SOUTHERN INDIANA — A carload of people pulled into Clark Memorial Hospital's emergency room last weekend, delivering multiple patients in need of life-saving treatment. Three occupants, hospital officials said, had overdosed on heroin and needed naloxone, a medicine that blocks the effects of opioids and reverses an overdose.
Heroin-related overdoses have spiked in the region in recent weeks. Hospitals have kept naloxone on hand to stop overdoses from killing patients, but both emergency rooms and patients have needed more of the antidote.
Steve Pahner, emergency medicine doctor at Floyd Memorial Hospital, said his team is used to seeing one or two overdoses a day, but it's gotten worse as Louisville and surrounding areas have reported a deadly mix of the drug with other substances. He said the strain that's on the streets sometimes results in overdose patients requiring higher doses of naloxone.
“It's related to what it's being mixed with,” Pahner said. “If this was just pure heroin, they wouldn't end up in the ER as much for an overdose. The trouble with drug abuse is that you never know exactly what you're buying, You don't know the strength or what it really is.”
Wednesday night alone, he said, about eight calls for heroin overdoses came into the emergency room, all within about a two-hour window.
He said lately, the problem has gotten so bad that the emergency room doctors and nurses have taken extra precautions, keeping naloxone on their person. He said if someone young comes in unconscious, they almost assume it's an overdose.
“It probably really picked up a week ago,” Pahner said. “We were seeing, on a daily basis, an overdose or two, but there's been a marked spike here in the last few days.”
Clark Memorial Hospital has seen a similar increase. Bridgett Hanlon, director of marketing, communications and community outreach, said staff there actually saw a spike in overdoses at the beginning of July. She said it's tough to nail down some of the more recent numbers without looking at individual patient charts, but more and more people are coming in for overdose treatment.
In a statement from the hospital, Carrie Dodson, director of emergency services, said about half of all the overdoses documented in July were caused by heroin. In a week's time, 17 cases were noted.
“Clark Memorial is committed to making communities healthier,” Dodson stated in the release. “We are very aware of the drug-related issues that are affecting our community. Our goal is to provide solutions through hospital services to reduce substance abuse and addiction in our area.”
Hanlon said she expects to have more numbers on heroin overdoses from August available next week.
Those patients typically require more observation from emergency workers, too. Pahner said it's not as simple as injecting naloxone and sending patients on their way.
“They do because these patients will need to be observed, typically, for a period of time after the Narcan [has been administered] to watch for a rebound, where the Narcan can wear off and the overdose becomes prominent again with decreased mental status or respiration.
Pahner said he's worked in an ER for the last 27 years. While heroin's become more of a problem in the last decade, he said it's something with which staff is somewhat used to dealing.
“It's just a variation of what we already do,” Pahner said. “The heroin and IV drug use, period, has increased the general burden, along with the infections and other issues they get that aren't necessarily overdose related. We drain abscesses on a daily basis related to contaminated injection sticks. We also have several heart valve infections related to drug abuse.”