County looks to curb OD problem (Continued coverage in photos)
The front lines of Jefferson County’s opioid epidemic to keep up the fight as crisis gets ever deadlier
By JEN JACKSON
PUBLISHED: MONDAY, JULY 3, 2017 AT 12:30 AM
WATERTOWN — City Fire Battalion Chief James R. Holland tracks every call to an overdose meticulously, from the subjects’ ages and symptoms, to how hard it was to revive them — and his department has responded to 244 of those calls in the last 18 months alone.
“The number is increasing every year. This year is on pace to increase again,” Chief Holland said.
The good news is his department has a 100 percent survival rate for everyone it’s attempted to revive. The bad news is that sometimes responders get there too late.
“In a crude way of doing the math, is you double the number of overdose deaths now, six months in, we’d beat (last year’s death rate) by a significant number,” said Stephen A. Jennings, Jefferson County Public Health planner and Alliance for Better Communities chairman.
In 2016, 23 people in Jefferson County died of confirmed drug overdoses, at least 16 of which, though likely more, were caused by opiates.
As of June 29, there have been nine confirmed deaths by overdose this year and seven pending toxicology. Three of those deaths occurred in the six days between Friday, June 23, and Thursday, June 29.
“(Overdoses) seem to appear in a cyclical fashion,” Anita Seefried-Brown, director of community prevention at Pivot and project director for the Alliance for Better Communities, said. “When that happens, we have to assume heroin is being adulterated with something even stronger. We have to assume fentanyl is in Jefferson County.”
Fentanyl is the powerful synthetic opiate making headlines since law enforcement officers in multiple states have overdosed from accidental exposure, through either making skin contact or breathing in the powder during arrests.
According to the office of County Medical Examiner Dr. Samuel A. Livingstone and Medical Investigator Vonnice L. Joels, designer fentanyl was ruled the cause of death in an overdose for the first time late last year — the only recorded instance in 2016.
This year, it has killed six of the nine people whose deaths have been confirmed by toxicology.
Mr. Jennings says it’s not always clear if the individuals knowingly purchased fentanyl or if they were trying to purchase heroin and were instead sold the synthetic substance, either on its own or cut into heroin.
“It has been quite a dramatic shift,” Mr. Jennings said. “We’re kind of in the trenches, learning about it as we go.”
Chief Holland estimates the fire department gets around four overdose calls per week.
“Sometimes you get one in a week, sometimes you get four in a night,” he said, affirming that overdose cases tend to come in cycles.
The fire department and other first responders use naloxone, a generic form of Narcan, to revive those who have gone into overdose. Naloxone reverses the effects of the overdosed drugs, traditionally in only one or two doses.
As the opioid epidemic worsens and substances get stronger and deadlier, first responders nationwide have had to start using higher and higher doses.
Chief Holland records the number of vials required to reverse overdose each time the fire department administers naloxone. Last year saw the use of one to two vials almost exclusively, whereas this year as many as four doses have been needed to save a life.
“We really have to try to figure out what’s going on and get in front of it,” Chief Holland said.
Watertown’s fire department gets its naloxone, carried by every first responder and stocked into every truck, through the Fort Drum Regional Health Planning Organization’s North Country EMS Program Agency overdose training initiative.
The program has trained more than 270 people to treat opioid overdose since 2016. Of the naloxone kits distributed by the program in Jefferson, Lewis and St. Lawrence counties, 150 vials have been used to treat 91 individuals — only four of those people didn’t survive the overdose.
Chief Holland said the program allays the cost consideration of something that helps our community.
“Before the program, we couldn’t consider stocking naloxone like this because of the cost,” he said. “Anything included in our budget gets a lot of scrutiny.”
Ms. Seefried-Brown worries that as the opioid crisis worsens, the public discourse coarsens,
“When you’ve spent your whole life doing the right thing and still struggle with money or to get help, it can be hard to see money spent on this problem,” she said. “But we must be careful how we talk about these people in our community, how we talk about this disease, not to do so without compassion.”
In Watertown, most overdose-related emergency calls are for young people, ages 20 to 29. In 2016, they were almost twice as likely to be male, though the gender gap is closing fast, and multiple calls are often clustered around the same neighborhoods.
“This problem isn’t going away, every bit of data shows that,” Chief Holland said. “Until we can get on the front side of this with treatment and prevention, we really need (naloxone) to help save people who do overdose. Until we don’t have to anymore. We’re going to keep doing this until we can turn the tide.”