An unusual number of fatal overdoses, combined with a dozen people hospitalized for possible overdose in a 24-hour period, spurred Hamilton County’s anti-heroin overdose coalition to warn the public Saturday about the spike.

Emergency crews were called to 23 suspected overdoses from 6 a.m. Friday to 6 a.m. Saturday, the Hamilton County Heroin Coalition reported.

The alert from the coalition, which includes public and private health providers, elected officials and police and firefighters, did not specify the number of deaths that could be attributed to overdose.

The Cincinnati region, and much of Ohio, has been experiencing overdose surges since about April. The spikes tend to happen on weekends, leading some experts to suspect the spikes are among recreational users of crack cocaine and ecstasy that may have been cut with fentanyl. Eighteen people died locally during the last two weekends of May, for example.

“It’s frustrating,” said Newtown Police Chief Tom Synan, a member of the heroin coalition. “We continue to see an unacceptable, high number of overdoses and deaths no matter what drugs people are using.

“But it’s the fentanyl that’s doing it.”

Fentanyl, a synthetic opiate usually made in “bucket” factories overseas by rogue chemists, is sold on the streets as is. It’s also added to heroin, meth and cocaine to give users a more powerful euphoria. It is a potent opioid that can kill even if used in tiny amounts.

The heroin coalition’s alert urges drug users, including those who use recreationally, not to use alone and asks them and the public to have the opioid overdose antidote naloxone on hand.

The difference in the number of people reached by paramedics and the number admitted to hospitals could come because many who overdose and are revived refuse to be hospitalized.

Public health officials urge people to go to the hospital, noting that naloxone can wear off in about 90 minutes, and breathing may slow again, pushing someone back into overdose and possibly death.

Among the dead was a Newtown resident who was revived, did get hospitalized and was released. Synan said it’s possible that the individual used drugs again, later in the day or night, after he was discharged.

Synan said more OD calls might come in now because more drug users are out in the open in the spring and summertime than in the winter.

The spike Friday came on the first day of summer – a sunny day after days of rain.

Dr. Lakshmi Sammarco, the Hamilton County coroner, could not be reached Saturday to confirm the number of suspected overdose deaths. However, she said in May, after seven people died in several days, that it appeared that some of the dead then had been using crack cocaine, which may have been tainted with fentanyl. Toxicology reports had not been finalized, so she could not be certain of the cause of death.

Franklin County health officials issued warnings of surging overdoses earlier in the week.

More: UPDATE: Fake ecstasy, other adulterated street drugs may be tied to 11 fatal ODs in Hamilton County

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