Alarming Trend of Fentanyl-Related Fatalities in Montana

Submitted by
Montana Department of Health and Human Services


State officials stated the alarming increase of
fentanyl-related fatalities in Montana that occurred
in 2020 does not appear to be slowing down thus far into 2021.

The Montana Department of Justice’s State Crime Lab reported 41 fentanyl-related deaths in 2020,
up from 19 in 2019. As of May 2021, 22 confirmed
fentanyl-related fatalities had been documented,
including 11 in April alone.

“This latest trend is extremely concerning and adds to the already existing deadly and costly impact illegal drugs have in Montana communities,” said Governor Greg Gianforte.

Fentanyl is a synthetic and short-acting opioid
analgesic. It was developed for pain management
treatment of cancer patients and is 50-100 times
more potent than morphine. Due to its powerful
opioid properties, fentanyl is abused and illegally

Attorney General Austin Knudsen said the DOJ
continues to work with local law enforcement and
other states to investigate the situation. DOJ officials believe that fentanyl is being sold as a substitute for heroin meant for injection drug use, or in the form
of counterfeit pills. DOJ reports counterfeit pills,
disguised to look like a legitimately prescribed
opioid, but containing fentanyl, have been found in
the state.

“This is an ongoing investigation, but we know
that counterfeit pills laced with fentanyl are manufactured overseas and smuggled across the border
before coming to Montana. The federal government must secure the border and stop the flow of drugs into our country,” Attorney General Knudsen said. “Even a small amount of fentanyl is enough to be fatal. No one should take pills that were not prescribed to them and parents need to talk to their kids about the dangers of ingesting unknown substances.”

Department of Public Health and Human Services (DPHHS) Director Adam Meier expanded on this
message. “Do not take pills that you can’t prove came from a pharmacy and only take pills prescribed to you,” Meier said. “Remember that street drugs may look
like prescription pills, but may be counterfeit.
Do not rely on markings, size, or lettering.”

Bryan Lockerby of the DOJ Division of Criminal
Investigation said it’s important people understand
the dangers of ingesting any unknown substance.

“This is critically important,” Lockerby said. “It’s
crucial that Montanans, especially youth, understand how dangerous these pills can be – especially when
you take into account the pills have likely been
tampered with and can contain highly potent fentanyl.”

A DPHHS Health Alert Network message to medical providers was recently issued through a collaborative, cross-agency information-sharing effort involving DOJ and DPHHS. Lockerby said the U.S. Drug Enforcement Administration, the DOJ-Division of Criminal Investigation, and local law enforcement have all been working together on the criminal investigation as well.

This is an issue impacting multiple counties.
The 11 deaths in April occurred in Missoula, Bozeman, Cascade, Yellowstone, Butte-Silver Bow and Flathead.

Overall opioid calls also on the rise

Not only has there been a sharp rise in fentanyl-related deaths, but DPHHS data also indicates that simultaneously there’s been an uptick in overall
opioid overdose calls to Emergency Medical Services (EMS) statewide.

Meier said the health department collects and
analyzes EMS data which provide critical information to identify potential drug overdose trends because EMS are often the first on the scene. When a sharp rise in drug overdose-related calls is detected, DPHHS shares this information with medical providers and other partners.

“Clearly, overall opioid-related calls to EMS statewide are trending upward, and this continues in 2021,” Meier said. “To have 68 opioid overdose calls in one month this year is significant.”

In 2020, Montana averaged 45 opioid overdose calls per month. Thus far in 2021, the state has averaged 54 opioid overdose calls per month, including a sharp increase that began in March with 68 calls – the highest number of calls in one month over the last three years. In 2018, the state averaged 18 calls a month, and in 2019 it was 24 monthly calls.

Some cases also required high doses of naloxone
to reverse the overdose. “In Missoula County, we are seeing a tremendous increase in the application of naloxone and in some instances the use of higher
doses used by law enforcement prior to EMS arriving to the scene is occurring,” said Don Whalen of
Missoula Emergency Services.

Naloxone is a safe medication and should be
administered any time there is a suspected overdose and the individual is exhibiting symptoms such as loss of consciousness, extreme drowsiness (nodding out), irregular or absent breathing, vomiting, snoring or gurgling noises, has pale/cold or clammy skin and slow or no heartbeat. Counterfeit pills laced with
fentanyl may require additional naloxone.

The 2017 Legislature passed HB 333 that made it possible for the State of Montana to issue a standing order to prescribe naloxone on a statewide basis.
This standing order allows Montanans to get naloxone from select community organizations and pharmacies at no cost.

First responders, public health professionals, and others can also access naloxone for free by participating in a DPHHS-sponsored Master Trainer course and can then train others to administer naloxone.

Multiple state agencies, including DPHHS, DOJ, Montana Medical Association, Board of Pharmacy, Board of Medical Examiners were involved in the statewide rollout in 2017 of naloxone through the standing order issued by DPHHS.

DPHHS continues to work closely with law
enforcement, health care providers and social service agencies to ensure that adequate supplies of naloxone are available statewide.

Giving naloxone to a person who has not taken an opioid will not hurt them. “If someone is experiencing the signs of an overdose but you are unsure if it is
due to an opioid, it is recommended to administer naloxone,” Meier said. “By saving lives, we are
providing individuals with the opportunity to get
the treatment they need.”

State Agencies Highlight Wildfire Air Quality

Preventing Wildfires and Checking Air Quality is Key


HELENA—As Montanans and visitors emerge from a year of the COVID-19 pandemic, summer
travel around the state—including camping—is likely to increase. Summer also means wildfire season andWildfire smoke can impact Montana’s air quality causing unhealthy air.

“It’s important to pay attention to air quality as you are traveling around the state this summer,” said DEQ Director Chris Dorrington. “Check air quality on the DEQ ‘Today’s Air’ website and take the necessary precautions whether you’re visiting or you’re lucky enough to call Montana home.”

Exposure to wildfire pollutants can irritate
lungs, cause inflammation, alter immune function
and increase susceptibility to respiratory infections,
including COVID-19. Respiratory symptoms such as dry cough, sore throat and difficulty breathing are common to wildfire smoke exposure. If you are
experiencing severe symptoms, such as difficulty breathing or chest pain, you should seek prompt medical attention by calling 911 or calling ahead to the nearest emergency facility.

“It’s important to protect your lungs during wildfire season,” said DPHHS Director Adam Meier. “It’s especially important to pay attention to air quality and realize that conditions can change very quickly.”

For information about how to protect your health during wildfire season, go to

If you have a chronic lung or heart condition, check with your health care providers before the fire season about precautions to take during smoke events.

This summer, DEQ will post smoke forecasts
during times when smoke is causing air quality
impacts. The forecasts will be posted to social media and can be viewed on by clicking on the “Wildfire Smoke Outlook” link.

“The best way to mitigate smoke exposure and poor air quality is to prevent fires from occurring in the first place,” said DNRC Director Amanda Kaster. “Over 80% of wildland fires in Montana are human caused and these fires can put our homes,
communities, and health at risk.”

It is important that we all take action to
prevent wildfire starts when working and recreating outdoors. Here are a few simple ways to reduce your wildfire risk and limit the chances of smoke events occurring:

– Avoid burning or conducting other activities that involve sparks or fire on hot, windy, or dry days.

– Never leave a fire unattended, and ensure your campfire or burn is cold to the touch when you are finished.

– Regularly maintain your vehicle and equipment and avoid driving or parking your vehicle and
operating equipment near dry vegetation.

– Report any unattended or uncontrolled fires. You may do so by calling 9-1-1.

Through our collective action to prevent wildland fire starts, we can minimize the number and severity of smoke events this summer.

Knowing how to prevent wildfires and what to do in the event of a smoke event will prepare visitors and Montanans for a safe summer.

“We’re excited to welcome visitors to Montana this summer and want to make sure you have the
information you need to plan a safe trip,” said
Montana Department of Commerce Director Scott Osterman. “Wildfires are a natural part of summer in Montana and there is usually no reason to let them stop you from enjoying your Montana experience.”


Submitted by
Montana Department of
Environmental Quality