Heroin killed 16 people in Anoka County last year, and deaths have been going up each year since 2015, according to data from the Anoka County Sheriff’s Office.
The local uptick comes amid a national opioid crisis.
Last year opioids accounted for more than 90 percent of reported drug overdoses in Anoka County, and about a third of opioid overdoses resulted in the victim’s death.
Overall drug overdose deaths were down by 5, with 25 total deaths in 2018, but the Sheriff’s Office is concerned with the ongoing danger opioids like heroin pose.
The majority of overdoses reported last year were from heroin (56 cases), sometimes combined with methamphetamine or other drugs. Eight cases involved fentanyl, a synthetic opioid that’s about 30-50 times stronger than heroin and 50-100 times more potent than morphine. One case also recorded carfentanil, about 100 times stronger than fentanyl.
Investigations by the Sheriff’s Office into overdoses really kicked off in 2012, according to Detective Gary Patterson, who was recently recognized by the Sheriff’s Office for his work combating the opioid epidemic.
Patterson has worked 11 cases that resulted in criminal convictions of third-degree murder for narcotics distribution. In cases where the victim survives, Patterson charges great bodily harm caused by distribution of drugs.
While most of the deaths are young people, victims ranged in age from 17 to 61, according to the Sheriff’s Office data.
Patterson said most people who died from heroin overdoses started using after being prescribed opioid painkillers for an injury, usually an orthopedic injury.
“They are not like criminal elements to us, they’re victims and we’ve actually put a lot of time, effort and resources ... going after dealers,” Patterson said.
Investigations into heroin drug dealers are difficult and time consuming, in part due to the small quantity the drug is moved in.
“A lot of times in the cases that I’ve worked there’s not product for me to test left over at the scene,” Patterson said. “There’s sometimes packaging, which is evidentiary value to my case. I have to wait until toxicology comes back to determine cause of death.”
Unlike drugs such as methamphetamine or marijuana, which are the two most common drugs by volume in Anoka County, heroin and other opioids are moved in small quantities, according to Lt. Brent Erickson a member of the Anoka-Hennepin Narcotics and Violent Crime Task Force.
In 2018 the task force seized about 175 grams of heroin, or roughly a little over half a cup by volume.
“To put in perspective, it’s less than a half-of-a-pound throughout the year,” Erickson said.
Despite that, the majority of overdoses the task force sees are opioid-related.
“Heroin is far and away the more dangerous of the drugs that we deal with,” Erickson said.
That could be due to the increased presence of powerful narcotics like fentanyl and carfentanil, which are being mixed in with heroin.
Both have started to creep into the area in the last few years, though carfentanil is still uncommon. Carfentanil was reported in only one overdose death in 2018.
Analysis and toxicology can slow down an investigation of a death, but even when the victims survive, they are often reluctant to roll on a dealer.
“I’ll be frank: victims that survive, they are not always cooperative, wanting intervention,” Patterson said.
He largely blames that on heroin addiction being so intense that once people are addicted, they don’t take heroin to get high but “to start feeling normal again” and ward off withdrawal symptoms.
On the other hand, new technology has changed how investigators search for evidence. With the prevalence of smart phones and computers, a significant amount data is collected by searching suspects’ devices.
“If we arrest four or five people in a house, everybody’s got a phone, we’re going to be going through every one of those phones,” Erickson said.
However, the equipment and specialists necessary for gathering that data are expensive, and it takes special equipment to parse through terabytes of data each year, Erickson said.
Still, Erickson considers the digital forensics a positive development for law enforcement. He called it unbelievable what people will put on social media, and even paging through text messages can help investigators build a case.
The task force has not been able to catch the really big dealers, and Erickson said it’s unclear why.
The task force does catch mid-level opioid dealers. Even then, it’s hard to tell how one bust affects drug distribution. It can take a year or more of watching rates of drug seizures and overdoses to see if a bust has reduced circulation, Erickson said.
In the meantime, analysts have found trends between regions that can help predict, based on overdoses, when and where opioids are being moved.
“We know if we see a kind of an influx or spike in overdose deaths in Chicago, we’ll expect to see that here within the next day or two, and if we see it here, then we know that ... Duluth can expect to start seeing overdoses within the next six hours,” Erickson said.
Another development helping stem the tide of overdose deaths is naloxone, often referred to by the brand name Narcan.
In 31 overdose cases in Anoka County, Narcan was administered. In one case, the victim still died after receiving Narcan.
The drug is an opioid antagonist; it binds to opioid receptors and can quickly reverse the effects of an overdose, restoring normal respiration.
“What happens with opiate overdoses is their breathing depresses, and it slows down and fluids back up, and if you can help them with their breathing, you can sustain them,” Patterson said.
Many first responders have begun carrying the drug, such as the Blaine and Lino Lakes police departments. In some cities, such as Coon Rapids, the fire department carries Narcan but the police don’t.
The Coon Rapids Fire Department started carrying Narcan in 2014 and purchases Narcan devices unassembled for about $45 a kit, whereas an assembled kit can run between $92 and $125, Fire Inspector Nick House said.
In the Anoka County Sheriff’s Office, sergeants carry Narcan, but deputies do not, because Allina’s ambulance crews carry it, and their response time of about six-and-one-half minutes in Anoka County, Patterson said.
The Anoka-Hennepin Narcotics and Violent Crime Task Force also carries Narcan to protect investigators who may be exposed to fentanyl or carfentanil.
The Centennial Lakes Police Department has carried Narcan since the summer of 2016, according to Lt. Russell Blanck, who administers the program. Since implementing the program, the Centennial Lakes Police Department has saved more than 10 lives and has spent a total of $66, thanks to grant funding.
“I’ve never seen one tool have such a drastic impact in the field as Narcan has,” Centennial Lakes officer Benjamin Stepan said.
Stepan, who has been an emergency medical technician about 26 years and an officer about 19, said most overdose victims go from almost no pulse to awake and breathing within minutes of receiving Narcan.
Upon arriving at a scene, Stepan said the department administers about half a dose to each nostril before attempting rescue breathing, if there’s reason to suspect a person has overdosed.
“Essentially anytime we’re on a call where there’s an unknown reason that this person isn’t breathing we will kind of fall back on Narcan, because there are such limited side effects to it that we’re not going to do any harm in administering it to somebody who is not having an overdose,” Stepan said.
Most victims awaken confused and can be aggressive. Overdose victims are always transported to the hospital.
The follow-up is important, Stepan said, because Narcan can wear off 30 minutes to an hour after being applied, which can send victims back into an overdose state if the opioid hasn’t fully left their system.
He also said that, in accordance with state law, officers responding to medical assistance calls don’t charge overdose victims with drug possession crimes.
While Narcan has and is saving lives – Erickson suspects the county’s drop in 2015 deaths is related to Narcan becoming more widespread – there are some concerns over how it is treated.
Patterson worries that Narcan is giving carte blanche to some users, who think it will protect them.
“I think people are getting too complacent and too comfortable, thinking that Narcan is their safety net,” Patterson said.
He points to overdose deaths where he has found someone with Narcan unused. While some will have a partner while taking heroin, that may not be enough – especially when the partner is also using and can enter a semi-conscious state called “the nod,” Patterson said.
Narcan’s increasing prevalence also has Patterson concerned about a shortage, he said.
While health care systems such as Allina aren’t suffering a supply problem, according to Allina spokesperson Tim Burke, House said the Coon Rapids Fire Department has seen the cost of Narcan double or triple since 2014.
“My hope is that people will wake up and realize the deadly game that they are playing with using these drugs,” Erickson said. “They don’t know where they came from, they don’t know what’s in them ... and it’s a deadly game.”