JOHNSON CITY, Tenn. (WJHL) — Fentanyl was no more familiar to Rachel Taylor Lee than it was to most people when Labor Day rolled around. Then the deaths started hitting closer to home.
The Johnson City small business owner knew the powerful synthetic opioid was responsible for an increasing portion of overdose deaths, but not much more. By Sunday, Lee had lost several friends and acquaintances to suspected overdoses from fentanyl-laced drugs, and even more tragically, 22-year-old Isaiah Coleman, who was almost like a son to her.
The best Lee can determine, Coleman did nothing more Saturday night than smoke some marijuana. Whatever Coleman used, though, included something that was powerful enough to kill him. And the young man with a 2-year-old, who Lee met when he was 15, is not alone.
“From what I am understanding and from what I know, we have a crisis here locally,” Lee said. “Isaiah did something that many people do already and decided to go out with his friends and have fun, and he apparently got ahold of marijuana that was laced with fentanyl unbeknownst to him. And unfortunately he’s not the only one that has.”
The night and early morning that Coleman ingested what caused his death, first responders also made one trip to a downtown bar and two trips to an apartment on the Tree Streets.
News Channel 11 obtained 911 calls from that night.
DISPATCHER, 1:28 a.m.: “Emergency, unconscious, Numans, 225 East Main Street.”
“Patient’s gonna be up on the second story, 25-year-old female, bouncer should be lookin’ out for you, direct you to where she’s at.”
The three separate calls took first responders to aid a total of four people — a young woman at Numan’s around 1:30 a.m. Sunday, two young women at a West Pine Street residence around 3:50 a.m., and a man around 30 at the same Pine Street residence at about 5:20 a.m.
A woman who sounded to be the caller both times from the Tree Streets kept a level head, triaged people using advice from 911 dispatchers, and even told a dispatcher she was keeping the bag of drugs she’d been able to get from people at the home.
She managed it all as first the women, then the man lay unconscious or barely conscious. At one point another woman tries to perform CPR on the male victim, who eventually begins vomiting and is turned on his side at the advice of the dispatcher.
“Okay, he’s gasping for breath,” the caller says as the man can be heard making loud wheezing noises. “He is breathing. He is breathing.”
90 minutes earlier she’d been telling another dispatcher how often one of the female victims, still unconscious, was breathing.
“Is someone getting here quick?” she can be heard asking with a trace of desperation in her voice.
“They’re on the way,” the dispatcher says.
“Okay. Thank you,” the woman answers.
Trending in the wrong direction
It’s a scene Angela Hagaman of East Tennessee State University’s (ETSU) Center for Addiction Research is afraid will continue to become more frequent.
Hagaman told News Channel 11 Tuesday the number of overdoses linked to fentanyl have risen dramatically over the past three years. But the two clusters that have occurred just this month — and the seeming presence of fentanyl in non-opioids like cocaine and marijuana — suggests the crisis could be entering a new phase.
“We don’t have any data to confirm, but what we do know is that over Labor Day weekend there was a cluster of overdose in the downtown Johnson City area, and I believe that four of those were fatal,” said Hagaman, who has worked in the field for ETSU for close to a decade.
“And then most recently (last weekend) in the downtown area…I’ve heard anywhere from 5 to 15 overdoses and only one fatality.”
That fatality apparently was Coleman, whom Lee called “a great kid.” She met him when she began dating Coleman’s father, who died a couple years later, and Lee has maintained a relationship with both Coleman and his biological mom, who told Lee about her son’s death.
“I had just spoken with him a few days ago but Isaiah was just one of those kids that, he had a more quiet old soul energy about him, but he was just fun and vibrant and intelligent,” Lee said of the young man who worked at Mid-City Grill. “I don’t know of many people in town that didn’t like Isaiah.”
Coleman was one of the unlucky ones. Hagaman said there are 10 to 12 non-fatal overdoses for every fatal one.
She said the ETSU team’s high level of knowledge about the region’s drug scene and overdose numbers comes from long-time relationships with healthcare systems, the Tennessee Department of Health and local law enforcement.
“We hear about it anecdotally because we’ve been doing this work for a number of years. Folks tend to text, call, reach out and then we employ best practices,” she said.
Those include working to get naloxone, a medicine that rapidly reverses opioid overdoses, into as many hands as possible. Recently, the efforts also include distributing fentanyl test strips, which people can apply to drugs to find out whether they are laced with fentanyl.
Hagaman said that’s becoming increasingly important as the drug is suspected of appearing in non-opioids from marijuana and methamphetamine to cocaine.
“We have folks that don’t know what they’re purchasing and fentanyl is showing up in a variety of different drugs that one may not expect them to be in,” she said.
Can the wave be tamed?
As people working to reduce the harm caused by drug overdoses watch the rising tide of fentanyl incidents threaten to sweep over the region, much seems to be working against them.
The drug is 50 times more powerful than heroin. As it appears to be lacing the types of drugs no one previously associated with it, fentanyl creates a risk of taking many lives before the wider community knows what’s hit it, Hagaman said.
“We have a community that may not be aware and we might not have had these clusters before that look like this, so we’re a little unprepared,” she said. “We don’t have data ready right away. A lot of our data lags by weeks.”
Lee certainly wasn’t prepared when she heard that a couple of friends had died of overdoses earlier this month. And she certainly wasn’t prepared, just hours after seeing the first responders outside Numan’s herself after a rare girls’ night out, to learn from Coleman’s mother that he had died at home from an apparent overdose.
As Hagaman said, it can take weeks to confirm the cause of an overdose. Johnson City police acknowledge they worked non-fatal overdoses this past weekend, but said with the cases still under investigation they won’t comment further.
But Lee said the word on the street and on social media, along with drug prevention professionals’ theories, seem pretty solid to her.
“Knowing some of the people in our community that we’ve lost that aren’t out there…doing the simple drugs, the non-hard drugs and losing so many at one time and having so many overdoses, it kind of leaves you to wonder what else could it be? What else could it be?”
Within two weeks, Lee has gone from a semi-informed Johnson Citian to an advocate for what is known as harm reduction, described as “a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.”
Within just the past few days she’s learned about the importance of naloxone in preventing overdose deaths, and of the ability to detect fentanyl-laced drugs using test strips.
Lee has purchased Narcan, a brand name naloxone product, and 20 boxes of test strips. She’s begun integrating herself into the growing community of people who are confronting the reality that the region has a growing problem with a drug that can kill in tiny quantities and in unexpected settings and circumstances.
“If people in the community need it (naloxone) I’d like to make it even easier accessible, but people need to really start researching and really being careful where they’re getting their products, even the ones that are innocent.
“Things need to be tested. Things need to be really thought over and people need to be very careful.”
Lee’s is the kind of response Hagaman would like to see more of. She said access to lifesaving measures varies greatly from site to site.
I think that’s what our center really wants to support — how do we organize these efforts and make them really accessible.”
The woman on the other end of the line, dealing with her second overdose incident in less than two hours early Sunday, seemed to be recognizing just how vulnerable people who use any type of drug are in the current situation.
DISPATCHER: “Now do ya’ll have any kind of Narcan there or anything?”
CALLER “We do not, unfortunately. Clearly it’s something I need in my life. I cannot believe this is happening again.”
DISPATCHER: “Ok, there should be somebody there on scene. Can somebody open the door for them?”
CALLER: “Yep. Yep. Yep. We’re coming down. Thank you.”
It’s too late for Isaiah Coleman, who in addition to a child leaves behind a loving mom, sister and “dozens and dozens of friends” including co-workers from Mid-City Grill, Lee said.
In a text message about this story, his mom told Lee to “absolutely” use his name for awareness. “Let everyone know how amazing and loved he was.”
Lee said she grew up in a strict Christian household and understands the stigma surrounding drug use as well as the frustration families experience when a loved one becomes addicted. But she said she’s hopeful the community is ready to turn the page.
“If we can stop people from having to hurt, from losing more people in our community, if that’s what it takes, a small investment from me, absolutely,” she said.
“And I’m shocked at the amount of people that have come forward, ‘let me help you, let me see where I can help you find more Narcan,’ or ‘let me donate toward this.’ If I have to run around town every weekend and kind of keep an ear to the ground and see who needs it then that’s what I’m going to do so our community can start to heal instead of continue to hurt.”