Fentanyl in Sioux City - Have we reached a local crisis?
It's a crisis spanning all 50 states. War at the southern border. Not immigration, but fentanyl.
"It's coming across our borders illegally. And so from there, just like any other drug in the United States, it makes its way up north." Like other illicit substances, it's taken its time to move north. Fentanyl has made its way to Sioux City and has resulted in overdoses and deaths. But has it reached a local crisis?
"I would say our numbers are increasing since 2020, but nothing close to bigger cities or other areas that have more access to it," Detective Paul Yaneff has been working fentanyl investigations since 2020. "We saw just like anything else that starts moving from the coastlines into the internal areas here in the state of Iowa, Nebraska and the tri-state area."
In 2022, Sioux City Police seized over 20,000 fentanyl pills. Most look like these small blue pills, marked with M30. To the average eye, it looks like something prescribed by a doctor, but fentanyl doesn't always look like this.
"It comes in different forms, whether it's other colors, and whether it's a bluish green or a green or a white. The M30 is more prevalent around this area. But there has been documented whether it's having the letter K and a nine behind it, the number 215 or a V as in Victor 48," explained Detective Yaneff, who also said that fentanyl typically begins as a powder. "So they're taking this powder and pill pressing it, whether it's already pulled press across the border, or you can get a pill press here in the United States and do it themself and then they disguise it from there."
While fentanyl itself is coming across the border, here in Sioux City, it's local residents selling the pills.
"The ones that we have arrested recently, either this year or last year or the year before, have all been residents or have kind of dual residency," Yaneff said, "whether we're in a different state or not and they come here and visit, but nothing that we've seen that cartel member or anything like that that I've seen, but mostly local people."
And they are selling them to anyone, from teens to older adults.
"With this drug just like any other drug, you're dealing with people that are trying to fit in and try new things and be part of the group. You also have people fighting addiction. And that's a serious issue as well that we try to address."
So there's really no target area of an age group. It's just I think, who wants it for their addiction purposes or who's going to try because their friends are doing it.Let's dig into the numbers. In 2022, Sioux City Police documented at least 18 confirmed fentanyl overdoses that's up from 3 the year before. These were confirmed through toxicology and interviews.
Now it's important to note that an overdose does not mean death. According to MedlinePlus.org, an overdose is when you take more than the normal or recommended amount of something, often a drug. An overdose may result in serious, harmful symptoms or death.
Of the 18 confirmed fentanyl overdoses in Sioux City last year, 3 were fatal. Detective Yaneff says several of those who did overdose on fentanyl thought they were taking something else.
"They thought they were getting cocaine, they thought they're getting marijuana," Yaneff explained. "Let's be honest, a lot of these drug dealers don't separate these items, you know, and put them in labels and containers. So they all kind of mix it together. And so a person may be getting a gram of marijuana or a little thing of cocaine might accidentally be exposed to fentanyl and when they're doing that its reactions are horrible and they get to overdose."
The police department takes fentanyl and any illegal substance interaction seriously. They are working with other area agencies to keep it off the streets.
"We try to tackle as much as we can with fentanyl along with other drugs to try to slow it down. It's very hard because it's flooding our borders like crazy is coming in and getting dispersed but anytime we have any fentanyl case, I work with the tri-state area and also other agencies to advise them, okay, this individual might have had 15 pills and that person told me this and this and this and, of course, there's follow up and there are investigations to do."
Sioux City Police is currently testing out field kits that can test for fentanyl on site. While not currently pushed out to patrol officers, the department hopes to implement these test kits very soon.
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Local first responders see increase need for Narcan as overdoses rise in Siouxland
"We don't use it every day, but we have used it with alarmingly increasing amounts over the last couple of years."
With the rise in opioid usage also comes a rise in overdoses. Which is what Sioux City Fire Rescue's EMS team is seeing.
"I probably started working in this area in 2012 and in 2012 compared to now, I bet you we use it far more than we ever did," said Terry Ragaller with Sioux City Fire Rescue's EMS team.
That drug is Narcan which can reverse the effects of an opioid overdose and save lives.
Amanda Monroe-Rubendall is a clinical educator at Mercyone Siouxland and says they also use it in the emergency room to treat overdoses. "So the way that opioids work is that they attach to parts of our brain and that's how they deliver pain relief. But if we have too much of them in our system, that's how they also slow down our respiratory drive, and people can get in trouble that way. So what Narcan does, is it goes in and it kind of kicks those opioids off of those receptors and takes their place."
Some who overdose on an opioid like fentanyl don't know the strength of the drug they are taking is lethal. Ragaller puts it into perspective.
"Imagine an M&M is a fatal dose but then they put it in a cookie, it absorbs that and you're okay. But the stuff they're putting in M30, it's pure fentanyl."
READ MORE: Fentanyl in Sioux City - Have we reached a local crisis?
While Sioux City isn't seeing the levels of overdoses as many major cities, Ragaller and Sioux City Police say the numbers are climbing. "The number of overdoses that we have seen in probably the last two years here in Sioux City. It's frightening," Ragaller said, "absolutely frightening."
Last summer, we had seized over 20,000 pills of fentanyl," said Sioux City Police Detected Paul Yaneff. "So we've been investigating those and trying to put a stop to it if at all possible
In 2022, Sioux City Police used Narcan 22 times. Sioux City Fire Rescue, 76 times. Now it is important to note that some people may require several doses of Narcan to reverse the effects of an opioid overdose.
But what does an overdose look like? Well, there are a few signs to look for. Their breathing may be shallow or they may not be breathing at all. Their pulse is slow and erratic. They may be unconscious. And if you look at their eyes... their pupils will look very small... like pinpoints. These are all signs of a potential overdose and a sign you should call 911 and use Narcan if you have it.
Anyone can deliver a dose of Narcan and the nasal spray is free to get at most pharmacies.
"You don't have to have a prescription to get it, most pharmacies participate in a program through the state of Iowa where they can get Narcan for free," said Monroe-Rubendall.
Ragaller and Yaneff credit our local dispatchers for ensuring first responders are prepared when responding to a possible overdose. All police officers, fire trucks and ambulances are equipped with Narcan, so whoever is first on the scene, can deploy a dose immediately.
"With the aggressiveness, with the detection from our dispatchers, the aggressiveness of PD, of our guys jumping in. We've saved a lot of lives," Ragaller said.
And sometimes, that first lifesaving dose comes from a family member or friend.
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Fentanyl playing a large part in opioid addiction treatment in Siouxland
Rosecrance Jackson Centers is a leader in helping those fighting many types of addiction. But one they are treating more of is opioids.
"We're seeing a lot more people with opioid addiction than we saw even two years ago." For people with opioid addictions or people who struggle with this dependence both physiologically and psychologically on various opioids, and there's a lot of different opioids, the one that we're seeing the most overdoses from nowadays is fentanyl," said Iliff.
The nationwide opioid crisis hit a deadly peak in 2022 killing a record number of Americans. Fentanyl played a big part in that.
"A lot of the overdoses are happening because people think, Oh, I'm buying some Xanax or some meth, but it's laced with fentanyl, and that's how people are dying," said Iliff. "That's the fentanyl that's killing them but they don't know what's in there."
Brenda Iliff is the Vice President of Clinical Services at Rosecrance Jackson Centers in Sioux City. She's seen firsthand how fentanyl has impacted the local area.
"One of the powerful pieces of fentanyl is that takes just a very little to get a high. So that's why drug dealers are putting it in a lot of the different drugs," she explained.
But fentanyl is just one piece of the opioid puzzle. Opioids are a common prescription drug for the treatment of many injuries and ailments. It's also commonly found on the street. But no matter how someone was first introduced to an opioid.. addiction can happen to anyone.
"It's different for people, how they got access to the drugs," she said. "So sometimes people are just shocked like there's no addiction in my family. How did I get on this?"
"And the very addictive qualities of the people with opioid addiction doesn't matter if you got it from the healthcare professional, from the pharmacist from the internet, from the street addiction doesn't care." Iliff says that while Rosecrance Jackson treats people of all ages and backgrounds "most of those people were in the 18 to 44 age range. So they're, they're not the teens. They're not the older adults, but they're the working adults, the people in our society that are out there and they're supposed to be doing life and at the top of their careers and they're dying because of opioid addiction."
Recognizing the addiction, and admitting you have a problem is one of the biggest steps in recovery. And that recovery isn't linear, it can look different for every person.
"People should seek help whenever they think they have a problem, and usually it's the families, the communities the people that love the person with opioid addiction that notices the problem first," Iliff explained.
Relapse is not inevitable. It's not inevitable. But for some people, it is a part of their process."Our hope is that we can keep people alive and in the system and surrounded by support. So if there is relapse, they can they're able to come back to treatment services or outpatient services"
And as with other chronic diseases, addiction and recovery needs to be tended to daily. "So just like people who have diabetes, they have to do certain things. Daily to take care of their diabetes. addiction is a chronic disease that has behavioral components. Absolutely. But people need to do things daily."
And anyone can find themselves dependent on opioids.
If you or someone you love is fighting addiction of any kind, there are resources to help aid in recovery and for family and friends to best support their loved one, too.
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