Terry DeMio

tdemio@enquirer.com

At least eight people who overdosed and died in Cincinnati and Hamilton County since mid-July had the mega potent opioid carfentanil in their blood.

More ominously, Hamilton County Coroner Dr. Lakshmi Sammarco said that the bombardment of carfentanil on Greater Cincinnati in mid-July and August raised the question of whether the region was targeted as a testing ground for dealers trying out the drug – an obscure synthetic opioid normally used on elephants and other large zoo animals – as a cheaper, more easily available substitute for heroin.

"The way this was carried out in our communities in the region brought up a lot of fears... that our community was being used as a test tube," she said Tuesday. Sammarco stressed it was a theory that she and her forensic toxicologist, Bob Topmiller, had while discussing the "focal nature" of the overdoses, although she thinks it makes sense.

Meanwhile, police officers (sometimes acting on tips from the public) have found possible sources of carfentanil- and fentanyl-tainted heroin, said Newtown Police Chief Tom Synan, who heads law enforcement efforts of the Hamilton County Heroin Coalition.

Testing and investigations are ongoing, he said, without giving details. No arrests have been made.

Synan said the recent overdoses underscore the "transition from the original opiates shifting to the synthetics," which generally are made in China and are legal there.

Last year's uptick in overdose deaths due to the potent opioid fentanyl was the first evidence of this shift, which has made officials fearful because they're new and unfamiliar.

A number of other cities and counties across Kentucky (including Northern Kentucky and Louisville), Indiana and West Virginia, have seen a recent surge in overdoses. And over the weekend, Clermont County experienced a surge. On Friday and Saturday, emergency room visits for overdoses hit 10, six more than expected. But none have had overdoses to the level of that of Cincinnati.

The local death toll may rise from the recent OD spree, Sammarco warned during a news conference at her office in Corryville, because toxicology is not yet back for another five people.

The coroner's tests found carfentanil was a cause of three deaths from Aug. 19-25 when Cincinnati experienced a staggering 174 overdoses. The number of overdoses has slowed somewhat, although police reported substantially more overdose runs than usual through the holiday weekend.

Sammarco came up with the test theory after she looked at drug deals "from a business perspective." A business would test-market a new product in a specific location, then watch and draw conclusions.

"You put your drugs out there and see what happens," she said. Otherwise, Sammarco said, "You don't know anything about this drug with customers, you want repeat customers. You might want to know, how is law enforcement going to react? How are firefighters going to react?" Will people return and ask for the same drug to try to achieve the same euphoria, she said.

Estimates of the total number of recent overdoses run as high as 300. But Synan cautioned that some overdoses may have been counted twice since emergency room reports sometimes coincide with police or fire runs.

Over the holiday weekend, city overdose runs totaled 56, Cincinnati Police Lt. Steve Saunders said. Prior to the spike in mid-August, the city had been called to about four such runs per day.

The coroner tested cases that stretched back to mid-July after investigators initially found the large-animal opioid in the heroin stream in the region. Sammarco initially wasn't able to locate a carfentanil sample for testing, but finally was able to obtain some from the Summit County coroner's office with the aid of U.S. Sen. Rob Portman, R-Terrace Park.

Synan made it clear that he was not making excuses for those who are addicted and commit crimes or cause harm to others because of their addiction. But the chief added repeatedly that "we can't arrest our way out of this," noting that overdose victims need quality addiction treatment – with the funding to support such treatment.

He called for Ohio Gov. John Kasich to declare a public health emergency and "release funding" for treatment for the addicted.

Sammarco said that if a similar spike in overdoses would have happened even a year-and-a-half ago, more people would have died. That's because local police been armed with Narcan, the drug that reverses opioid overdoses, only since 2015.

"I really give credit to the first responders," Sammarco said. Emergency crews are having to use more than one dose of Narcan (also called naloxone) because of the higher potency of fentanyl and carfentanil, which is substituted for heroin or mixed with it without the knowledge of purchasers.

She urged families of the addicted, those who are addicted, as well as first responders to carry the non-narcotic. And she warned the general public, "This affects everybody in the community."

On Saturday, Chinese and U.S. officials announced new efforts to stem the tide of synthetic opioids.

China committed "to targeting U.S.-bound exports of substances controlled in the United States, but not in China. Additionally, we agreed to increase our exchange of law enforcement and scientific information with a view towards coordinated actions to control substances and chemicals of concern," said National Security Council spokesperson Ned Price. The Obama administration "will continue to work with China bilaterally and multilaterally to tighten international scheduling and improve the capacity of states to monitor and analyze illicit synthetic drugs."

China has "taken several steps over the past year to control over 100 substances which threaten world health and public safety," Price said in a statement issued by the White House.

Portman last week said he plans to introduce legislation that would add electronic tracking for packages coming from overseas in an attempt to stop the synthetic opioids from entering the United States.