Four overdoses — one fatal — in a Southwest Alaska village in mid-August involved heroin mixed with fentanyl, a powerful synthetic opioid, increasingly being seen nationally, troopers said Friday.
The heroin seized in Quinhagak, with a population of about 700, contained more fentanyl than heroin – the first time the Alaska State Crime Lab has seen a batch like it, the Alaska State Troopers said.
"The news is not welcome as this trend is sweeping across the country," troopers wrote.
Four people overdosed Aug. 15, troopers said, and one of them died. Two men found not breathing required a medical evacuation to nearby Bethel, and a third man found in distress received care in the village.
The woman who died was Jamie Roberts, 19. Health aides in the village tried for two hours to resuscitate her before she was pronounced dead, troopers said.
The day after Roberts' funeral, the community held a drug awareness march, wrote Stephan Jones, an environmental assistant with the Quinhagak tribal government.
Roberts' mother suggested community members ride through the village on four-wheelers because Roberts had loved participating in an annual New Year's ride through town, Jones said.
Schoolchildren made signs protesting drug and alcohol abuse, and condemning dealers, Jones wrote. The ride lasted about 40 minutes and was led by tribal police chief Sonny Jones.
The march was organized "to show respect for Jamie and also her family, and also to see if that seller can be intimidated by that to maybe stop," said Eleanor Merritt, the village's tribal services director.
Heroin use is a growing problem in the village, Merritt said. She had never heard of fentanyl before Friday's news.
This is only the second time in Alaska a drug submitted to the state crime lab has been confirmed as a mixture of heroin and fentanyl. The first came from Juneau in 2015, wrote troopers spokesperson Megan Peters.
"Recently a few other heroin samples have given results indicating the possible presence of fentanyl but the percentage was too low to confirm," Peters wrote.
Fentanyl is primarily produced in transdermal patches, and is prescribed for chronic pain management, Peters wrote.
The patches are the most common form submitted to the state lab, though they're still rare, Peters said.
As recently as 10 years ago, no opioid deaths were reported in the Yukon-Kuskokwim region. Now, the Yukon Kuskokwim Health Corp. sees one to two deaths a year, according to spokesperson Tiffany Zulkosky. Those deaths are due to either illegally obtained prescriptions or heroin, she said.
In response to the growing use of opioids, the YKHC has tightened its guidelines around how the drugs are prescribed, Zulkosky wrote.
Roberts' death is the third time this year the State Medical Examiner Office has found fentanyl in a dead person's system, said Jay Butler, chief medical officer for the Alaska Department of Health and Social Services.
Statewide in 2016, Alaska has had more than 40 opioid deaths, Butler said. Each case is manually reviewed and that process wasn't complete, so he was unable to give an exact number. In 2015, 81 Alaskans died from opioid overdoses, Butler said.
Nationally, heroin and fentanyl deaths are increasing, according to the Drug Enforcement Agency.
"The United States is in the midst of a fentanyl crisis," the DEA wrote in a July report.
Between 2014 and 2015, fentanyl deaths more than doubled, the Centers for Disease Control and Prevention says. Fentanyl is 50 to 100 times more potent than morphine, according to the CDC.
It is often combined with or sold as heroin on the street without the knowledge of the drug user. For the past two years, a new form of fentanyl, counterfeit opioid pills, has been seized by law enforcement.
So far, Alaska's crime lab hasn't seen these counterfeit pills, Peters wrote.
Still, the presence of fentanyl in Alaska creates new dangers for drug users who may inadvertently overdose on the powerful substance, according to Peters.
"Heroin mixed with fentanyl has been a trend the crime lab has been aware of for some time. … Up until now, it seemed to be only affecting the Lower 48," Peters wrote.