LOCAL

'On a pace to set a record': Overdose deaths in Vanderburgh on the rise for 2nd year in a row

Christina Elias
Evansville Courier & Press

EVANSVILLE, Ind. — From rehab, Corey Keown reflected in a letter to his sister about the far-reaching impact of addiction.

"I am here with people from all different walks of life: Doctors, lawyers, dentists, Wall Street brokers, millionaires and everyday people like me who have all kinds of addictions," he wrote in the letter to his younger sister Katie Carley. 

The letter hits her more intensely now than it did when she first received it since Keown died of a drug overdose in 2016. 

Overdose deaths in Vanderburgh County so far are on pace to break a record that no one wants to even exist, the number of overdose deaths in the county.

Keown, like so many others, struggled with substance use for years, but Carley said her family didn't know Keown had progressed to using heroin, which he took – laced with fentanyl – the day he died at just 34. Their cousin, Christopher Alvey, 33, was found with Keown. He also died of an overdose.  

Both in the prime of their lives.

When Carley thinks back on the years before Keown died, she remembers her anger and her family's attempts to help however they knew how. Looking back, she wishes she had known more about addiction. 

"That's the only thing I ever regret," she said. "I just would say 'Stop; it's your choice. It's your choice.'"

"I know it's a choice, but at the same time it was so powerful and overcame him," Carley said. "Addiction's hard, and I never understood that."

This is the last picture of the Keown family together before Cory Keown's death. From top left, Katie Carley and Julie Keown, were on vacation in Gatlinburg, Tennessee, with Casey Keown, from bottom left, Rick Keown, Clinton Keown and Cory Keown. Carley said the family returns to Gatlinburg every year for the anniversary of Cory Keown's death.

Drug overdoses have claimed the lives of at least 50 people in Vanderburgh County in the first half of 2021, rapidly approaching the number of total people who died last year. 

"We're set on a pace to set a record for the most (deaths from) overdoses ever in a single year," Vanderburgh County Coroner Steve Lockyear said.

For now, that record was set back in 2017, when 82 deaths were attributed to drug overdoses. Since then, the next-worst year was 2020, with 67 victims.

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Between January and June, Vanderburgh's County's official count reached 50, but in reality, Lockyear said the number has already gone up.

"It could take several weeks past an overdose before it's actually ruled an overdose," Lockyear said.

Toxicology results can take weeks to come back, and his office updates their data on a monthly basis. He said he knows there are some that haven't been added to the official count yet. 

'Spiraled from there'

Carley is a member of an Evansville-based group called the 7 Sisters, formed by local women who have each lost a loved one to an overdose.

Casey Blake, another 7 Sisters member, lost her younger brother in 2015 after he overdosed on heroin. Evan Wininger died at 31.

Blake said Wininger's substance abuse began after doctors prescribed opioids to manage his pain after a basketball injury required surgery during his junior year of high school. He had a second surgery right before his senior year.

"It started from the pain prescription pill, and then just kind of spiraled from there," Blake said.

11 deaths an hour

That's a story many families locally and across the country could tell as the nation is gripped by the opioid crisis.

Overdose deaths soared to a record 93,000 last year in the midst of the COVID-19 pandemic, the U.S. government reported earlier this month. That estimate far eclipses the high of about 72,000 drug overdose deaths the previous year and amounts to a 29% increase.

The estimate of more than 93,000 overdose deaths translates to an average of more than 250 deaths a day, or roughly 11 every hour. 

The 21,000 increase in overdose deaths nationally from 2019 to 2020 is the biggest year-to-year jump since the count rose by 11,000 in 2016.

More historical context: According to the CDC, fewer than 7,200 overdose deaths were reported in 1970, when a heroin epidemic was raging in U.S. cities. There were about 9,000 in 1988, around the height of the crack epidemic.

The CDC reported that in 2020, drug overdoses increased in all but two states, New Hampshire and South Dakota.

Neighboring Kentucky's overdose count rose 54% last year to more than 2,100, up from less than 1,400 the year before, one of the largest increases in the nation. 

'Wasn't something we talked about'

Many, like Wininger, will experience stints of sobriety.

In the couple of years before Wininger's death, he graduated from a rehab program, lived in sober housing and moved into a new apartment. A few months later, his family received a call informing them he had overdosed. 

"I don't know if that was his first use, or if he'd relapsed prior to that, but we kind of like to think it was his first use, you know? That he hadn't (relapsed), but I don't know," Blake said. "We're not really sure."

Over the decade-plus during which her brother struggled with substance abuse, Blake's family knew about his drug use, but didn't often talk about it until it was too late, she said. 

"Our family kind of felt almost ashamed, a little embarrassed about it," she said. "So it wasn't something that was talked about very often."

But since Wininger's death, Blake has been surprised at the number of people she meets who are affected by addiction, either in their own lives or through their loved ones. That is why she helped form the 7 Sisters group.

Fentanyl's role in OD deaths

According to the data on those 50 fatal overdoses so far this year in Vanderburgh County, 21 have involved fentanyl, either on its own or mixed with other substances like heroin or methamphetamine. The next most common drug involved in fatal overdoses was meth, which was found in 18 cases, both alone and with others substances.

Lockyear said people who die of an overdose often have more than one substance in their system. Their deaths are overwhelmingly ruled accidental. 

Over the course of his career, Lockyear has watched the nature of fatal overdoses move from "street drugs" like cocaine or meth, to prescriptions drugs, then heroin and now fentanyl, a dangerously powerful opioid. Fentanyl was developed to treat intense pain from ailments like cancer but has increasingly been sold illicitly and mixed with other drugs.

Lockyear said fentanyl-triggered overdoses spiked in Vanderburgh County last year and this year. 

2020 Drug Overdoses:The Evansville area saw a large jump in overdoses in 2020. Fentanyl was a huge problem

Fentanyl is 80 to 100 times more potent than morphine, according to the U.S. Drug Enforcement Administration. It's become popular both as a substitute for heroin and mixed with other substances to make them stronger, often without individuals knowing.

"What's really driving the surge in overdoses is this increasingly poisoned drug supply," said Shannon Monnat, an associate professor of sociology at Syracuse University who researches geographic patterns in overdoses. "Nearly all of this increase is fentanyl contamination in some way. Heroin is contaminated. Cocaine is contaminated. Methamphetamine is contaminated."

There's no evidence that more Americans started using drugs last year, Monnat said. Rather, the increased deaths most likely were people who had already been struggling with addiction. Some have told her research team that suspensions of evictions and extended unemployment benefits left them with more money than usual. And they said "when I have money, I stock up on my (drug) supply," she said.

Many of the people who overdose on fentanyl – including those who survive – take it without realizing it, Lavender Timmons said. She is the director and co-founder of the Evansville Recovery Alliance, a local nonprofit organization focused on harm reduction. 

“Fentanyl is obviously one of the biggest issues right now," she said. "That’s being cut into even things like Xanax. So people with anxiety are taking fentanyl accidentally and overdosing.”

Timmons said the path to substance use disorder typically begins with legally prescribed drugs for pain management. When their doctor determines they no longer need the medication and the prescriptions run out, some turn to opioids and other substances to fill the gap. 

“Then they don’t know what they’re taking and they don’t know the correct dosage for pain management," Timmons said. "So these people are basically just trying to medicate themselves, and they just can’t tell what’s actually in these drugs. So the increase in overdoses has a lot to do with the uncontrollability of that supply.”

Timmons said the increasing presence of fentanyl and stressors inflamed by the pandemic have tipped the scales when it comes to drug abuse. 

“Within the COVID pandemic, those extreme circumstances of isolation, lack of resources, lack of medical care exacerbated all of those qualities that make people susceptible to risky substance use and overdose probability," she said.

Brandon Marshall, a Brown University public health researcher who tracks overdose trends, said the country was already struggling with its worst overdose epidemic, but clearly "COVID has greatly exacerbated the crisis," he said.

"This is a staggering loss of human life," he said.

Lockdowns and other pandemic restrictions isolated those with drug addictions and made treatment harder to get, experts said.

One of the primary goals of Timmons's organization is to make the overdose reversal medicine naloxone, commonly known by the brand name Narcan, more accessible to help stem fatal overdoses. 

She said the Evansville Recovery Alliance distributed roughly 3,000 doses of Narcan in Vanderburgh County in 2020; this year, she estimated they are already at approximately 2,000.

Thanks to Indiana's "Good Samaritan" laws and Aaron's Law, bystanders can carry and administer naloxone without formal training or licenses. 

Evansville Fire Department EMS manager Keith Current recorded at least 244 Narcan doses administered by a combination of agencies and bystanders as of July 23. The fire department has used 144, AMR 50, law enforcement 24 and bystanders have used 26 doses.

The 24 doses administered by law enforcement include both Evansville Police and the Vanderburgh County Sheriff's Office, Current said. 

Based on the number of both fatal and nonfatal overdoses so far in Vanderburgh County this year, Timmons said she is concerned about the second half of the year. 

"I'm definitely worried for folks," she said.

Vanderburgh County and the surrounding areas are not an anomaly; 2021 is shaping up to be a continuation of what was a deadly year across the nation in terms of overdoses.

According to preliminary data from the Centers for Disease Control and Prevention, drug overdose deaths in Indiana increased by approximately 33% between December 2019 and December 2020. Over the same 12-month period, overdose deaths went up by 29% nationally.

In neighboring Warrick County, there has been one confirmed death from a drug overdose, according to coroner Sarah Seaton. The cause of death of another suspected overdose victim is pending toxicology results. 

In 2020, there were seven victims of fatal overdoses in Warrick County. Five had fentanyl in their system when they died.

In Henderson County, there have been two confirmed drug overdose deaths so far this year, according to deputy coroner Sheila Patterson. In 2020, eight people died from overdoses.

'Complex kind of grief'

Lisa Seif – a local licensed clinical social worker and addiction counselor who works with 7 Sisters – believes in addressing the individual, not the substance.

Seif is also an adjunct professor of social work at the University of Southern Indiana. She said individuals who lose loved ones to unexpected deaths experience complex grief, different from other kinds of grief.  

"Grief is grief, and we know the stages of grief... but when you've lost somebody to death by suicide or a death by an overdose, (with it) comes a more complex kind of grief or more disenfranchised grief, if you will, because you don't feel as free to talk about it," Seif said.

And often, "the family doesn't know what the hell's going on until they die," Seif said. 

What Timmons wants to emphasize is that people struggling with addiction deserve compassion; anyone could fall into substance abuse.

“There isn’t a barrier of who becomes addicted to substance; it is about exposure," Timmons said.

For help

For those who may be interested in finding help for themselves or their loved ones, here is a list of resources related to substance abuse:

Opioid rescue kits are located at 1035 North Fourth Street and 30 East Virginia Street in Evansville.

The 7 Sisters and Lisa Seif host seminars and support groups at the YWCA located at 118 Vine St. in Downtown Evansville on the first Monday of every month from 6-7 p.m. All are welcome.

The Associated Press contributed to this report.