Summit County’s opioid crisis is evolving.

Both overdoses and accidental overdose deaths are declining compared to the second half of 2016 when the powerful synthetic drugs fentanyl and carfentanil first devastated the area, sending nearly 20 people per day to hospitals after overdosing.

Yet the executive director of the county’s Alcohol, Drug Addiction and Mental Health Services Board Jerry Craig isn’t sure whether the downward trend will continue.

“We’re entering a new phase,” Craig said.

Over the past 40 years, Summit County, like the nation, has experienced waves of deadly drugs, starting with crack, then methamphetamine, heroin, fentanyl, and carfentanil, he said.

“When people are addicted, they’re looking for the next high,” Craig said.

This week, for example, Alliance police sent a warning to other area law enforcement after discovering that the skin on a heroin user’s arms looked as if it had been eaten away. The heroin user told officers he was using heroin mixed with Rizzy powder — a floral additive that, when mixed with water and absorbed through flower stems, makes flower petals glow phosphorescent under black light.

It may be the first report of heroin spiked with Rizzy.

But addicts are often on the prowl for other drugs, including other street drugs if they can’t find the drug they are addicted to, Craig said.

Meth not safer

Heroin addicts may turn to meth if they can’t find heroin, Craig said, because meth can soften the effects of detoxing from heroin.

Area police agencies and federal officials last year said Greater Akron and parts of Ohio were seeing a surge in crystal meth, often called “ice” on the streets.

“This isn’t your shake and bake stuff people were making 10 years ago,” Craig said. “It’s Walter White grade.”

(White is the main character in the AMC series Breaking Bad about the transformation of a high school chemistry teacher into a meth-making wizard.)

Some Summit County addicts seeking emergency help through a division of Portage Path Behavior Health have said they have turned to meth, assuming it’s a safer alternative to heroin, which they know is often laced with potentially lethal doses of fentanyl or carfentanil.

But that’s not true.

The Summit County Medical Examiner’s office won’t have a final report on last year’s overdose deaths for another month or two. But preliminary data show that many of the 199 overdose deaths last year involved meth, cocaine, heroin and other drugs mixed with fentanyl or carfentanil.

In some of those cases, people were likely taking multiple drugs, Craig said.

But police in Akron and elsewhere have said they’ve also seen cross-contamination. Drug dealers don’t package their supplies in a lab. Police say they often mix and package heroin cut with fentanyl or carfentanil on the same table they use to package everything from marijuana to meth.

Mixtures deadly

The recent spread of fentanyl from heroin into other street drugs so troubled Columbus public health officials this week that they sent out a news release urging anyone who uses recreational drugs or knows someone who does to carry Narcan, a brand name for naloxone which can reverse opiate overdoses.

In Franklin County, about 30 percent of people who died from overdosing in 2017 had both cocaine and fentanyl in their systems, health officials reported.

Health Commissioner Mysheika Roberts said Friday that officials have no data from law enforcement showing whether street drug supplies have been intentionally spiked.

But anecdotal evidence from EMTs and hospital emergency rooms points to that happening.

“When people are revived, they say ‘I’m not an opiate user, why would Narcan work on me? I was using cocaine’,” Roberts said.

“We believe dealers and suppliers are intentionally putting fentanyl into street drugs to make them more potent, to drive users back to their product and, because fentanyl is so cheap, to stretch their product and make more money,” she said.

And fentanyl, Roberts said, can be mixed with any street drug without users knowing it’s there.

In Summit County, officials have two barometers to measure what’s happening in the opioid crisis — hospital statistics about overdose cases and medical examiner reports, Craig said.

Last week, between Jan. 12-18, 23 Summit County residents sought treatment at hospital emergency rooms after overdosing. That’s half the number of weekly overdoses reported through much of 2017. But if the pace continues, slightly more Summit County residents will overdose this January than last.

Unintentional overdose deaths in 2017, meanwhile, appear to have decreased by about 100 compared to 2016. That year, 299 Summit County residents overdosed and died here, along with 41 others who lived outside the county.

“Maybe we’re doing some things that are having an impact,” Craig said. “But I’m not prepared to take credit for that.”

Quicker treatment

Craig did point to several public health accomplishments here since the opioid crisis began.

Among other things, the wait time for outpatient treatment in Summit County has plummeted from 45 days at the beginning of the crisis to about eight days now. Craig said officials aim to decrease it to five days.

There’s still about a 30- to 35-day wait for residential treatment, he said, but pregnant women are bumped to the top of the line and others on the waiting list can do outpatient treatment until a bed opens.

Additionally, Craig said Summit County residents are disposing more of their unused medications, often seen as a gateway to addictions. More drugs were incinerated in Summit County during the first nine months of 2017 (9,238 pounds) than in all of 2016 (8,159 pounds).

And quick-response teams — comprised of a medic, police officer and a counselor — are now working in 10 Summit County communities, including Akron. The teams go to the homes of those who have overdosed in hopes of preventing another overdose.

About 40 percent of the time, addicts agree to go into treatment, Craig said.

And no person visited by a team in Summit County has since died from a later overdose.

But, Craig said, that could change any day. Or a new drug — or drug mix — could hit the streets and make overdose deaths soar again.

“I’ve never seen anything this lethal in 30 years,” he said. “We don’t know what we don’t know, and that’s what makes this so daunting.”

Amanda Garrett can be reached at 330-996-3725 or agarrett@thebeaconjournal.com.