Drug-related deaths continue to rise in Linn and Johnson counties, fentanyl and pandemic may be to blame

Courtney Hammond was nine months pregnant, sitting at a Texas Roadhouse in Coralville in August 2020, while her partner and the father of her unborn son was dying from drug-related complications at University of Iowa Hospitals and Clinics.

Trevor Daniels died on Aug. 12, 2020, just a week before Hammond gave birth, on Aug. 19, 2020. Because of COVID-19 related hospital restrictions, she wasn’t able to visit Daniels before he died.

About eight months earlier, shortly after Hammond found out she was pregnant, Daniels had overdosed on heroin. Unable to find Daniels’ Narcan, Hammond had called 911, resulting in the couple’s apartment being raided and both of them being arrested on drug charges after Daniels was given emergency medical care.

Hammond, 31, didn’t use heroin herself, but she did use and sell methamphetamine. She started using meth about 10 years prior, after divorcing her now 12-year-old daughter’s father.

“Prior to (using meth), I was on the PTA, preschool board. I had a really decent life. I was assistant teacher at a day care. I was very well off. I just couldn’t stand my own reflection and the failure that my marriage had fallen apart,” Hammond said. “I was someone back then, I just didn’t feel like I was, so I fed those feelings with meth.”

For the next 10 years, Hammond was in and out of jail. She gave custody of her daughter to her grandparents, and went through multiple abusive relationships before meeting and falling in love with Daniels.

“I found myself being madly, truly in love with a heroin addict. And I had no idea what that was like. I thought meth was the worst that you could get. I didn’t even know that loving someone on heroin was primarily just signing up to attend their funeral,” Hammond said.

After Daniels’ overdose and their arrests, both Hammond and Daniels went to substance abuse treatment centers. Hammond went to a private center in Ottumwa, where she was from, and Daniels, who was a veteran, went to a Veterans Affairs treatment center in Des Moines.

Then the pandemic hit. For Hammond, it was a blessing — the first step in her recovery from addiction. She was locked in treatment, not allowed to leave because of COVID-19 restrictions.

For Daniels, the pandemic was a death sentence. The treatment center he was attending shut down, and he ended up back out on the streets, eventually dying from health complications related to his drug use.

Increased overdoses and drug-related deaths

Daniels is one of 21 friends and loved ones that Hammond has lost to overdoses and other drug-related deaths in the past two years. Her story is not unique.

In Linn and Johnson Counties, drug-related deaths have been rising consistently since 2018, mirroring national trends. Numbers dropped between 2017 and 2018, likely because in 2017 Narcan — or Naloxone, a medication that reverses the effects of drug overdoses — was made available over-the-counter in Iowa.

But from 2018 to 2022, drug-related deaths increased from 19 to 36 in Linn County and from 13 to 48 in Johnson County.

The need for Narcan also appears to have increased. Johnson Area and Linn Area Ambulance Services both report that the number of times emergency responders have administered Narcan has been increasing, with a big jump in both counties in 2020.

In Johnson County, Narcan was administered by first responders 29 times in 2019, and that number jumped to 47 in 2020, then decreased to 34 in 2021 and 37, preliminarily, in 2022. In Linn County, that number jumped from 93 to 135 from 2019 to 2020, then went down to 130 in 2021 and 129, preliminarily, in 2022.

But those numbers don’t tell the whole story, said Jesse Lennox, a Cedar Rapids firefighter and EMS responder.

“Back in the day, before Narcan was more easily available, in order to wake (someone who overdosed) up, their friend would dump a bunch of cold water on them,” Lennox said.

“Now that Narcan is more available, there’s a lot of overdoses that we don’t even know about. The big thing that we’re seeing now is there’s a lot of Narcan given in the field before we even get there, multiple times. Instead of us getting called after the bucket of water didn’t work, we’re getting called after the first dose didn’t work, the second dose didn’t work. The third dose is given (by police, who usually arrive first), and now we’re there. So, that time is starting to get really stretched out as far as the outcome of that victim.”

Gov. Kim Reynolds, in her 2023 Condition of the State Address on Jan. 10, called on the Iowa State Legislature to increase availability of Narcan by allowing first responders to give it out to the public to use. Currently, while first responders can administer Narcan in an emergency, only pharmacists can distribute it for public use.

“The opioid crisis is a human tragedy taking place across this country, and fentanyl has taken center stage. While Iowa maintains one of the lowest overdose death rates in the country, we’re still experiencing unacceptable trends,” Reynolds said. “Overdoses are up by more than 34 percent, and for Iowans under 25, they’re more than double. In 2021, illicit fentanyl was implicated in 83 percent of all Iowa’s opioid-related deaths, compared to just 31 percent five years ago. These aren’t just numbers; they’re missing siblings, parents, and friends. They’re shattered families and grief-stricken parents.”

Prevalence of fentanyl

Reynolds also announced the launch of a public awareness campaign “to help parents understand the threat of fentanyl and how to protect their kids from it.” She urged lawmakers to increase penalties for manufacturing and distributing fentanyl, a powerful synthetic opioid that many experts blame for the increases in overdoses in the past few years.

Rod Courtney, who runs CRUSH Recovery Community Center in Cedar Rapids, said fentanyl is often mixed into other drugs to make them more addictive. However, people buying the drugs don’t always know that fentanyl has been added, which can lead to overdoses because fentanyl is usually much stronger than the drug the person thought they were buying.

“Fentanyl has been on the increase over the last couple of years for sure,” Courtney said. “I think the people that sell the drugs are realizing that anything they could do to make their substance more addictive is just money in the bank for them, because it’s addiction that brings people back.”

A proposal outlined on Reynolds’ website explains her proposal for increasing penalties by reducing the weight limits at which federal penalties would apply to fentanyl. The proposal would also allow for sentences to be doubled if any controlled substance is delivered to a minor, and doubled or tripled if a fentanyl crime results in serious injury or death.

Currently in Iowa, manufacturing, delivering or possessing with the intent to manufacture or deliver more than 10 kilograms of fentanyl, or a mixture containing fentanyl, is punishable by up to 50 years in prison and a fine of up to $1 million. Reynolds’ proposal would apply this punishment to anyone with more than 50 grams of fentanyl.

Possession of more than five kilograms, but less than 10 kilograms of fentanyl currently carries a penalty of up to 25 years in prison and a fine of up to $100,000, but Reynolds’ proposal would apply these punishments to more than five grams but less than 50 grams of fentanyl.

Having less than five grams of fentanyl would carry the punishment currently applied to anything less than five kilograms of fentanyl, which is up to 10 years in prison and a fine of up to $50,000.

According to the United States Drug Enforcement Administration, two milligrams of fentanyl, equal to 10 to 15 grains of table salt, is considered a lethal dose. Fentanyl is 50 times more potent than heroin and 100 times more potent than morphine.

Johnson County Attorney Rachel Zimmerman Smith said charges stemming from possession or distribution of fentanyl are becoming more common locally. She said law enforcement is getting better at identifying it, even though it’s often disguised as a legal prescription drug, or mixed in with other illegal substances.

“I think that the challenge, from a public safety angle, is the lethality of fentanyl, and then, being able to identify it in combination with other substances,” she said.

Many of fentanyl-related charges come after someone has already been arrested and charged with distributing another drug, like heroin, Zimmerman Smith said. The original drug is sent to a lab for processing and it’s discovered that there was fentanyl mixed in.

The pandemic effect

Courtney said he believes the COVID-19 pandemic also played a role in the increase in drug-related deaths in recent years, and he hopes that as pandemic restrictions continue to ease, those deaths might decrease.

“I know COVID played a big hand. There’s a lot of people — myself included — who will say the opposite of addiction is connection. There’s nothing more that addiction loves than isolation. It’s easier to use in isolation. It’s easier to get depressed,” Courtney said.

“We’re not completely over that yet, of course, but things are changing where I think people are getting back out. They’re starting to socialize more, which is very much a double-edged sword, because it also creates more access, depending on what your substance is. You’re going back out to bars more, you’re going back out to parties more, but also, you can get out to support groups more easily,” he said.

For Hammond, the pandemic was an opportunity to reconnect with family and strengthen her support system.

After graduating from the recovery center program, Hammond moved to Cedar Rapids with her grandmother and children. Being in a new place without much opportunity to socialize helped Hammond remove herself from her drug community.

Now Hammond works as a parent partner in Linn County, advocating for parents who are working to regain custody of their children. She also works with CRUSH Community Center to support people who are recovering from addictions.

Having seen so many people die from overdoses and long-term health complications related to drug use, Hammond said she sees a need for more education, and greater support for people with substance use disorders, whether they are actively seeking recovery or not.

“You are not ready to quit until you are ready,” Hammond said. “Drugs are one of the hardest things to be a part of and one of the hardest things to come out of. Not everyone can make it in that world, and I’m glad I made it out.”

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