By Tony Marco

(CNN) — There were 27 heroin overdoses within four hours, including one death, in Huntington, West Virginia on Monday. Officials believe the drug may be laced with something making it particularly dangerous.

“I do not know what it was laced with but I would love to know at this point,” Cabell County’s EMS director Gordon Merry told CNN.

There is some hope that the death can lead to some clues about what may be making the drugs so dangerous. Huntington Chief of Police Joe Ciccarelli told CNN, “The state medical examiner will conduct a toxicology analysis to determine what was in the drug, but that will not come back for about ten weeks. We did not seize any heroin from the other overdose victims so we can’t analyze theirs.”

It all started Monday

The calls started coming Monday afternoon, overwhelming the 911 call center and taxing ambulance resources in the area, according to Merry.

“We had tied up seven ambulances within minutes due to overdose calls and still needed more, which we had to get from other parts of the county. It was basically like a mass casualty event,” said Merry.

“Huntington has a population of about 50,000 people and usually sees around 18 to 20 overdoses in a week. So this was a huge increase, catastrophic,” added Merry.

All of the overdoses happened within a mile and a half radius, which leads officials to believe they are from the same batch of heroin. The overdose victims ranged from 20 years old to 50, according to Merry.

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Eight of the people were revived using naloxone, an opioid reversing drug. Others were revived by manual resuscitation, with a bag that simulates breathing. One of the victims had to be given naloxone three times because the heroin and whatever it was laced with was so strong, according to Merry.

Overdoses on the rise

Huntington is in Cabell County where there have been at least 440 overdoses so far this year and 26 of those where fatal, said Scott Lemley an investigator with the Huntington Police department.

There were 413 overdoses countywide during the same period last year, so overdoses are up, but the number of deaths are down. Last year there were 35 deaths in the county for the first half of the year, that represents a 25% decrease, according to Lemley.

According to the U.S. Centers for Disease Control and Prevention’s latest data from 2014, West Virginia has the highest rate of drug overdose death in the country.

“It’s way too early to tell what the heroin in these latest cases was laced with but I suspect it was fentanyl and maybe something else,” said Lemley. “A majority of the overdoses cases are laced with fentanyl, Xanax or something. It’s very rare to find pure heroin these days.”

A third of the overdoses deaths in Cabell County are likely related to fentanyl, according to Lemley.

How did this happen?

The Cabell-Huntington Health Department was not directly involved with the latest overdoses but has been keeping track of the overdose statistics and has been working on solutions to the drug problem in the area.

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“I can’t speak directly to this case but we have been preparing for heroin laced with elephant tranquillizers, which is the latest thing communities close to us are dealing with,” said Michael Kilkenny, director of the health department.

“When I graduated from medical school in 1982 we used opioids for patients with acute pain and those close to death and dying only; not for chronic pain because they were thought to be addictive. Then in the 1990s our thinking changed and we thought we were under-treating pain, so we started using more opioids,” said Kilkenny. But since then, the thinking reversed again. “In Huntington we began prescribing much less opioids in 2010 because we thought they were harming people. We thought we were becoming more responsible and people would stop using opioids when we stopped prescribing them. But then they turned to heroin. In many cases it wasn’t to get high, it was just to keep from going into withdrawal. It’s a very miserable existence for people, but heroin is cheaper.”

Cabell-Huntington Health Department is trying to combat the heroin problem with education, needle exchange programs, and providing naloxone to law enforcement and community organizations, according to Kilkenny.

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