse, where at least one victim, not breathing and slumped in the front seat, was driven by a friend on Jan. 30.
Firefighters attended to that victim, who survived. At the time, the ambulance was unavailable because it had been dispatched to an overdose in another part of town, Winn said.
“It’s everywhere,” the chief said. “The thing is, good people are getting sick and dying from it.”
Pinpointing a reason for the recent spike is difficult, said authorities, but one possibility is that heroin has been mixed with fentanyl, a dangerously potent opiate generally used as a painkiller for end-of-life cancer patients.
Lab tests from Cape Cod overdoses have yet to detect fentanyl, officials said, but its presence in heroin bought on the streets has been linked to fatalities in Rhode Island, Pennsylvania, and other states. The sense among public safety officials and outreach workers is that fentanyl is on its way to Cape Cod, if not already there.
In Falmouth, Detective Captain Brian Reid said he suspects that fentanyl has arrived. “The evidence indicates that, absolutely,” Reid said.
Max Sandusky, prevention and screening director for the AIDS Support Group of Cape Cod, echoed that belief.
“We’ve had reports of fentanyl from about a handful of users through our outreach; we don’t know where it’s coming from,” said Sandusky, whose group is part of a pilot program to train the public in use of naloxone, an opioid widely known by the trademark name Narcan that can quickly reverse life-threatening effects of overdoses.
The AIDS Support Group, which also runs a needle-
exchange program, provides training and distributes naloxone kits to a range of people, including family members and friends of addicts, emergency workers, and users. Since 2008, Sandusky said, about 100 people have reversed overdoses with Narcan they got from the organization. “That’s 100 lives saved,” he said.
The need for naloxone might become greater very quickly because fentanyl can be more than 40 times more powerful than heroin, said Sandusky. For that reason, mixing it with heroin can be irresistible to a user seeking a more intense kick.
But that combination carries unpredictable and occasionally fatal risks, particularly because heroin on Cape Cod is generally sold in larger units now, often in half-grams or grams, which are exponentially bigger than the traditional bags of heroin that dealers offered as recently as several years ago, Peterson said.
As a result, the narcotics detective said, the user’s “ability to regulate dosages is different; the potency is higher.”
On Cape Cod, the frequency of overdoses this year compared with last year at this time is striking.
In Centerville, Osterville, and Marstons Mills, officials reported a total of two overdoses with no deaths in early 2013, compared with the nine overdoses, including one death this year. In Yarmouth, two nonfatal overdoses had been recorded by this date in 2013, although a cluster of them occurred shortly afterward. That compares with the 13 overdoses, including two fatalities in 2014 in Yarmouth.
Falmouth police said they did not have data readily available for early 2013, but that overdoses have increased this year.
The spread of heroin on Cape Cod has sparked an increase in public discussion about the problem. Barnstable public safety officials and outreach organizations, including the AIDS Support Group, met Wednesday on the issue. “We, as fire chiefs, came together and said we have to do something as stewards of good health in our community,” Winn said.
The first of a series of public awareness sessions is scheduled at Centerville fire headquarters in Barnstable on March 5. In Yarmouth, weekly meetings are held at the police station by Learn to Cope, an organization that reaches out to families of addicts.
Cape Cod is not alone in battling the rise in opiate use, but the area’s relative isolation in the offseason might tempt some to abuse drugs as a way to relieve boredom, officials said. The Cape “goes from being a vacationland to being a pretty rural type area” in winter, said Joe Carleo, executive director of the AIDS Support Group. “People lose their jobs. It’s pretty quiet. There are probably a variety of issues.”
Carleo said that “we definitely have seen more kids using and using to a point where they’re overdosing.”
The ripple effects from overdoses often devastate families who feel powerless against the pull of an addictive drug on a son, daughter, or other family member, and the perceived stigma can prompt families to withdraw in shame. But in recent years, Sandusky and others said, the scourge has affected a much broader segment of society and led to a greater willingness to step from the shadows.
“Now what we’re seeing is communities coming together to address the problem in a way that we have not seen,” Sandusky said. “This isn’t the drug user of the 1970s. It’s your brother, your sister. It crosses all socioeconomic strata.”
Winn, the fire chief in Barnstable, said that attacking the issue head-on should be part of the job description for a public safety department, even if firefighting is its main focus.
“We’re in the business of saving lives, and I and my staff are passionate about that,” Winn said. “If we’re able to have a proactive approach — that is, a response before we respond — then we’re doing the right thing.”
Brian MacQuarrie can be reached at firstname.lastname@example.org.