Solutions sought to curb opioid epidemic

Montgomery County Commissioner Dan Foley kicks off a meeting of the Community Overdose Action Team steering committee at the Business Solutions Center, Friday, June 2, 2017.
Montgomery County Commissioner Dan Foley kicks off a meeting of the Community Overdose Action Team steering committee at the Business Solutions Center, Friday, June 2, 2017.

Crisis care center being created to ease burden on emergency rooms, jail.

The Greater Dayton Area Hospital Association is leading an effort to create a one-stop crisis care center in Montgomery County to ease the current burden on hospital emergency rooms and the jail, which are overloaded with opioid addicts and those in need of mental health services.

It was one of many projects tackling the opioid epidemic presented Friday at a meeting of the Montgomery County Community Overdose Action Team (COAT).

RELATED: County, Kettering surpass 2016 fatal overdose total before June

“The numbers in our community are not getting better,” County Commissioner Dan Foley said in opening the meeting.

Ninety-eight people died from accidental overdoses in the county in May, according to an unofficial tally he shared from the coroner’s office. The total number of deaths in the county in the first five months of 2017 has surpassed all of 2016.

Fentanyl deaths outnumber those from pain pills and heroin in the county and deaths are increasing in the black community, said Montgomery County Health Commissioner Jeff Cooper. Based on state data, Montgomery County had the first or second highest rate of overdose deaths based on population last year, he said.

Source: Montgomery County Poisoning Death Review
Source: Montgomery County Poisoning Death Review

Foley said COAT — which brings together all the various agencies involved in addiction prevention and treatment — has been successful since its formation last year in improving the county’s treatment bed capacity and increasing the doses of life-saving naloxone available to first responders and the community.

Search for solutions

The proposed crisis center would likely be a partnership involving the area’s largest hospital systems — Premier Health, Kettering Health Network and Dayton Children’s Hospital — along with the county.

RELATED: What Ohio governor candidates plan to do about opioid crisis

The idea, according to Bryan Bucklew, president and CEO of the local hospital association, is to create a single point of entry into detox and treatment that isn’t the emergency room or the jail.

The center would house people anywhere from a day to about a week either on a voluntary or involuntary basis to get them started with medication and counseling plus referrals to further services.

Financing is still being worked out, and there are some hurdles to overcome, officials said.

State administrative rules, for example, require that an ambulance team take someone suffering from an overdose or a mental health condition to the hospital, not a treatment facility. Bucklew said the committee is working with state lawmakers to make sure that rule can be circumvented for the crisis center to operate.

Currently, 78 percent of local emergency room patients are presenting with some sort of mental health need and 22 percent are abusing drugs or alcohol, Bucklew said. At the jail, 60 percent of inmates are in need of substance abuse treatment, according to the sheriff’s office.

MORE: Lt. Gov. Mary Taylor opens up about her sons’ opioid addictions

COAT committees also shared updates on initiatives that have already been implemented in the county.

They include education programs in local schools, a needle exchange program, making naloxone available to those leaving the jail, getting info on resources into the hands of family members at the moment of overdose crisis, and a program that reunites recovering addicts with the emergency personnel that saved them.

Some at the meeting said better tracking of people who leave detox or a treatment program is needed so the effectiveness of those programs can be evaluated.

‘I just don’t want to be sick’

Naloxone has saved numerous lives throughout the area — in May, Washington Twp. firefighters and EMS crews were introduced to a man they’d brought back to life with naloxone last year — but township Fire Capt. Joel Holbrook acknowledged there are “a lot of naysayers in the community” who don’t think addicts should be revived on the taxpayers’ dime.

He said that attitude comes from a lack of knowledge about addiction.

“They have a chemical imbalance in their brain,” he said. “When you talk to addicts it’s, ‘I’m no longer seeking a high, I just don’t want to be sick.’”

READ MORE: Recovering addict thanks EMS for Narcan rescue 

Shared strategy

As the county deals with an increased number of inmates who are addicts, a need has arisen for outpatient detox rather than having prisoners detoxing in the jail. At some jails, there has even been deaths among detoxing inmates.

Montgomery County Jail officials want to hook up with a detox program like the one offered at Samaritan Behavioral Health. That program has been successful at getting more than 300 people into treatment with no wait, according to Jodi Long, director of treatment and supportive services for Montgomery County Alcohol Drug Addiction and Mental Health Services.

The 10-day outpatient program accepts people who are currently using on a walk-in basis with no waiting list. They get detox treatment followed by a shot of Vivitrol, a drug that blocks opioid receptors for 30 days, giving people a chance to get into further counseling.

Jail officials Friday wanted to know if inmates could be transported there for treatment.

Source: Montgomery County Coroner's Office
Source: Montgomery County Coroner's Office

Those at the strategy session Friday said the type of information sharing that took place is what’s needed to attack the opioid problem, which is hitting agencies in a variety of ways.

“COAT is our strategy to achieve collective impact,” Cooper said. “We honestly believe that this is the framework where we will see progress.”

This newspaper is your best source for information on Ohio’s opioid crisis. Our reporters are committed to covering every aspect of the problem, from the personal toll on families to the financial toll on taxpayers. For our story on Lt. Gov. Mary Taylor, who opened up about her sons’ drug problems in an exclusive interview with Laura A. Bischoff, see Sunday’s newspaper.

What can you do to fight opioid crisis?

The Community Overdose Action Team suggests the following actions as ways the community can help.

1. Encourage local school boards to implement the PAX Good Behavioral Game which teaches kids about decision making.

2. Attend naloxone training through Project Dawn. The free weekly training, including distribution of naloxone, is every Wednesday at noon at 601 Edwin C. Moses Blvd., the CrisisCare entrance. Businesses, faith organization, service groups can request weekday or weekend training classes.

3. Encourage primary care practices to follow Ohio and the CDC's opiate prescribing limits. Find more information on CDC.gov or mha.ohio.gov.

4. Be knowledgable about local treatment options. A list is available at www.mcadamhs.org.

5. Sign up for Know! E-Alerts which provide parents and caregivers with twice monthly email tips about educating kids. Go to starttalking.ohio.gov/Prevention/Know.aspx.

6. Complete a mental health first aid course. The 8-hour course teaches you how to start a conversation with a family member or friend about possible mental health or drug crisis. Contact Jennifer Cox at jcox@mcadamhs.org or 937-443-0416.