Paramedics attend to Kyle Coughenour at the Aventine at Boynton Beach apartments. Paramedics revived Coughenour, who survived after treatment at the hospital, according to police reports.
A woman's screams ring through the hallway.
Inside, her boyfriend can't breathe. He barely has a pulse.
"I don't know why he's out," she cries to Boynton Beach first-responders.
"Do something," she begs.
One after another, police and paramedics charge up the stairs and into the apartment.
They've seen it all too often.
It's a head cold, she tells them.
They know better.
Kyle Coughenour, 21, is on the bedroom floor.
For the 28th time in June, police and paramedics are forced to confront the painful toll brought to Boynton by drug overdoses, most often heroin. Since the beginning of the year, 151 people have overdosed in the city. Nine died.
Coughenour would survive.
Needing more space, paramedics carry him into the living room. They lay him down and hover over him.
Wait outside, they tell his girlfriend. The doors slams.
She answers a torrent of questions from officers poking their head through the door. She rests her back against the wall and leans forward. Her hands cradle her face.
For police and paramedics, such scenes have become routine.
Overdoses defy prediction, they say. At one point in June, they had 10 in seven days. There's no busy day of the week. There's no busy time of day. There's no Saturday night rush.
That's not surprising. It's an addiction. A disease. An addict's need has nothing to do with the calendar.
It's rarely clear why they overdose. Some relapse after getting clean. They return to the same amount of heroin. But this time it's too much. Others don't know the heroin they inject has been laced with fentanyl, a far more potent, cheap drug.
The problem has grown so dire, Police Chief Jeffrey Katz wants the public to know more about what confronts his officers every day. Six times over four months, at his invitation, a Palm Beach Post reporter and photographer have taken to city streets, accompanied by veteran, high-ranking officers.
Boynton Beach Police Sgt. Hap Crowell looks over a printout of reported overdoses in the city during late March and early April. Police say overdoses from opioid abuse have risen dramatically over the last year. Some addresses have been redacted.
In all of the talk between emergencies, two words stick out the most when officers reflect: Frustrating and sad.
"Can you imagine if there were 45 homicides in 45 days? Even comparatively if there were 45 robberies in 45 days?" Sgt. Daniel Dugger said in April about a recent spike in overdoses. "People would be going haywire. I've never seen this many people close to death or dying from one thing."
'No way to stem the tide'
Delray Beach in sunny South Florida is known as the addiction recovery capital of America. The industry there dates back decades. But over the past couple of years, as the recovery industry has grown, becoming the county's fourth-largest, it has spread to neighboring cities, such as Boynton.
Recovering addicts who relapse often end up on the streets. And end up using again, creating what rescuers call the worst drug epidemic they've ever seen.
"It's frustrating. Typically when you have an issue like this … there's always a plan. If there are burglaries in a certain area you can deploy assets and make arrests," said Dugger, an 11-year veteran. "With overdoses there's not really a plan you can devise at the local level. There is no end. There's no way to stem the tide."
It's not a homegrown problem — it's addicts from the north, such as New York, New Jersey and Massachusetts, coming to Florida to get clean, police say.
They live in sober homes and one big piece of the problem is the ones run by operators who are motivated by profit instead of the best outcome for the addicts. The cops know where these places are. They drive around town and point them out.
"Right back here, you have sober homes. How do you expect them (addicts) to be successful? Putting them in a large drug-infested area? It's just sad," said Sgt. Hap Crowell, a 16-year veteran. "Unfortunately, a lot of these places fall through the cracks. They're not regulated. They're not licensed and I think that's a big problem.
Sgt. Hap Crowell recalled a case in which someone dumped an addict at a motel. "That's what's sickening — to see what little value people put on the human life."
"It's just sad because a lot of the kids want and really need the help. Sometimes they're not getting it. We just need to make sure they're doing the right thing for these guys."
But the police have no legal right to walk inside and shut them down.
If an addict gets kicked out, which often happens when they relapse, they can wind up homeless. They wander neighborhood streets. Police call them "zombies." And zombies will do whatever they can to chase their last high. For some, that means turning to crime.
Residents of neighborhoods overcome with sober homes complain as if it's the officer's problem to fix. But it's not, police say.
"It's easy to try to catch this as a law enforcement issue but it's really not. It's a public health crisis," Katz said. "You can't arrest somebody for being an addict. That's a sickness. That's an illness. And that needs to be addressed."
'Don't send your kid to Florida'
While patrolling the streets, if Capt. John Bonafair sees a group in recovery, he starts a conversation to see how their lives are going. He recalls one time he spoke on the phone with an addict's parents about finding a better place for treatment.
"I've been fighting this war for a long time and we are not winning it."
— Capt. John Bonafair
It's not rare to spot him in his police truck at grocery store or gas station parking lots. He's there watching for drug deals or for someone who just shot up.
Bonafair worked through the height of the pill mill crisis, when pain clinics handed out prescription medication by the bucket. The present, he said, reminds him of the past.
"We're right back into the same situation," he said. "I've been fighting this war for a long time and we are not winning it. All we're doing is keeping a lid on it. It's really frustrating."
The only way to put a stop to this?
"Put up a big banner saying 'Don't send your kid to Florida; it's a sham.'"
Left 'like a bag of trash'
Overdoses happen throughout the city. Users are found unconscious in cars, hotels, gas station bathrooms, apartment buildings, sober homes.
Crowell drives into the The Homing Inn parking lot on South Federal Highway and recalls the dumping of an addict who had overdosed.
"Their intention was just to leave her on the floor like a bag of trash. That's what's sickening — to see what little value people put on the human life."
Often the life is saved because of Narcan, the heroin overdose antidote.
In a video provided by Boynton Police, city paramedics administer Narcan to a man who appears to be passed out in a car. Watch what happens when Narcan, the heroin antidote, takes effect.
"It's bizarre. It's like a shot of coffee. It's almost like you're bringing them back from the dead," Crowell said.
Boynton's emergency medical technicians carry Narcan, but Boynton police don't. At least not yet.
Delray Beach police recently began to carry it in nasal spray form. Boynton would use it like an epi pen that would hold just enough of the drug to keep an addict alive until paramedics arrived. Officers have mixed thoughts about whether it will make a difference.
"Hopefully it'll have some effect. But in our jobs if we get there, the fire department gets there two, three minutes tops," Bonafair said. "Am I in favor of it? Yes. Do I think we'll save more lives? No. But if we save one life, it's worth it."
But it works only if they are called in time.
'Makes my stomach hurt'
It's 4:30 a.m. Cody Lee wakes up for work and walks over to the bathroom. He tries to open the door.
It's locked. He bangs on it. No answer. His roommate, a man he barely knows, must be inside.
He goes to work at his nearby construction job.
It will be six hours before he returns and realizes that his roommate, Michael Burruano, 31, is inside, dead.
Michael Burruano (contributed)
Officers cram into Burruano's hotel room, their eyes trained on his body.
He is already stiff, his arms and legs locked into a contorted pose, as if he died in a fetal position before he was flipped onto his back. His face is dark red from the blood that pooled in his head.
In the bathroom, officers note the evidence on the vanity: A bottle cap. A lighter. A Q-Tip with one end bare. A heroin capsule.
They find a syringe on the floor next to the body.
An officer outside the room has seen this scene far too often. He sounds jaded.
"I'm sure there will be another one," he says.
Cody Lee is talking to police in the hallway. He's a roommate by circumstance. He and Burruano were working together and their employer housed them in the same room at the hotel, The Inn at Boynton Beach.
Outside a hotel room where police say Michael Burruano died of a drug overdose. Burruano was recently hired by a construction company and shared a room at the hotel with a co-worker. The roommate, Cody Lee, (left) was not charged or suspected in any crime, according to police reports.
He last saw Burruano alive the night before at the pool.
"It makes my stomach hurt," the roommate said, while coming up with answers to the peppering of questions by police.
Down the hall, police interrogate a man they think might have helped Burruano get high.
Burruano was an alcoholic, his mother, Karen Burruano, would later tell The Post. He spent time in recovery, she said. He tried drugs such as Xanax, she said, but wasn't one for anything with a syringe.
The scene in his room surprised her, she said, even though she knows her son had used heroin before.
Chief weighs amnesty
Burruano wonders whether her son fell victim to a problem adding to the epidemic: The cutting of heroin with the more potent synthetic drug, fentanyl.
"All I'm hearing about is that the heroin is laced with fentanyl and that it's twice as powerful," she said. Fentanyl is actually 50 to 100 times more potent than heroin.
Police say that's become a big problem — the addict doesn't know how much the heroin has been "stepped on" or altered. With fentanyl, the drug cocktail is often fatal.
"They shoot it in and it's like nothing they've had …" Crowell said.
"We have to be creative and non-traditional in the way we address these issues because the public still looks to us to be the problem-solvers."
— Police Chief Jeffrey Katz
Police want to help, Katz said.
He is exploring an "angel" program similar to ones up north. In Gloucester, Mass., addicts are invited to turn in their drugs at the police department without being arrested. The addict is set up with an "angel" to help them get clean.
"We have to be creative and non-traditional in the way we address these issues because the public still looks to us to be the problem-solvers," Katz said. "And we might not have the tools to solve the problems, but at least maybe we can direct people to resources or at least advocate for the development of resources that will help the underlying issue."
Police also arrest heroin buyers and sellers. While officers wonder if those busts have an impact, Katz said they have helped. In late May, police made six arrests, including a father and daughter accused of buying heroin from an undercover officer. Earlier in May, they charged 17 people with selling heroin and cocaine.
Overdoses are so common in semi-public places that police scour the parking lots just for the chance to save a life.
While on patrol in an apartment complex in June, Capt. Mike Kelley spots a woman sitting in the driver's seat of a parked car. She looks like she is slowly falling to the side.
Kelley throws the police truck in park, and darts up to her. But when he finally sees her face, he sees she was looking at her cellphone.
Armed and passed out
Police and paramedics never know what they are up against.
Jamarr Harris is passed out behind the steering wheel in the middle of a neighborhood road. The officers try to help him out of the car so paramedics can treat him. But he wants nothing of it. Kelley spots him reaching toward his waistband.
Boynton police officers respond to a call about a man parked in the middle of the road in a neighborhood. Jamarr Ramone Harris was arrested on charges including cocaine, marijuana and heroin possession.
They search him. It's a handgun. Loaded.
"Gun," he alerts the paramedics.
In Harris' car, police find a magazine of bullets and a black sock holding 36 rounds. And a bag each of heroin, cocaine, and marijuana.
Boynton Beach Police Department officers arrest Jamarr Ramone Harris after Harris was found behind the wheel of his car and parked in the middle of a neighborhood road.
Paramedics attend to Kyle Coughenour inside an ambulance at an apartment complex. Coughenour was revived by Narcan after he was found unconscious in his apartment.