After spiking during the first year of the pandemic, overdose rates in Chattanooga stayed relatively steady in 2022, data from the Police Department shows.
Experts in health care and harm reduction say with the synthetic opioid fentanyl becoming more and more common, overdoses continue to be a serious public health threat in Hamilton County.
Chattanooga police officers responded to 959 overdoses last year, Executive Chief Harry Sommers said in a news conference this week.
(READ MORE: Opioid settlement funds soon up for grabs in Tennessee. Here's what you need to know.)
The year before, officers responded to 953 overdoses – a 66% increase from 2020, when 575 were reported to police. That jump lines up with a dramatic increase in overdoses reported across the country during the pandemic, experts said.
"We know there's a lot more overdoses than are reported to 911," said Robert Childs, a Chattanooga-based national harm reduction expert, in a phone interview this week.
As of Wednesday, 25 days into the year, 56 overdoses had been reported to Chattanooga police in 2023. Fourteen of those resulted in death, Sommers said.
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Since 2020, around 15% of all overdoses the department responded to have been fatal, he said.
Across Hamilton County, estimates from the Health Department show the number of people dying from overdoses rose slightly in 2022 from the year before.
In 2021, department data shows, 176 people died of overdoses in Hamilton County. Of those, 125 were related to fentanyl.
Provisional data shows that last year, around 200 people died of overdoses, with 147 of those related to fentanyl. Exact numbers won't be known for several weeks, Hamilton County Health Department epidemiologist Megan Sloan said in a phone interview Friday.
Childs said many people who use drugs aren't just trying to reach euphoria – it's usually much more complex.
"I see a lot of people who use stimulants so they can work two full-time jobs to make ends meet. They're using so they can be a more present parent," he said. "A lot of people may also use drugs because they're hungry, and a lot of them actually suppress your appetite."
(READ MORE: Hamilton County overdose deaths outpace state, federal increases)
Naloxone, an opioid overdose reversal medication commonly known as Narcan, has become more accessible in the last few years. Since 2020, 57% of people whose overdoses were reported to Chattanooga police were resuscitated by Naloxone, which can help people experiencing an overdose breathe better or begin breathing if they've stopped.
But Naloxone doesn't work in every case -- only for overdoses caused by opioids. It's become more common, in the Chattanooga area and nationwide, for people using opioids like fentanyl to also use stimulants like methamphetamine and crack cocaine to counteract the sedating effect, Childs said.
Police are also seeing fentanyl increasingly added to meth or cocaine, Sommers said. In those cases, people using drugs may or may not know they're also ingesting fentanyl, he said.
The East Brainerd area has the highest concentration of overdose deaths of any zip code in the county, Sloan said, followed by parts of Soddy-Daisy, Hixson, Red Bank and downtown Chattanooga.
The majority of people dying of overdoses in Hamilton County are white men between 31 and 50, Sloan said.
In the last few years, experts say several other drugs in addition to fentanyl have increasingly shown up in overdose cases, including the veterinary sedative xylazine, mitragynine (sold at gas stations as kratom) and other strong synthetic opioids called nitazenes.
"This is something that is taking lives," said Lacey Goolsby, manager of the Health Department's overdose prevention program. "We're trying to collaborate and come up with different ideas on ways to, essentially, keep this from happening to another family."
Be prepared
Getting Naloxone/Narcan
Giving Naloxone to someone experiencing an opioid overdose can save a life or keep them alive until first responders can arrive, experts say.
In Hamilton County, residents can receive free doses of Naloxone, or Narcan, from the Hamilton County Coalition (hccoalition.org), which also provides training on how to use it.
"Giving people one (kit) isn't a solution, giving them as many as they need is part of the solution," Childs said. "I can't tell you how many times I've talked to someone that said, 'All I could get was one Naloxone kit, and several people I love overdosed.' And who do they administer the Naloxone on? What a horrible decision."
Depending on the person and the drugs they used, one person could need more than one dose of Naloxone to fully reverse an overdose. Having kits available can buy more time for medical intervention, said Debra Clark Morgan, a regional overdose prevention specialist with the coalition.
"The more people that have access to Naloxone, they're able to respond and not have to wait for emergency services to get there," she said in a phone interview Friday. "They can go ahead and give that initial dose and get that started in their system."
Using safely
Before using drugs, you should test them for fentanyl using test strips, which were decriminalized in Tennessee last year, Childs said. Test strips are available online or through organizations including the Chattanooga Free Store.
(READ MORE: Test strips now a new tool to combat Tennessee's fentanyl overdose crisis)
You can avoid an overdose by using slowly, Childs said, and not consuming your entire quantity of drugs at once. It also helps to not use alone, he said, when possible.
If you do choose to use drugs alone, you can use apps including Canary or Brave, or the Never Use Alone hotline at 800-484-3731 to connect with a real person who can alert first responders if you become unresponsive.
Recognizing an overdose
If you think someone may be overdosing, there are a few telltale signs to look out for.
Common indicators for opioid overdoses include pinpoint pupils, being unconscious and unresponsive to stimulus and breathing slowly and shallowly or not at all. Someone experiencing an overdose may also make choking or rattling sounds from trying to breathe, Clark Morgan said.
The person may be limp, pale and clammy, with bluish or dark lips from a lack of oxygen.
Childs said if you're unsure whether someone is overdosing, you can make a fist and rub your knuckles up and down their sternum at the center of their chest.
"It causes excruciating pain," he said. "If someone doesn't respond to a sternum rub, that's a pretty good sign you need to call 911."
Calling for help
Experts recommend always calling for help during an overdose. In reality, that doesn't always happen.
"People are afraid to call 911, because they fear arrest," Childs said. "Making sure people feel comfortable calling is really important."
Tennessee law protects someone seeking help for an overdose from arrest and prosecution just once -- many calls after that could land you in trouble with the law, earn you a probation or parole violation or count as a violation of a protective or restraining order.
But during an overdose, every minute counts in the effort to save a life.
"The sooner you can respond, obviously, it's going to be better," Clark Morgan said.
Contact Ellen Gerst at egerst@timesfreepress.com or 423-757-6319.