CAMBRIDGE — All markets are driven by demand, even the illicit market for opioids, heroin and other drugs in Dorchester County. Drug dealers calculate demand, profit, risk and reward in their dealings. The increasingly deadly dangers of heroin, fentanyl and pain killers demand a response from police, emergency personnel and the criminal justice system. In some cases, the response from police and other emergency personnel in the county demands the use of naloxone, or Narcan, to reverse the effects of an overdose caused by opioids. Following a spike in overdoses in August in Cambridge from a suspected batch of heroin laced with fentanyl, editorial staff at the Banner conducted a number of interviews with county and city leaders who are working to curb the opioid epidemic that is growing in Maryland and the nation. Narcan saves lives Sheriff James Phillips Jr. joined other county representatives in an October roundtable discussion on opioids. During that discussion, the sheriff said in summer 2014, Dorchester became the first county in Maryland where all officers, including police in Cambridge and Hurlock, were fully trained and certified to administer naloxone in the field. According to information distributed by the Maryland Department of Health and Mental Hygiene, naloxone is, “... a life-saving medication that can quickly restore the breathing of a person who has overdosed on heroin or prescription opioid pain medication like oxycodone, hydrocodone, morphine, fentanyl or methadone.” Naloxone has few side effects and has been used by medical professionals like doctors and paramedics for decades. In March 2014, then-U.S. Attorney General Eric Holder urged law enforcement agencies across the country to begin carrying naloxone. Also in March 2014, Maryland DHMH launched its Overdose Response Program. Through the program, police officers and even concerned citizens like friends and family of opioid users, can be trained and certified to administer naloxone. Certificate holders can now get naloxone without a prescription from participating pharmacies in the state. Naloxone certification is now part of standard training for new municipal and county police in Dorchester. As the first county to fully implement the program among police in 2014, Dorchester helped pioneer a life-saving program in the state and the nation. “That was something that we weren’t mandated to do,” Sheriff Phillips said in October. “It’s something we were asked to do. … We give Narcan to the deputies to go out there and respond and save somebody’s life. You know what? That’s what we’re supposed to be doing. That’s why we’re carrying Narcan.” Anna Sierra, director of the Dorchester County Department of Emergency Services, researched more than 200 cases from October 2015 to October 2016 in which naloxone was administered by police or emergency personnel. She said at the October roundtable that among those cases, 63 had evidence to suggest opioids were involved with the overdose. Since naloxone is administered to treat the symptoms of an overdose rather than the cause, it’s use does not necessarily reflect an actual overdose. The numbers provided by Ms. Sierra include cases in Cambridge. Lt. Shane Hinson is commander of the patrol division with Cambridge police. He has served with the city police for 17 years. “We’ve got numerous documented cases where officers have administered Narcan and brought people back,” Lt. Hinson said Tuesday. “Back even a couple years ago, when we arrived at an overdose scene, if somebody stopped breathing, basically the only thing that we could do was start CPR and let EMS know that we started CPR. Beyond that, we were very limited.” At the October meeting, Sheriff Phillips and Mr. Jones said members of the Dorchester County Narcotics Task Force communicate with law enforcement groups in other Maryland counties and Delaware. Spikes in overdoses are often reported in Wicomico County and Sussex County, Del., days before such cases occur in Dorchester. According to preliminary statistics provided by DHMH, in the first nine months of 2016, 40 overall overdose deaths were recorded in Wicomico County. There were 12 overdose deaths in Wicomico during the same period in 2015. Of the 40 overdose deaths in 2016, 30 were related to fentanyl. In Dorchester County, overdose deaths in the first nine months of the year grew from one in 2015 to six in 2016. All six 2016 deaths in Dorchester were related to opioids. According to U.S. Census data, 32,618 people lived in Dorchester County and 98,733 lived in Wicomico in 2010. The population of Wicomico County is roughly triple that of Dorchester County, yet more than six times more people died of overdoses in Wicomico than Dorchester from January through September 2016. “I think that there is no question that the employment of Narcan in Dorchester County has saved lives,” Mr. Jones stated in a Jan. 4 email. At the October meeting, the state’s attorney said, “we are fortunate to live in a county that, in my view at least, is fairly progressive in terms of public safety.” Mr. Jones said the county council, Sheriff Phillips, Cambridge and Hurlock police, and others are working well together to fight the scourge of opioids. “We don’t spend a lot of time talking about problems around here,” Mr. Jones said in October. “We spend a lot of time fixing them. There’s not a lot of hand wringing. A big jurisdiction like the western shore where they’ve got a 1,500-person police department, implementation of a Narcan program there is not easy. Here, when we decide we want to do something, the size and scope is such that it’s a little easier for us to say that we’re going to do it, so let’s do it.” ‘We can’t let off the throttle’ According to Mr. Jones, police efforts in Dorchester County including the City of Cambridge, have focused on heroin and opioids for the past few years. “Law enforcement collectively in this county engaged in a very serious crackdown,” the state’s attorney said Dec. 15. “Particularly, the sheriff really made this an emphasis. And then when the cases came to us as an office as prosecutors, we made those cases an emphasis.” Mr. Jones said while marijuana and cocaine are dangerous, heroin and opioids are killers, and judges are responding to the threat. “Law enforcement matched the danger brought on by heroin and opioids,” Mr. Jones said Dec. 15. “The prosecution effort, I think, matched that effort. And then the court’s view, as well, matched the danger presented by those.” Drug dealers in the county are responding to the crackdown and stiffer court sentences that come with opioid distribution. A dealer can potentially be charged with murder if a fatal overdose case can be traced back to the source of the deadly drugs. “We’re seizing a lot more marijuana and cocaine than we are heroin,” Sheriff Phillips said in October. “If we’ve got a particular problem with something, we should see that reflected in our enforcement when we’re doing interdiction or we’re doing search warrants. I’m not saying we don’t have heroin arrests. We do, but the majority of what we’re seeing is a resurgence of cocaine use. We’re seeing a huge return to that.” In response to Sheriff Phillips’ observation of an uptick in marijuana and cocaine cases, Mr. Jones said, “I think that that is reflective of the business model that is drug dealing. I think that a lot of drug dealers are trying to figure out how to maximize their profits while minimizing their risk.” In October, Sheriff Phillips said recent enforcement efforts in Delaware have also helped to limit the availability of heroin and opioids in Dorchester, but the struggle to stop the flow into the county continues. Last week, the sheriff’s office reported drug busts Jan. 5 and Jan. 6 that turned up alleged OxyContin, heroin and fentanyl. According to a news release, on Jan. 5, members of the Dorchester County Sheriff’s Office executed a search and seizure warrant at 802 Phillips St., Cambridge. The target of the operation, Rymarr Tyquan Rideout, 30, was found inside the residence with 34 capsules that field tested positive for heroin and fentanyl. Five small bags of marijuana, 11 small bags of synthetic marijuana and 13.3 grams of heroin laced with fentanyl were seized along with a loaded rifle. Mr. Rideout faces numerous charges and was ordered held without bond. The Dorchester County Narcotics Task Force assisted with the case. According to another news release from the sheriff’s office, on Jan. 6, members of the narcotics task force, sheriff’s office, Maryland State Police and Cambridge police teamed up to execute two warrants in Cambridge. One warrant was executed at 400 Charles St., and the other was at 312 Crusader Road, apartment 204. Items seized at Charles Street included a 22-caliber revolver allegedly stolen from Arizona, 19.6 grams of marijuana, and items related to alleged drug dealing. At Crusader Road, 43 OxyContin pills, 9 grams of marijuana, $1,022 in cash, digital scales and numerous cell phones were seized. The targets of that investigation, Leroy Sharps, 59, and his son, Tyuane Johnson, 38, were both arrested and charged with their involvement, Johnson lived at the Crusader Road address and Sharps lived at the Charles Street location. Both were ordered held without bond. While Sheriff Phillips has seen a resurgence in marijuana and cocaine, longtime officers in the Cambridge police department including Lt. Hinson and Lt. Justin Todd, said they continue to see a mix of drugs in the city. Lt. Todd is commander of special operations including criminal investigations and community policing with City of Cambridge Police. Tuesday marked his 16th anniversary with the department. He spoke Tuesday about heroin, opioids, overdoses, naloxone and his department’s response to the epidemic. “It’s changed so much,” Lt. Todd said of how Cambridge police officers respond to overdoses. “Years ago, when you heard an overdose come across the radio, it was a suicide attempt where somebody took too many sleeping pills, or an overdose where they attempted to kill themselves by taking narcotics, but decided it wasn’t the right thing to do. Now, with overdoses, the first thing everybody thinks when we hear them on the radio is, ‘Oh no, there’s another heroin overdose.’” Lt. Todd said Tuesday that in many cases he sees in the city, users obtain heroin, and other opioids like painkillers, from dealers after first becoming hooked through lawfully obtained prescriptions like oxycodone or Percocet. “It’s hitting home to so many people whether they’re living in poverty or they’re living in wealth,” Lt. Todd said. “It affects every family that’s involved. It’s sad. ... “It’s gotten to a point now where we treat every overdose as a crime scene because we’re trying to trace back the heroin to the dealers. It’s become a major, major issue for us, especially in the last few years.” Despite the major issue of heroin and opioid use in Cambridge, Lt. Todd and Lt. Hinson said Tuesday opioids are no more or less prevalent than marijuana or cocaine in the city. However, Lt. Todd, in his 16 years with Cambridge police, has seen the same trend as the state’s attorney. Since 1987, Mr. Jones has worked as a police officer, as a lawyer in a private practice, a public defender, prosecutor and assistant state’s attorney. In 2007, he became interim state’s attorney in the county and was named state’s attorney in 2009. Mr. Jones said he has seen more and more “medicine cabinet cases,” in recent years. These cases include people who were lawfully prescribed painkillers and became addicted to opioids, as well as cases of minors and young adults taking prescription pills to parties and school. Mr. Jones said he sees far more cases of drug users transitioning from their legal prescriptions to opioids obtained through illegal or manipulative methods like doctor shopping. Mr. Jones believes the county crackdown has been effective in limiting access to opioids, and strong enforcement efforts must continue. “We can’t let off the throttle,” Mr. Jones said Dec. 15. “As soon as we stop, then the supply, the availability, is going to go back up again.” Visit bha.dhmh.maryland.gov/NALOXONE for more information on the DHMH Overdose Response Program. Editor’s Note: This is the third part of a series of six stories about opioids, heroin and related issues in Dorchester County. The series will appear in Friday editions of the Dorchester Banner through Feb. 3. In the next story in the series, one Shore resident discusses his history of dependence.