After making progress in reducing opioid overdose deaths last year in Guilford County, heroin fatalities are again on the rise.
Deputy Chief James Hinson provided some sobering statistics about how the opioid crisis continues to inflict devastation on residents of Greensboro during his testimony before a House Homeland Security subcommittee in Washington on July 25.
Hinson, who commands the patrol bureau for the Greensboro Police Department, told lawmakers that the department has seen a 500 percent increase in heroin overdoses since 2014, as measured by 911 calls. That’s not particularly surprising, considering that opioid-related deaths shot up nationally around 2014, but what stood out in Hinson’s testimony was the increase in overdoses from 2018 to 2019. In only the first six months of 2019, Hinson said, the Greensboro Police Department has responded to 56 heroin deaths (compared to 67 for all 12 months of 2018) and to 319 overdose calls in the past six months (compared to 418 in 2018).
“This opioid crisis has left few untouched, with Americans dying every day from opioid overdose,” Hinson said in his testimony before the House Homeland Security Subcommittee on Intelligence and Counterterrorism. “Families are impacted from children being born with neonatal abstinence syndrome or children experiencing trauma as a result of a parent or family member’s addiction.”
The dramatic rise in opioid deaths in Greensboro this year stands in contrast to heartening news from Guilford County Emergency Services earlier this year. In 2018, for the first year since 2013, the county agency, which covers High Point and unincorporated areas of the county along with Greensboro, recorded a drop in overdose deaths, from 104 in 2017 to 79 in 2018, even as the number of overdoses continued to climb. Part of the reason cited for the reduction in fatalities at the time was the efforts of a partnership called Guilford County Solution to the Opioid Problem, or GCSTOP, which provides clean needles to addicts, equips first responders and family members with Naloxone to reverse overdoses and refers addicts to treatment.
Jim Albright, director Guilford County Emergency Services, told Triad City Beat that the shift in opioid fatalities cited in Hinson’s testimony is consistent with what officials are seeing countywide.
“We are seeing an uptick in deaths related to the ‘poly-pharmacy’ issues in the community (Greensboro, High Point and Guilford County),” Albright said in an email. “The heroin has a high degree of fentanyl analogues, as well as crossover into the other illicit drugs.”
Hinson described fentanyl — a synthetic opioid whose potency makes it both easier to smuggle in small quantities and more deadly — during his testimony.
“Fentanyl is a potent synthetic opioid pain reliever,” he said. “It is impossible to measure the difference between a lethal or effective dose outside of a laboratory; this drug is deadly. Fentanyl can be disguised as heroin to unsuspecting individuals. Some individuals will gain access to fentanyl and sell it as a very potent heroin. This is where the majority of overdose deaths occur due to unfamiliarity with the drug they are actually using.”
Hinson also cited a marked increase in drugs taken off the streets this year.
“In 2018, the vice-narcotics division of the Greensboro Police Department has seized over 1,366.65 grams of heroin,” he testified, “and in 2019, from January through June, there have been 8,478.8 grams of heroin seized.”
Bryce Pardo, an associate policy researcher at the Rand Corporation, testified that the amount of fentanyl seized by US Customs and Border Protection leaped from 1 kilogram in 2013 to 1,000 kilograms in 2018.
An executive assistant commissioner at Customs and Border Protection previously testified in 2017: “The majority of US-trafficked illicit fentanyl is produced in other countries such as China, and is principally smuggled through international mail facilities, express consignment carrier facilities (e.g. FedEx and UPS), or through POEs [ports of entry] along the southern land border.”
By sheer weight, the majority of fentanyl is coming into the country across the US-Mexican border, Pardo testified. But that doesn’t tell the whole story: Fentanyl analogues — which are similar in chemical structure, but even more potent — are mostly coming in through mail from Chinese manufacturers.
“According to CBP data, the bulk majority of fentanyl that arrives by weight comes over the southwest border,” Pardo testified. “However, the purity of what’s being seized there is very, very low. The purity that’s seized at mail facilities or express consignment facilities is very high, about 90 percent above. Adjusting for purity, the bulk majority of fentanyl is coming from mail or express consignment.”
Sondra McCauley, assistant inspector general for audits at the Department of Homeland Security, testified that more than half of the international mail arriving in the United States comes through John F. Kennedy International Airport in New York City.
McCauley testified: “We identified a number of deficiencies in CPB’s inspection processes at JFK that inhibit CBP’s ability to prevent illegal drugs and contraband from entering the country, including: (1) CPB does not inspect all international mail selected for inspection; (2) CPB does not inventory all mail selected for inspection; the [Automated Targeting System] pilot for targeting mail has limited impact; and (4) CPB’s chemical analysis process for detecting illegal opioids in arriving air mail is problematic.”
Among the specific problems McCauley’s audit found: Customs and Border Protection does not have an adequate number of canine teams trained to detect narcotics, Customs did not have adequate equipment needed to inspect hundreds of thousands of pieces of mail coming through airport each day, and the agency had limited, outdated X-ray machines that could examine only a portion of the incoming mail.
McCauley said the Automated Targeting System only examines only 0.01 percent of packages arriving at JFK each day, and that it relies on data provided by foreign post offices. She added that the US Postal Service does not have an agreement with the Chinese postal service.
McCauley provided a scathing assessment of Customs and Border Protection’s handling of seized fentanyl.
“One of the two vaults with naloxone in the lockbox also contained the largest recent seizure of fentanyl in CBP history,” McCauley testified. “At that vault, staff had taped a piece of paper bearing the code to this vault on the wall next to the lockbox. However, when asked to open the lockbox at the other vault, staff could not do so because they could not remember the code. If actually exposed to fentanyl, a person could die without prompt access to naloxone.”
She testified that the agency lacks an official policy on handling fentanyl and lacks required training, and that because staff doesn’t have easy access to naloxone, employees are unnecessarily placed at increased risk of injury or death.
Consistent with the major flow of fentanyl through JFK and other major East Coast mail hubs, Pardo testified that to date, synthetic opioid deaths are mostly concentrated in the eastern half of the country.
China remains the dominant manufacturer of fentanyl, but Pardo said two seizures in late 2018 suggest that India could become a player.
“Beyond Mexico and China right now, which are the largest exporters to the United States, according to law enforcement data, India is on the horizon,” Pardo testified. “Late last year there were two substantial seizures of fentanyl that were inbound leaving India to North America. That is the next place it could go. India has a substantial pharmaceutical industry and lacks resources to police it.”
In response to concerns by lawmakers that Customs and Border Protection equipment is outdated, Pardo said there are handheld devices that use infrared spectrometry, allowing for line operators to quickly detect chemical substances. But that assumes agents know what they’re looking for.
“The problem with the analogues is it only tests against the known universe of chemicals,” Pardo testified. “A chemical that was designed last week we don’t know about yet, so that machine’s not going to detect it.”