By Tobias Wall
Belleville News-Democrat
BELLEVILLE, Ill. — A state regulator has ordered the removal of the powerful painkiller fentanyl from all ambulances in the region amid a local investigation into “unauthorized tampering” of the supply of the narcotic.
“It was discovered that an unauthorized tampering of fentanyl occurred,” said Memorial Hospital spokeswoman Anne Thomure in a statement.
A Memorial physician, Dr. Savoy Brummer, issued a memorandum earlier this year to all emergency medical services in the region, ordering them to turn over their supplies of the drug. The memo also instructed the EMS providers to submit documentation of every instance where fentanyl was administered to patients between May 25, 2013 and May 25, 2015. Brummer asked to receive those reports by June 16.
Brummer and Memorial serve the Illinois Department of Public Health as a regulator of ambulance service in the region. Memorial serves as the Southwestern Illinois EMS System’s hospital coordination center, overseeing regional ambulance activity and supplying them with some of the drugs they carry.
Thomure said Memorial is cooperating with a police investigation into the matter and would not describe the tampering in detail.
‘Resolve the issue at hand’
Brummer wrote in the memo that “our team at Memorial is diligently working on resolving the issue” and that “it is crucial to resolve the issue at hand,” but he did not elaborate on what “the issue at hand” was.
It wasn’t immediately clear which police agencies are involved in the investigation.
Only EMS providers which have a designation of Advanced Life Support can carry fentanyl on their ambulances. Ambulances with Basic Life Support designations do not carry fentanyl and were not subject to the order.
The region’s EMS services designated as Advanced Life Support include private companies Abbott EMS and Medstar and publicly-supported providers in Breese, Columbia, Dupo, Mascoutah, Millstadt, Monroe County, New Baden and O’Fallon. They’ve been without the medicine, which is sometimes used as a substitute for morphine, since the supply was recalled in June.
According to Thomure’s statement, “Memorial has agreed to replace medical supplies and exchange equipment, as needed, for participating EMS vehicles.”
Thomure didn’t elaborate on what changes would be made and it wasn’t clear when ambulances would be restocked with the painkiller.
“We know (fentanyl) was pulled back in June,” Abbot EMS general manager Mark Corley said Thursday. He said EMS providers would be able to use the drug again once its manufacturer was able “to produce it in a more easily controlled dose.”
He said an example would be ready-to-use, single-use syringes rather than vials that contain higher quantities of the drug.
‘Extremely dangerous combination’
Fentanyl is a synthetic opiate used in medical settings as a painkiller. It’s chemically different from opium-based narcotics such as morphine, making it an effective choice to manage severe or chronic pain in patients who have built up a physical tolerance to opium-based drugs.
It’s also up to 100 times more potent than morphine, according to the U.S. Drug Enforcement Administration. It’s easily absorbed through the skin using patches, is easily inhaled in powder form, can be administered via an IV or orally as a lozenge. In addition to its use in emergency medicine, fentanyl is sometimes prescribed to cancer and other patients suffering from chronic severe pain.
“It is the most potent opioid available for use in medical treatment,” a DEA release from June stated. DEA agents in St. Louis had partnered with other area law enforcement agencies in a heroin takedown that led to the arrest of 51 individuals and the seizure of 28 guns.
On the black market, fentanyl can be mixed with heroin to increase the heroin’s purity. According to Madison County Coroner Steve Nonn, the DEA has warned officials to be on the lookout for the mixture.
“What we’re getting is information from DEA that we should be on the lookout that this mixture is occurring and it’s in the Chicago area,” Nonn said. “We haven’t really seen it yet, but they were also the ones who told us we were going to have a heroin problem and they were spot-on.”
Nonn said he tests for fentanyl in the blood of drug overdose victims.
“It’s an extremely dangerous combination” that can kill a first-time drug user, Nonn said. “There’s no Angie’s List to call to ask, ‘Is my local drug dealer selling drugs that are killing people?’”
(c)2015 the Belleville News-Democrat