While overdose deaths are trending down across the state, the numbers continue to tell a different story in Madison County.
Through Nov. 8, there have been 42 confirmed overdoses and two more pending, according to Madison County Coroner Jimmy Cornelison.
"We've already surpassed last year," he told The Register on Friday.
The confirmed number of overdoses is potentially the highest ever. In 2016, there were 33 overdose deaths in the county that increased to 40 in 2017 and 42 last year.
Cornelison said he is seeing more methamphetamine, but there is nothing consistent in terms of trends.
Through Nov. 8, EMS has administered 307 doses of Narcan to 257 patients this year.
Madison County EMS Director Carlos Coyle said while his department's numbers are down, he cautions drawing much from the statistics due to a difference in how Narcan, or naloxone, is given to patients. He said first responders are using intravenous naloxone, rather than intranasal to reverse opioid overdoses, which wakes them up slowly and is more controllable than intranasal.
At the end of October, the Richmond Police Department posted on social media a warning that officers had responded to six suspected heroin overdoses in a 24-hour period.
Coyle noted EMS did see an uptick then as well, but said that is not uncommon.
"We see that from time to time," he told The Register. "That was a little higher number. What we see often is clusters. A dealer comes to town, their heroin or drug is stronger than what people are used to and then EMS receives several calls in succession on potential overdoses."
The EMS director said there is a frequent uptick near the first of each month, especially when that occurs close to a weekend.
"People have more money typically then and I think drug dealers are aware of that," Coyle said.
Cornelison said he has noted similar trends, or clusters, in his files.
"I went through all my cases, not just drug related. There were four in a row that were drug cases at one point," he said. "You could see the pattern."
The coroner added he's also had several stretches were he's gone several weeks without a drug-related death.
"What contributed to that," he asked. "That tells me there's nothing in town then."
Cornelison said he doesn't have the answer, but knows what the problem is.
"This affects all of us," he said. "I don't care if you have only a dollar or you have millions, it affects all of us."
Jonathan Greene is the editor of The Register; follow him on Twitter @jgreeneRR.