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The problematic heroin may be laced with Fentanyl, a synthetic opiate used to stretch supplies, said Dr. Chris Eberlein, an emergency room doctor at Gundersen Health System.

A particularly perilous form of heroin is circulating on La Crosse streets, spiking overdoses and raising the specter of potentially deadly cases — perhaps killing one person already, said Dr. Chris Eberlein.

“The potential for death is big, from what I’ve heard,” said Eberlein, an emergency room doctor at Gundersen Health System and medical director for Gundersen Tri-State Ambulance.

The stronger heroin may be the culprit in the death of 29-year-old Mellisa Dobrunz found Sunday in the 800 block of South Sixth Street, Eberlein suggested. Police have said she probably died of an illegal drug overdose.

“We may never find out” whether the bad batch led to her death, “but we might not know for months” until toxicology reports are available, he said.

Eberlein suspects that the heroin is laced with the synthetic opiate Fentanyl, which dealers often use to stretch supplies. Fentanyl sometimes is hard to detect in tox screens, he said.

Fentanyl, a prescription drug, is similar to morphine but much more potent. It typically is used to treat patients with severe pain or to manage pain after surgery. It also sometimes is used to treat people with chronic pain who are physically tolerant of opiates, according to the National Institute for Drug Abuse.

“What we’ve seen in the past is when too much Fentanyl is added, it can make the heroin 50 times more potent,” Eberlein said.

“The user doesn’t know that even when they use the same volume, it is 50 times more potent and causes a significant overdose,” he said.

Users then go into respiratory failure and die of heart failure, he said.

Overdose victims in such cases require repeated and higher doses of Narcan, the antidote for an opiate overdose, said Eberlein, who has advised Tri-State Ambulance crews to be on the lookout for such instances.

Narcan has been credited with reducing overdose deaths in La Crosse County.

Tri-State Ambulance paramedics’ use of Narcan has increased steadily since 2007, when they used it on 35 patients, through 2014, when they used it in 181 cases, with a dip last year to 139, according to statistics from Tri-State executive director Tom Tornstrom.

“We’re seeing more patients and more effectiveness on more cases,” he said, adding that that indicates the paramedics are becoming more proficient with the antidote.

For example, 90 out of 180 patients had improved consciousness and/or breathing in 2014, compared with 105 out of 139 who improved last year, the statistics show.

Narcan use is on an upward trend for the first 40 days of the year, with 26 doses used on 16 patients, improving the condition of all 16, Tornstrom said.

First responders with the La Crosse Fire Department also administer Narcan, although Assistant Chief Warren Thomas said their uses have not increased much lately, compared with last year.

People trained to administer Narcan through the AIDS Resource Center in La Crosse reported using it 77 times last year.

Eberlein, who said he became concerned when four to six OD cases occurred this week, said one patient “said it was the strongest drug they had ever taken.”

The ER cases don’t take into account overdoses that may have occurred at home in which users self-treated with Narcan, Eberlein said.

Dr. Eric Grube, an ER doctor at Mayo Clinic Health System-Franciscan Healthcare, said he has not noticed an increase of overdoses at that facility.

“But we’re seeing is more heroin-related cases, such as abscesses and domestic cases,” Grube said.

Abscesses occur at injection sites, often causing severe infections that can attack other parts of the body, he said. Domestic abuse cases result from drug use in which the incidents become violent, he said.

“There was none of it when I went to school here, but when I came back, it was all over,” said Grube, who attended the University of Wisconsin-La Crosse as an undergrad before going to medical school in Des Moines, Iowa, and serving his residency in emergency medicine in Columbus, Ohio.

“I don’t know if people know how bad the drug problem is,” he said.

People can obtain Narcan from agencies such as the AIDS Resource Center, and it is expected to become more accessible under Wisconsin legislation signed into law in December. The law’s acronym, HOPE, stands for Heroin, Opiate Prevention and Education.

“The HOPE legislation should cut down on overdoses,” Gundersen’s Dr. Eberlein said. “The sooner you get Narcan into people, the better chance of saving them.”

Along those lines, Walgreens announced Tuesday that it will offer nonprescription naxolone, a form of Narcan, over the counter by the end of the year in 39 states, including Wisconsin. The drug, available in injection or nasal spray form, will be sold mostly in 24-hour stores, Walgreens officials said.

Many insurance plans will cover the drug, company officials said, and it will cost about $80 a dose for the uninsured.

Asked what he might advise users, Eberlein said:

“First, as always, get into treatment and break the addiction,” he said. “If you do use, greatly reduce the amount. Third, if you use, make sure you are with somebody” to administer the antidote or call 911 if necessary.

Asked whether giving the public access to the OTC antidote might convey a sense of entitlement or permission, Eberlein said, “We need to keep these people alive until we get them into treatment. We can’t just write them off.”

“What we’ve seen in the past is when too much Fentanyl is added, it can make the heroin 50 times more potent.” Dr. Chris Eberlein


Mike Tighe is the Tribune newsroom's senior citizen. That said, he don't get no respect from the cub reporters as he goes about his duly-appointed rounds on the health, religion and whatever-else-lands-in-his-inbox beats. Call him at 608-791-8446.

(9) comments


There is very little hope for these people. Our doctors have created them. They don't understand what "Normal" is anymore. I have very little sympathy, because when it comes to somebody that really needs the drug for pain, there are way to many abusing it for pleasure. And then it turns into this when they are cut off.


That's what killed Janis Joplin. There were 11 other less famous deaths from that same strain.


ctd...from the link below:

"Claims that prohibition didn’t work overlook the fact that most historians agree that national prohibition succeeded both in lowering consumption and in retaining political support until the great depression radically changed voters’ priorities. Repeal resulted more from this
contextual shift than from characteristics of prohibition itself."

"One favorite argument of those who claim prohibition didn’t work point to the growth of
organized crime. Although organized crime flourished under its sway, historians trace the
beginnings of organized crime in the United States to the mid to late-1800s. Organized
crime existed before prohibition was enacted, and persists long after its repeal. "


ctd...from the link below:

"The laws and enforcement mechanisms created after 1919 by the 18th Amendment and the Volstead Act, which charged the Treasury Department with enforcement of the new
restrictions, was far from all-embracing. The amendment prohibited the commercial
manufacture and distribution of alcoholic beverages; it did not prohibit use, nor production
for one’s own consumption."

"Alcohol consumption declined dramatically during prohibition. Cirrhosis death rates for
men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to State mental hospitals
for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928."




Natural Selection... We pay for their bad decisions :o


tmkgls: "Quote from other article by wingdam:"This is caused by drug laws not the drugs themselves. Many people went blind or died during prohibition for the same reasons!""

People are still dropping like flies from alcohol kills plenty: my family has been hit particularly hard. Tobacco, which is legal too, kills about 480,000 people in the USA every members included. The oft-quoted prohibition myth has now resurfaced as an argument for the legalization of hardcore drugs. Sounds so simple, doesn't it? All we have to do is legalize it and our drug problems will magically go away, right? Wrong!

"All too often, supporters of these initiatives mislead the public about the impact of drug legalization and ignore the harm that the wide spread use of narcotics will have on a community."


Machiavelli: "dropping like flies" "prohibition myth" "legalization of hardcore drugs"

I NEVER said anything about legalizing hardcore drugs!

Blindness & death during prohibition WAS caused by homemade alcohol mixed with ethanol. REALLY study history instead of being 1 of the SHEEPLES that believe corrupt agencies. The DEA, CDC, & FDA spew out lies mixed with BITS of truth in order to achieve their agendas.

Alcohol & tobacco should NOT be legal. BOTH are highly addictive, cause myriad health problems, & can cause death.

WISE people living with DEBILITATING CHRONIC PAINS do NOT accidentally OD & do NOT get addicted! They are CAREFUL with their opioids & take them ONLY AS NEEDED!

SOME people in DEBILITATING CHRONIC PAINS are turning to heroin for pain relief & SOME are committing SUICIDE because of their CONSTANT PAINS & LOSS of any hope!

Where is your empathy for those whose lives are so FULLY destroyed because they have UNTREATED CONSTANT DEBILITATING CHRONIC PAINS? Shame on you!


Heroin use, and therefore ODs from it, would not be rising in the La Crosse area, as well as nationwide, if the DEA, CDC, and now the FDA would not have made it impossible for those who live with high-levels of CHRONIC PAINS to get the pain medication that works for them. Prescribed opioids can be monitored whereas heroin cannot. Prescribed opioids are not cut with dangerous and lethal drugs, such as Fentanyl. Thus, IMO, it is the government's fault that ODs from heroin are on the rise.

Since Fentanyl can only be obtained with a prescription, how come it is so easy for the drug dealers to get it in order to add it to heroin? From what I've heard and read, they can barely get their hands on opioids now, yet they can get their hands on Fentanyl?!

Our government agencies need to get their heads out of their "you know whats".

Quote from other article by wingdam:"This is caused by drug laws not the drugs themselves. Many people went blind or died during prohibition for the same reasons!"

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