needle exchange heroinFollowing a disturbing trend over the past week in surrounding states, Louisville hospitals treated nearly 30 patients overdosing on heroin on Tuesday, a surge that likely is tied to a supply of heroin being cut with the more powerful and deadly opioid fentanyl.

A spokeswoman for Norton Healthcare says their hospitals treated at least 12 overdose patients on Tuesday, while KentuckyOne says 11 were treated at the University of Louisville Hospital, three at Saints Mary & Elizabeth Hospital, and five at Jewish Hospital within a 48-hour period. Such figures are unprecedented for these hospitals, surpassing numbers that already have begun to rise in recent months with the increasing presence of heroin cut with stronger drugs.

According to Louisville Emergency Medical Services records, during the first seven months of this year their personnel administered the opioid overdose antidote naloxone to an average of nearly six patients per day, with that figure reaching nine per day in March and 10 per day in May.

Dr. Robert Couch, an emergency medicine physician at Norton’s downtown hospital, says that as soon as he began his shift Tuesday afternoon, he started to witness something he had never encountered in his 30-year career.

“When I came on shift at Norton, the very first patient I saw was a heroin overdose,” says Couch. “And then the second patient was a heroin overdose. And then the third patient was a heroin overdose. We knew that something different was going on… it’s just unusual to see that many.”

By the end of his shift at midnight, he would see six more overdose patients, all of whom were unique because they required multiple doses of naloxone in order to continue breathing. He says this likely was due to the patients taking heroin cut with fentanyl or the much more powerful carfentanil — an elephant tranquilizer that recently surfaced in Ohio — as several who overdosed were longtime heroin users taking small doses, and they likely were unaware of its potency.

While Couch suspects one of those drugs was used to cut a supply of heroin that has entered the Louisville market, he says a definitive answer to that question could take weeks, as the Jefferson County Coroner conducts autopsies and the heroin is sent to the state police lab.

Couch says that a couple of years ago it was rare for him to treat a patient with an overdose, but they have since become more frequent and have grown exponentially even from the beginning of this year.

“I used to tell people we would occasionally see a heroin overdose,” says Couch. “And earlier in the year, I thought it was an astronomical number of people, but now I’m seeing three (overdoses) in a shift. Last month there were a couple of occasions when I might see even three at the same time, which was very unusual. Well, yesterday was completely different, the numbers were far greater than what I’ve ever seen, and I’ve been doing this for 30 years.”

Couch said all of his overdose patients survived yesterday, though he heard from EMS that there was at least one fatality among the nearly 30 overdose victims treated in hospitals yesterday.

This spike of overdoses in Louisville mirrors the disturbing incidents of the past two weeks in the region, as large numbers of patients have overdosed on a potent batch of heroin in a short time frame in southern Indiana, Cincinnati, Huntington, W.Va., and Mt. Sterling, Ky.

Overdose deaths involving fentanyl dramatically increased in Kentucky last year, and records from the Jefferson County Coroner show an even greater spike this year. Their records show there were 31 fatal overdoses in Louisville during the first three months of 2016 where fentanyl was detected in the autopsy, which surpassed the total for all of 2015 and was 15 times higher than that period in the previous year.

Louisville EMS records show the number of overdose patients receiving naloxone from their personnel so far this year has more than tripled the rate from 2015, beginning to dramatically increase this March, when the local health department warned about the increasing presence of heroin being cut with fentanyl.

Joe Sonka
Joe Sonka is a staff writer at Insider Louisville focusing on government, politics, education and public safety. He is a former news editor and staff writer at LEO Weekly and has also freelanced for The Nation and ThinkProgress. He has won first place awards from the Louisville Metro chapter of the Society of Professional Journalists in the categories of Health Reporting, Enterprise Reporting, Government/Politics, Minority/Women’s Affairs Reporting, Continuing Coverage and Best Blog. Email him at [email protected]