The opioid drug crisis is not just harming people and ruining lives in inner-city New York, Chicago and Los Angeles.

“It’s a new epidemic we’re having to face, even in small communities,” Somervell County Fire Chief Mark Crawford said. “We’ve ran several calls involving heroin this year already.”

Because the nationwide opiod crisis is creeping more and more into rural areas, and small towns like Glen Rose, on Oct. 24 Crawford arranged local firefighters and EMS personnel to attend a two-hour training session. Attendance was voluntary, as part of a continuing education class.

Crawford also watched a two-hour PowerPoint presentation of SCFD paramedic and EMS instructor Megan Pankhurst. He said the thing that stood out the most from her presentation was “how small of a quantity it takes to be deadly.”

Pankhurst said the Somervell County Sheriff’s Office arranged to have its deputies watch the PowerPoint presentation about opiods online.

Opioids, including prescription opioids, heroin and fantanyl, were responsible for the deaths of more than 33,000 people in the United States in 2015, according to the Centers for Disease Control and Prevention. That year had the most opioid-related deaths of any on record, the CDC website states.

Since 1999, the number of overdose deaths involving opioids has quadrupled. That includes prescription drugs such as oxycodone, hydrocodone and methadone. The CDC also notes that more than six out of every 10 drug overdose deaths now involve an opioid of one type or another.

President Trump's Commission on Combatting Drug Addiction and the Opioid Crisis presented 56 recommendations on the topic last Thursday. No. 30 on that list states, "The Commission recommends the White House develop a national outreach plan for the Fentanyl Safety Recommendations for first responders." 


Pankhurst said one of the newest and deadliest trends among opiod drug dealers is lacing or mixing (also known as cutting) drugs like heroin with fillers (also called adulterants) such as carfentanil, which is 10,000 times more potent than morphine. Fentanyl is 100 times more potent than morphine.

“Cutting carfentanil with heroin is becoming an epidemic,” she said. “A lot of times it’s made in China and shipped to Mexico.”

Carfentanil is an analog derivative of the synthetic narcotic fentanyl, which is produced from morphine, according to information on the RecoveryFirst website. It’s generally used only to sedate large animals such as elephants. It’s not approved for human use.

Pankhurst noted the stunning fact that “a lethal dose of carfentanyl is (the size of) a grain of rice.”

Because of the strength of such combination drugs even in tiny amounts, it’s a serious health hazard to first responders, in cases where they may absorb the powerful drugs into their bloodstream after contact with overdose victims. It causes respiratory depression along with drowsiness, and even loss of consciousness and death.

One of the PowerPoints included mention of SWAT officers who became ill after a flash-bang grenade tossed into an alleged illegal drug stash house exposed them to the fentanil and heroin.

Pankhurst said she told those who were in the PowerPoint class that “We all have the potential to be exposed to" carfentanyl.

“Because it’s becoming such an epidemic, I pushed the point that all our guys need this (training) because because we’re all exposed to it at one point or another. This stuff is everywhere. First responders are overdosing. They absorb it through their nose accidentally, and it gets in their bloodstream. It’s in cars. In the past year, it’s become more of a problem.”

Although these types of dangerous drugs can be absorbed through the skin and into the bloodstream, the primary risk (30 times more likely) is from inhaling dust that comes in contact with mucus membranes in the mouth, eyes or nose.

The presentation tells first responders to “assume all heroin contains” fentanil or fentanil analogs.