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Fentanyl adds a deadly dose to local heroin

Health and law enforcement officials are warning that deadly fentanyl has made it into the local heroin supply — putting at risk everyone from first-time users to those struggling with full-blown addiction.

Fentanyl may already have contributed to a sudden spike in heroin overdose deaths in Jackson County this spring.

From March 7 through April 21, the county experienced 10 suspected heroin overdose deaths, according to Dr. Jim Shames, health officer for Jackson County.

That compares to four overdose deaths for all of 2016 and six overdose deaths in 2017, he said.

The 10 who died this spring were all men and ranged in age from 23 to 53, with most in their 30s, officials said during a Tuesday press conference.

Shames said there could be a batch of significantly more potent heroin in the area, or dealers could be lacing heroin with the dangerous drug fentanyl.

“It could indicate that we have fentanyl in a significant amount in our drug supply, and in communities around the country where that’s occurred, there’s been a spike in overdose deaths,” Shames said.

Fentanyl can be 100 to 1,000 times more potent than heroin, he said.

When in powder form, a fatal dose of fentanyl is smaller than Abraham Lincoln’s face on a penny, according to an image distributed by the U.S. Attorney’s Office for the Southern District of California to illustrate the danger.

Shames noted even experienced users of heroin are at risk.

“A tiny amount of fentanyl can be dangerous and fatal to folks that are using drugs illicitly but think that they have figured out kind of what the dose ought to be,” Shames said. “That’s the problem throughout the United States.”

Shames said fentanyl that is illegally mixed with heroin typically comes from illicit manufacturers in other countries.

Because of a 16-week wait for crime lab results, officials aren’t certain yet whether the 10 people who died of overdoses in March and April used drugs laced with fentanyl.

But Medford police Lt. Mike Budreau, who heads the Medford Area Drug and Gang Enforcement team, said lab test results are back from heroin previously seized in regular drug cases. Fentanyl has been detected several times.

“The heroin appears to be laced with fentanyl,” Budreau said.

One man is already facing heroin possession and delivery charges for allegedly selling $40 worth of heroin to a 23-year-old Medford man who died of an apparent overdose and was found on March 13.

Isaac Phillip Escoto, also 23 and a Medford resident, is being held in the Jackson County Jail on $522,500 bail, according to Tuesday jail records.

Escoto told police he was the middle-man in the heroin deal, according to an affidavit.

Budreau said people who supply drugs that turn out to be deadly can be held responsible for overdose deaths and sentenced to 20 years in prison.

He noted dealers as well as users are playing Russian roulette.

To help detect fentanyl spreading into the community, Budreau said police officers are getting fentanyl test strips that they can use in the field to check heroin.

If fentanyl is found, police could increase their efforts to track down the dealers, Budreau said.

Officials urged people not to try heroin, to seek treatment if they are already using or to take precautions if they aren’t willing to seek treatment.

Medication-assisted treatment is available that can curb cravings and ease withdrawal symptoms for those addicted to opioids, Shames said.

However, only 10 percent of people in America with opioid use disorders are accessing medication-assisted treatment, said Dr. John Mahan, Jackson County Mental Health’s psychiatric medical director.

People can get a prescription for medications like buprenorphine, known by the brand name Suboxone, in an outpatient setting through qualified health care providers, Mahan said.

He recommended visiting the website to find local health care providers.

In Jackson County, Allied Health Services of Medford at 777 Murphy Road provides methadone, Suboxone and other medication-assisted treatment. Call 541-705-2258.

In Josephine County, the Grants Pass Treatment Center offers methadone and Suboxone at 1885 N.E. Seventh St. Call 541-955-3210 to schedule an appointment.

Methadone relieves withdrawal symptoms and curtails the desire to use both prescription and illegal opioids.

Suboxone eases withdrawal, curbs the desire to use and blocks the effects of opioids if a person does relapse and use drugs, according to the Grants Pass Treatment Center.

People who aren’t ready to seek treatment should use a buddy system when taking drugs, advised Matt Philbrick, medical operations manager for the Mercy Flights air and ground ambulance organization.

If one person shows symptoms of an overdose, the other person should call 911 immediately, he said.

Shames said opioids are sedatives that produce a sense of well-being, euphoria and sleepiness. A user may lose consciousness. Breathing can slow or stop.

The cessation of breathing can trigger cardiac arrest, Philbrick said.

Budreau and Jackson County Sheriff Nathan Sickler noted a state law protects anyone calling for help from prosecution on drug possession or delivery charges.

Budreau said police officers have seen situations where people delayed calling 911 about an overdose. Sometimes they try to clean up a scene before calling for help.

Police and paramedics in the Rogue Valley now routinely carry naloxone, which can quickly reverse an opioid overdose.

Shames said the state has provided Jackson County with $30,000 worth of naloxone to fight the overdose epidemic.

Naloxone comes in either an injectable form or an easy-to-use nasal spray.

Oregon law allows it to be sold at participating pharmacies without a prescription. Call a pharmacy in advance to see if it sells naloxone without a prescription.

The organization Max’s Mission, founded by an Ashland couple who lost their son to an overdose, also holds events to raise awareness about opioid overdose risk and distribute naloxone.

Visit for more information.

In April, U.S. Surgeon General Jerome Adams issued an advisory encouraging everyone who uses prescription or street opioids to routinely carry naloxone.

A person who receives a dose of naloxone should still be taken for medical treatment because the breathing suppression caused by opioids can last longer that the action of the overdose antidote, according to , a website for first responders.

Additionally, naloxone can trigger severe withdrawal symptoms that should be treated medically, according to the website.

Fentanyl also has been found in methamphetamine, cocaine and counterfeit prescription pain pills like Oxycodone, the website warns.

Multiple doses of naloxone may need to be administered, especially if drugs are laced with fentanyl. The overdose antidote also needs to be administered as quickly as possible because fentanyl is fast-acting, according to the federal Centers for Disease Control and Prevention.

Reach Mail Tribune reporter Vickie Aldous at 541-776-4486 or . Follow her at .

Jackson County Sheriff Nathan Sickler, left, Dr. Jim Shames, health officer for Jackson County, and Matt Philbrick, operations manager with Mercy Flights, hold a press conference concerning an epidemic of opioid overdoses in Jackson County at the Health and Human Services building Tuesday.