More than 1,000 people knocked on death’s door from heroin and opioid overdoses last year in Horry County.
They were pulled back by medics armed with Narcan — a potentially lifesaving antidote. Now, area law enforcement — often times first on the scene — are getting the remedy in an effort to combat against these drugs and help save lives.
Narcan, the brand name of the opioid overdose-reversal drug Naloxone, was administered by EMS 1,043 times in Horry County last year – the most of any county in the state. The number was more than double the amount the drug was used in 2015 (509 times), when 74 people here died in opioid-related deaths.
The death toll rose last year to nearly 100 suspected opioid deaths.
“It’s frightening,” said Arnold Alier, director of EMS for the S.C. Department of Health and Environmental Control. Alier was teaching officers in Horry County how to use Narcan on Wednesday.
“If you break it down by zip code, there’s one zip code in Myrtle Beach that has almost 400 overdoses that EMS responded to and gave Naloxone [in 2016],” he said.
Alier was referring to zip code 29577, which spans from the shores, encompassing downtown, reaching south to the state park area and northward to 62nd Avenue North. EMS delivered Naloxone 397 times in that area last year, according to his numbers.
This year, Myrtle Beach police responded to 27 calls in January that involved heroin or fentanyl, a synthetic opioid 50 to 100 times more potent than morphine. Seventeen of those calls were for overdoses.
So far this year, Horry County Fire Rescue EMS has delivered 176 doses of Narcan, which is up from the same time last year when they gave 154 doses within the same period.
But the amount of actual overdoses is much larger than those numbers show, according to Capt. Patrick Ellis with Horry County Fire Rescue EMS. His crews get around six to eight heroin-related medical calls a day, he said.
The hallmarks of overdose are unresponsiveness, issues with breathing and constricted pupils.
Ellis said EMS personnel don’t hesitate to use Narcan if they arrive on scene and a patient is clearly in dire need of it, but he said they are careful not to give it if the situation doesn’t call for it.
“If we get there and an addict is OK, (EMS will) try to hold off on administering Narcan, or give it in a small amount to pick up their breathing,” Ellis said. “…The last thing we want to do is completely reverse them quickly, unless they’re bad off. … If you take someone who’s high on heroin and you immediately take that high away, they can go into withdrawal quickly, which means they’ll be in a lot of pain, they’ll vomit, they could seize.”
While his crews administered the antidote 947 times last year, the actual number of overdose calls they’ve responded to is double that because Narcan is not always used when they respond, he said.
“It’s bigger than it looks. … We may not have given Narcan, but they were still overdosed, so that number can almost be double,” said Ellis, who stressed the actual number of overdose calls can be hard to quantify. He also cited a recent example of when crews last week responded to a heroin overdose call at a gas station. One addict was discovered in a restroom and a proactive EMS worker thought to check the other bathroom and found another overdosed addict.
Ellis said he’s glad law enforcement will also be armed with the lifesaving remedy.
“Any help we can get from law enforcement, first responders getting to these people as fast as they can, because a lot of times they’re in cardiac arrest and if you don’t get that medicine to them quickly, they’re not coming back, so I think it’s a good deal,” he said.
The opioid antidote was administered 54 times in the North Myrtle Beach area last year.
After seeing a rise in overdoses, the city’s fire department started carrying Narcan in November to use only when firefighters beat an ambulance to the scene. The department has administered it six times.
“All of them have been successful,” said Lt. Nathan Marker, of North Myrtle Beach Fire Rescue.
The average current response times for EMS in South Carolina is just over 11 minutes. The average response for fire departments running medical calls is just over 6 minutes. But police typically reach the scene in 3-5 minutes, Alier said.
Police departments throughout Horry and Georgetown counties are now training to use the lifesaving drug.
From numbers to Narcan
The numbers — from a coalition aimed at arming law enforcement with Narcan — tell a bleak story about the growing use of heroin and opioids in Horry County and the state.
Horry County ranked as one of the highest counties with opioid deaths in South Carolina.
There have been 20 suspected opioid overdose deaths in unincorporated Horry County in 2017, with the latest one happening early last week, Horry County police said.
In 2015, there were 594 statewide opioid-related deaths, eclipsing the number of homicides in the state, which was counted at 433, according to Alier. DHEC also is a member of a coalition called Law Enforcement Officers Naloxone that travels to counties all over the state, striving to educate officers on the signs and symptoms of overdose, how to use Narcan and the laws on its usage.
NMB Fire Rescue went through training in September.
Soon Horry and Georgetown county law enforcement agencies will be supplying their officers with Narcan thanks to the Law Enforcement Officers Naloxone (LEON) Training Program, which trains and arms police with Narcan by way of a federal grant.
On Wednesday morning, more than 50 people from 15 different area agencies packed into a room at the Conway DHEC office to undergo a two-hour training session on how to administer Narcan. Officers will be equipped with the nasal spray form of the overdose-reversing drug.
“There’s a lot we can do as a society to help, but it’s gonna take all hands on deck,” said Alier.
LEON was formed in 2015 and is composed of DHEC officials, the Fifth Judicial Circuit Solicitor’s Office, the S.C. Department of Alcohol and Other Drug Abuse Services and others. The group pursued a law that passed, granting police officers immunity so they can provide Naloxone to people suspected of overdosing.
Wednesday’s training session in Conway was a “training of the trainers” for area agencies that sent officers to learn about recognizing overdose signs and symptoms and how to administer Narcan. Those officers will then teach others what they’ve learned and more police will hit the streets armed with the antidote.
DHEC will stand by to help agencies when they roll out the antidote to their departments and school officers on how to recognize an overdose and use the Naloxone, Alier said.
After Wednesday’s training, about 47 law enforcement agencies statewide are trained to administer it.
“For many reasons EMS is not always first on scene,” Alier aid. “It’s not EMS’ fault. It’s just the nature of the beast. … It makes sense to equip the very first person on the scene with the Naloxone.”
The drug also can save officers who may come in contact with drugs in the field.
“Are we enabling overdose patients, allowing them to do it again?” Alier asks on one of the slides in his presentation. “No,” he answered, “we are giving addicts a second chance to live and choose freedom from addiction.”
Alier said he knows it won’t be easy for addicts to rid themselves of their addictions, but there is hope and a way out if they choose to take it.
“One of the things that we look at is more policing, arresting people and giving Narcan is not going to get us out of the problem,” Alier said. “It’s a part of the solution, so when an officer gives Narcan and saves someone, they’re giving that person a second chance.
“What they decide to do with that chance is totally up to them. We give them a choice at that point: You can either continue down this path, which will eventually lead you to death, because we do have the numbers for that, or we can enroll you in some sort of rehab to get you free of this.”
Voices of local law enforcement
Sgt. Thomas DelPercio with Horry County police helped organize Wednesday’s training of the trainers. He said his department is writing policy and making plans to arm officers with Narcan.
“Policy is being written and discussed as we speak,” he said. But no date has been set as to when or how many Horry County Police Department officers will carry Narcan, he added.
Narcan is being sold over-the-counter at pharmacies, DelPercio said, and some addicts arm themselves with it as a safety net, but DelPercio warned that when they’re rendered unconscious during an overdose, their Narcan will be useless.
“The potential is there,” he said of the possible positive impacts from officers carrying Narcan. “Unfortunately, a lot of the subjects we’re dealing with in this instance, they’re scared because obviously heroin and/or Fentanyl and other opioids that are causing these overdoses are being used illegally. So people are hesitant to call first responders and if we get there too late, the Narcan will be useless.”
Lt. Selena Small, spokeswoman with Conway Police Department, said attending the training was just the beginning for CPD.
“This is one of the first steps with Conway Police Department in this process and it is still in progress of being created,” she said via email.
The same can be said for the Myrtle Beach Police Department.
“Once the trainers have been trained, they will return and train selected officers,” said MBPD Lt. Joey Crosby.
The exact number of Myrtle Beach officers who will carry the drug has not been determined, but Crosby said they saw a need in the city to have that tool.
“Narcan allows officers to address the immediate emergency situation that heroin poses to a user that has overdosed,” Crosby said via email. “Narcan is a vital response to save the life of a person that has overdosed. Education and rehabilitation are essential to break the cycle and stop the individual from continuing to use the drug.”
Authorities say ridding medicine cabinets of unwanted drugs could be an important step in fighting against the epidemic. A list of drug dropbox locations where medications can be safely discarded is available on the Horry County Heroin Coalition webpage at http://www.horrycounty.org/Departments/Solicitor/HeroinCoalition.aspx
The webpage also lists where help can be found for those struggling with addiction as well as their family members.
The agencies present at Wednesday’s training were: Horry County Police Department, Horry County Sheriff's Office, Myrtle Beach Police Department, Conway Police Department, Coastal Carolina University Police Department, North Myrtle Beach Police Department, Surfside Beach Police Department, 15th Circuit DEU, Georgetown City Police Department, Georgetown County Sheriff’s Office, Andrews City Police Department, Pawleys Island Police Department and the S.C. Highway Patrol and the S.C. Probation, Pardon, and Parole.