Emergency services in Louisville, Kentucky, saw an alarming spike in overdose cases late last week, underscoring the state’s — and the country’s — ongoing opiate epidemic.

According to The Washington Post, in a 36-hour period late last week, Louisville Metro Emergency Services received 52 overdose calls — and one resulted in death: On Thursday afternoon, a pickup truck driven by someone reportedly under the influence of heroin rear-ended another car. The driver of the car was given Narcan, an opiate antidote, while one passenger fled the scene. Another passanger was pronounced dead, believed to have overdosed. The driver of the car that was hit was reportedly unharmed.

The influx of calls took place between midnight Thursday and 8 a.m. Friday, and they were not limited to heroin overdoses.

“When we say overdoses, we usually mean heroin, but that included alcohol, prescription medications, etcetera,” Emergency Services spokesman Mitchell Burmeister, told the Courier-Journal. According to the newspaper, health official are trying to determine whether the spike is an anomaly of a reflection of an accelerating problem.

Van Ingram, Executive Director of the Kentucky Office of Drug Control Policy told the Courier-Journal that overdoses are frequently a result of the potent painkiller fentanyl being introduced so a batch of drugs when the user is unaware of its presence of high concentration.

“I’m afraid it’s a reality we’re going to see repeated far too often,” Ingram said.

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