Every 15 hours last year, someone died of an opioid overdose in Palm Beach County, nearly double the rate of murders and fatal car crashes.
The 590 opioid overdose deaths in 2016, an all-time high for the county, are nearly twice as many as the year before, according to a Palm Beach Post analysis of records from the Palm Beach County Medical Examiner’s Office.
“That’s just a phenomenal number,” said Dr. Michael Bell, the medical examiner. “I don’t see any stop.”
The number dying with fentanyl in their system rose to 310 from 91 the year before. Fentanyl, a painkiller about 100 times stronger than morphine, often is cut with heroin to produce a more powerful high.
At least 109 died from carfentanil, an elephant tranquilizer that had not even been tracked before 2016. Carfentanil is 10,000 times stronger than morphine.
Opioid-related overdose deaths almost quadrupled from 2012, when 143 people died, according to statistics Bell shared Tuesday with the Palm Beach County Commission.
A November Palm Beach Post investigation on the epidemic’s local toll in 2015 focused on 216 deaths from heroin-related drugs — those that contained heroin, illicit morphine or fentanyl but not Oxycodone and its derivatives.
When similar standards are applied to the 2016 opioid-related deaths, about 90 percent appear to have been heroin-related. About 6 percent of those deaths were determined to be suicide.
In 2016, Bell’s office for the first time started testing for and tracking carfentanil, which killed more people than homicide in Palm Beach County. Now, the medical examiner breaks out carfentanil and its chemical cousins separately from fentanyl.
Analogs like carfentanil are produced by making slight changes to the fentanyl molecule.
“It becomes a real challenge to be able to keep up with all the changes that can be made to that molecule of fentanyl,” Bell said. “It’s much more dangerous, it’s much more more fatal in smaller concentrations than heroin or morphine.
“And probably the biggest problem is that nobody takes just one drug anymore. The overdoses we see are combinations of drugs,” he said.
The vast majority of the 590 people who died from overdoses showed more than one chemical in their system.
The variety of drugs found in overdose patients means rescue crews are spending more money on naloxone, a drug that can reverse the effects of opioids and is also known as Narcan.
Palm Beach County Fire Rescue spent $205,000 on naloxone last year, up from $18,000 in 2012.
A typical dose is a half milligram. Now, rescue crews are administering as much as 10 milligrams on a patient.
“That is unheard of. We are first in the country to step up to that level,” Fire Rescue Capt. Houston Park said. “We are combating a drug that was much stronger than anything we have seen before.”
The pace appears to be unchanged in 2017.
Through April 6, Bell said his office has received 157 overdose cases involving all drugs. He does not know how many of those cases primarily involve opioids because most of the toxicology reports have not been completed.
Last year, his office’s workload topped 2,000 cases for the first time. It’s growing so quickly, he’s preparing to ask for bigger quarters.
“That’s a 60 percent increase in the last two years, which is almost exclusively due to these opioid overdoes,” Bell told county commissioners on Tuesday. “It’s not like we’re getting more homicides. We’re not getting more heart attacks, more elder falls and head trauma. This is all due to opioid fatalities.”
In March, Bell thought he detected a change but it didn’t last long.
“Thought there was a slowing down,” his office tweeted on March 17, “but we have 10 drug overdose deaths today. Must be a bad batch … out there. You’ve been warned!”