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The head of the Lebanon County Drug and Alcohol Abuse Commission is worried.

“As of May 5, we have had 14 fatal overdoses. We had 29 throughout 2022,” said Jim Donmoyer.

This would put the county at a rate of 42 by 2023.

Read more: Global Pandemic Toll: COVID-19 takes a physical and mental toll on county residents.

Fentanyl was the leading cause of overdose deaths in Lebanon County in 2022, and was found in 16 of the 29 deaths.

Donmoyer points to one culprit above all others for the increase: fentanyl, a powerful synthetic opioid ー 50 to 100 times stronger than morphine ー intended for use as a pain reliever.

The drug has legal medical uses as a pain reliever, but dealers mix fentanyl with other popular illegal opioids to increase potency and profits.

Even a small amount of fentanyl can depress the respiratory system, which reduces the rate of breathing. If untreated, a fentanyl overdose can deprive the brain of oxygen and cause death.

That became clear when Donmoyer spoke from the records of County Coroner Dr. Jeffrey Yocum.

“Of the 14 that died, Dr. Yocum considered 12 of them to be ‘mixed toxicology,’ meaning multiple different drugs in their system. But the consistent thing was that 12 of the 14 had fentanyl mixed with other drugs,” Donmoyer said.

“Other drugs” are common. “We have a killer here with fentanyl and cocaine, we have OxyContin here, we have heroin here,” Donmoyer said.

Only one in 14 fatal drug overdoses this year was due to fentanyl, Donmoyer pointed out. “Usually it’s a drug that you’re taking in a place where you don’t know it’s mixed with fentanyl.”

Donmoyer said he is not aware of any cases in the county where marijuana has been laced with fentanyl, though he did not cite the case.

“Trank,” or xylazine, is another drug that is illegally mixed with heroin and fentanyl and has contributed to an increase in overdose deaths nationwide, including several cases in Philadelphia. Donmoyer previously told Lab Town that xylazine has yet to be found in any county overdose deaths, but based on past experience, what happens in Philadelphia will eventually spread to other parts of the state.

Read more: Local veterinarians are concerned about the proposed restrictions in connection with the opioid epidemic

Read more: The Lebanon County Coroner’s Office will investigate fewer deaths in 2022.

FASP sees a modest overall jump in all ODs

Lebanon First Aid and Safety Guard is the county’s largest provider of ambulance and EMT services. FASP Director Greg Smith told Lab Town that his organization is seeing a modest jump in overdose calls of all types, fatal and non-fatal, illegal and prescription drugs.

“We have responded to 251 overdoses of all types in the last 12 months,” Smith said on May 16. “This includes everything. Opiates and other illegal drugs, prescription opiates, over-the-counter drugs and alcohol.

“For the previous 12 months, we responded to 243 overdose calls. This is an increase of about 1.3%. That’s what our data is showing.”

That may be a modest increase, but opiates are still a major contributor. “Of those 251, 55 are known to be opiates, which may include prescription opiates,” Smith said.

Smith emphasized that those are just FASP statistics and he can’t speak to the experiences of other first responders.

Overdose can be reversed and prevented

Donmoyer emphasized that naloxone, a drug that can quickly replace opioids if taken in time, is now widely and cheaply available to anyone, including the general public. It is sold under the brand name Narcan.

“We distribute Narcan to the county,” he said. “We give it to EMTs, police, first responders, all school districts and county agencies.”

Donmoyer added that the general public has access to Narcan and minimal training is required to properly administer it.

“If someone calls us and asks for Narca, we’ll give it, no strings attached. There are online training videos. If you give Narcan to someone who doesn’t need it, there is no harm.

Narcan is sold at pharmacies including Rite Aid and CVS, “but you can get it for free from us,” Donmoyer said.

The county obtains Narcan through a grant from the Pennsylvania Commission on Crime and Delinquency. “They give us as much as we need,” Donmoyer said. “The idea is to flood Narcan there.”

Fentanyl is basically a white powder, which makes it easy for dealers to hide it in cocaine and heroin. Pennsylvania has legalized fentanyl testing kits that let drug users know if they are using drugs laced with the deadly opioid.

Donmoyer said the county is in the process of obtaining a supply of fentanyl detection kits. Local CVS and Rett Aid stores did not yet have the loot, they told The Libtown on May 26.

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