Alaska has been experiencing a significant rise in drug overdoses beginning in March, with a sharp increase in heroin-related overdoses seen in the last week, health officials said.
Last week brought “one of the worst spikes we’ve seen in several years across three different public health regions, mostly involving heroin,” said Elana Habib, with the Alaska Department of Health and Social Services’ Office of Substance Misuse and Addiction Prevention, during a public information call this week.
Habib cited emergency department data gathered from around the state as evidence of the spike. The average number of overdoses per week since March is almost three times as high as the weekly average for 2019 and 2020.
“We’re hitting new records, and the average is substantially above what we’d expect,” said Anna Frick, an epidemiologist with the state health department.
Officials said in an interview Thursday that the surge is unusual — and a cause for concern.
“This is a big spike, and I’m worried about it,” Frick said.
The three regions with the most significant increases were the Anchorage and Mat-Su area, plus the Southeast and Gulf Coast regions.
Overdoses have been reported across Alaska, however, and uneven data tracking across the state means it’s possible the spike in overdoses is happening in other regions too, Frick said.
While the majority of overdoses seen last week involved heroin, that drug doesn’t usually work alone — and there’s generally another one to three substances involved in an overdose, Habib said.
Frick said that the overdoses did not refer to deaths but rather overdoses involving hospitalization, and that it was too soon to know how many overdoses have recently resulted in death.
“What I can see now is that there are more people in the emergency department that appear to be overdosing on heroin than we’ve seen in a long time, and that number has been high for several weeks, and we’re concerned that it won’t go down,” she said.
The health department will likely issue a public health alert for potential users and health care providers soon to tell them that something unusual is going on, she said. The cause of the overdose spike isn’t clear and there are a number of possible factors, including a different group of people using heroin than normal, a different type of heroin, stronger heroin or heroin laced with something else, according to Frick.
“We aren’t exactly sure, but we think it’s important people know about this, so if they were planning on using heroin, they can try to do so more safely with a fully formed awareness that what they’re getting might not be what they’re expecting,” Frick said.
It’s possible that fentanyl, a synthetic opioid that is about 50 to 100 times more potent than morphine, was involved in the recent overdoses, according to Habib. Fentanyl is particularly easy to overdose on because of its extreme potency, and it’s often added to street drugs like cocaine, meth and heroin.
“We also know that meth has become more potent and pure,” Habib said. “So anytime either heroin is mixed with meth, which, that definitely happens ... that’s going to be a little bit more predictive of overdose.”
It’s also possible that Alaskans beginning to return to their pre-pandemic lives could partially explain the jump, said Jeannie Monk, senior vice president of policy and programs at the Alaska State Hospital and Nursing Home Association.
“People who maybe, because they were stuck at home, had less access to opioids, may have decreased their use. And then as things open up, it’s easier for them to get access to the drugs,” she said. “And that’s also a high-risk time because people haven’t been using as much, so their tolerance has gone down,” which could be leading to more overdoses, she said.
Alaska is not the only state that has been seeing an unusual amount of overdose activity in recent weeks — it appears to be part of a national trend, according to health officials.
Older data shows that opioid-related overdoses increased during the pandemic. Alaska in 2020 had its worst drug-related overdose death rate in a decade: 143 people lost their lives last year, Habib said.
Fentanyl was a big contributor: Preliminary 2020 data showed that fentanyl was involved in about half of those deaths, said Jessica Filley, an epidemiologist with the Office of Substance Misuse and Addiction Prevention.
“We’ve never seen this before in years past, so that’s a new thing” and that’s why fentanyl is on their radar, Filley said. “But again, we can’t be sure that’s what’s behind last week’s data.”
Habib shared some preventive measures Alaskans can take to prevent overdoses and death, which she said are very effective if used well. She said that any Alaskan, no matter who they are, should carry Narcan, a nasal spray that can be used to treat a known or suspected opioid overdose, Habib said. Narcan, or naloxone, has been linked to a 93% survival rate for those experiencing overdoses.
“You just never know when you are going to come across someone who’s showing signs of an overdose,” she said.
Other advice she shared:
• Don’t use more than the prescribed amount of prescription opioid, or alone.
• Do not mix opioids with benzodiazepines, alcohol or other tranquilizers.
• Don’t mix opioids with methamphetamines or cocaine.
• Test any illicit substance for fentanyl using test strips.
• Carry Narcan.
• If someone has overdosed, call 911, administer CPR and then use Narcan.
“We think people who are using know these things, but they generally don’t know these things,” Habib said.
Alaskans can contact their local public health center or email projectHOPE@alaska.gov for more information on treatment or recovery, or to access Narcan.