In the previous year, deaths related to opioid overdoses decreased in Guilford County. Now, the preventable fatalities are “back on the rise,” according to Deputy Chief James Hinson as he testified in front of a House Homeland Security subcommittee in Washington in July.
Since 2014, in the unit of 911 emergency calls, Hinson charted a 500 percent increase in overdoses related. The local increase falls right into place with national statistics. Between the months of January and June in 2019, the Greensboro Police Department responded to 56 heroin overdose fatalities, a humbling number compared to 67 of the same responses within the entire year of 2018. The first six months of 2019 has already had 101 more calls addressing non-fatal heroin overdoses in comparison to the 418, last year.
“This opioid crisis has left few untouched, with Americans dying every day from opioid overdose. Families are impacted from children being born with neonatal abstinence syndrome or children experiencing trauma as a result of a parent or family member’s addiction,” said Hinson during his testimony.
In a five year period between 2013 and 2018, the Guilford Emergency Services reported a record-breaking drop in heroin overdose deaths even though the amount of overdoses rose. The drop in deaths are credited to a program called the Guilford County Solution to the Opioid Problem (GCSTOP), which provides clean needles to addicts and arms first responders and family members with Naloxone, which reverses overdoses. The program also points addicts in the direction of rehabilitation. These statistics contradict the numbers reported by Hinson during the 2018-2019 period.
Director of Guilford County Emergency Services, Jim Albright, told local newspaper the Triad City Beat via email that the change in opioid fatalities mentioned by Hinson mirrors the same trend that officials are seeing countywide.
“We are seeing an uptick in deaths related to the ‘poly-pharmacy’ issues in the community (Greensboro, High Point and Guilford County). The heroin has a high degree of fentanyl analogues, as well as crossover into the other illicit drugs,” said Albright.
Fentanyl, a synthetic opioid that is very potent, is often the cause of these overdoses as the strength of the drug makes it easier to smuggle in smaller quantities.
“Fentanyl is a potent synthetic opioid pain reliever. It is impossible to measure the difference between a lethal or effective dose outside of a laboratory; this drug is deadly. Fentanyl can be disguised as heroin to unsuspecting individuals. Some individuals will gain access to fentanyl and sell it as a very potent heroin. This is where the majority of overdose deaths occur due to unfamiliarity with the drug they are actually using,” said Hinson.
An increase in drugs taken off the streets has not gone unnoticed.
“In 2018, the vice-narcotics division of the Greensboro Police Department has seized over 1,366.65 grams of heroin,” said Hinson, “and in 2019, from January through June, there have been 8,478.8 grams of heroin seized.”
The increase of confiscated fentanyl has also been seen by the United States Customs and Border Protection.
“The majority of US-trafficked illicit fentanyl is produced in other countries such as China, and is principally smuggled through international mail facilities, express consignment carrier facilities (e.g. FedEx and UPS), or through POEs [ports of entry] along the southern land border,” said an unidentified assistant commissioner at Customs and Border Protection in 2017.
The transportation of fentanyl has been traced across the US-Mexico border. However, the most potent forms of the drug is coming by mail from China.
“According to CBP data, the bulk majority of fentanyl that arrives by weight comes over the southwest border. However, the purity of what’s being seized there is very, very low. The purity that’s seized at mail facilities or express consignment facilities is very high, about 90 percent above. Adjusting for purity, the bulk majority of fentanyl is coming from mail or express consignment,” said Bob Pardo, an executive at U.S. Customs.
The Department of Homeland Security’s assistant inspector general, Sondra McCauley, has identified that over 50 percent of international mail arrives through the John F. Kennedy International Airport in New York City.
“We identified a number of deficiencies in CPB’s inspection processes at JFK that inhibit CBP’s ability to prevent illegal drugs and contraband from entering the country, including: CPB does not inspect all international mail selected for inspection; CPB does not inventory all mail selected for inspection; the [Automated Targeting System] pilot for targeting mail has limited impact; and CPB’s chemical analysis process for detecting illegal opioids in arriving air mail is problematic,” said McCauley.
McCauley addressed the Automated Targeting System only examines only 0.01 percent of packages arriving at JFK each day due to outdated X-ray machines and inadequate numbers of trained canine teams. Customs mainly rely on data provided by foreign post offices. Additionally, she stated that the US Postal Service does not have an agreement with the Chinese postal service.
The handling of seized fentanyl is described as such by McCauley: “One of the two vaults with naloxone in the lockbox also contained the largest recent seizure of fentanyl in CBP history. At that vault, staff had taped a piece of paper bearing the code to this vault on the wall next to the lockbox. However, when asked to open the lockbox at the other vault, staff could not do so because they could not remember the code. If actually exposed to fentanyl, a person could die without prompt access to naloxone.”
She points out that the agency lacks an official policy on handling fentanyl and lacks required training. She even goes to address the needs of the employees stating that and that “because staff doesn’t have easy access to naloxone, employees are unnecessarily placed at increased risk of injury or death.”
Consistent with the major flow of fentanyl through JFK and other major East Coast mail hubs, Pardo agrees with McCauley’s findings that most synthetic opioid deaths contained to the eastern half of the country. Although China is a leading manufacturer of the drug, two large seizures in the later third of 2018, point fingers in the direction of India also being a part of this epidemic.
“Beyond Mexico and China right now, which are the largest exporters to the United States, according to law enforcement data, India is on the horizon,” said Pardo. “Late last year there were two substantial seizures of fentanyl that were inbound leaving India to North America. That is the next place it could go. India has a substantial pharmaceutical industry and lacks resources to police it.”
In response to concerns by lawmakers that Customs and Border Protection equipment is outdated, Pardo said there are handheld devices that use infrared spectrometry, allowing for line operators to quickly detect chemical substances. But that assumes agents know what they’re looking for.
Addressing McCauley’s point on outdated machines, Pardo suggests that the use of handheld devices that are equipped with infrared spectrometry. The handheld allows line operators to seamlessly detect chemical substances. However, agents have to know what they are looking for.
“The problem with the analogues is it only tests against the known universe of chemicals. A chemical that was designed last week we don’t know about yet, so that machine’s not going to detect it,” said Pardo.