Montgomery County to combat overdose deaths like public health crisis

Continued coverage
The Dayton Daily News coverage of the heroin crisis in the Miami Valley continues with a coming special report on naloxone, the lifesaving opioid antidote.

Set to take 400 lives this year, the raft of drug overdose deaths in Montgomery County needs to be fought as ferociously as the worst infectious disease, public health and county officials said Wednesday.

“We don’t have lots of time,” said Montgomery County Commissioner Dan Foley, who convened a Collective Impact Collaborative to plan the attack. “The reality is it’s a public health epidemic.”

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More than 150 met at The Salvation Army Ray & Joan Kroc Corps Community Center to begin working on a strategy to reduce the number of overdose deaths primarily attributed to heroin and synthetic opioids like fentanyl. The crowd included public health officials, those in government as well as law enforcement, the courts, treatment providers, community organizations, addiction support groups and others including some in recovery from drugs.

“What we haven’t done is gather together and really develop a strategic plan around one single goal,” Foley said. “And that single goal is: How does this community reduce the number of deaths?”

Data from the county coroner’s office show 192 confirmed unintentional drug overdose deaths plus 31 pending or probable during the first six months of the year. If the trend continues, the total this year would eclipse the high of 264 overdoses in 2014 and last year’s 259, said Jeff Cooper, Montgomery County health commissioner.

“We are all doing really good things,” Cooper said. “Despite the many resources that are being applied to address this issue we still see this increasing trend.”

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“This epidemic is a public health and a public safety crisis and as such it requires a unified community response,” Cooper said.

Whatever the resulting response, it’s too late for at least 50 of Chadd Walter’s acquaintances or former classmates, he said. They’re all dead. The Miamisburg 29-year-old, too, would have been a November 2015 statistic without the opioid overdose drug naloxone.

“I just turned straight blue and green,” Walters said. “(A friend) ended up driving me to Miami Valley (Hospital) and they were pretty much barely able to save me.”

Walters, who attended the meeting, is on parole for drug charges but has been clean for six months. He said he hopes the community cant stop the out-of-hand epidemic.

“You’ve got all these people dying everyday more and more and they need to put a plan into action and hopefully that’s what they do.”

The first step is identifying a steering committee to represent all of the diverse stakeholders now providing services to those addicted, Cooper said. A joint information center would be formed to unify messaging to the media and public. An operations section would implement the plan supported by finance and logistics sections.

Cooper said the effort will be scaled to the opioid problem employing an incident management system much like efforts to combat other diseases or outbreaks of food-borne illness.

Public Health – Dayton & Montgomery County used a similar incident management framework to respond to an E.coli outbreak at a Germantown picnic in 2012, a 2013 potential tuberculosis outbreak at a nail salon in Miami Twp., and the community’s 2009 response to H1N1 influenza virus, Cooper said.

Lack of useful local data is also hampering the response to the heroin epidemic, Foley said.

“There’s the whole issue of data and data sounds like such a wonkish thing to say, but we can’t even tell you right now how many people are addicted in the community,” he said. “We can’t tell you how many people get into treatment and fall out of treatment.”

The collaborative will also focus on collecting and analyzing data to determine the scope of the local problem and gauge the success of any new strategy, Foley said.

Ruth Simera, program administrator at the Criminal Justice Coordinating Center of Excellence at Northeast Ohio Medical University, discussed sequential intercept mapping, a sort of “funnel” where those in need of treatment can be identified at various intervention points through contact in the community or later during encounters with law enforcement and the judiciary at jails or in court.

Simera said 65 percent of all inmates in the United States meet the medical criteria for having a drug problem yet only 11 percent get treatment.

“Our goal in mapping is to identify the best possible practices we know exist along segments of the justice system and in the community,” she said. “The data become really, really, really important. Unfortunately around Ohio — really around the country — the data is oftentimes what’s missing at the local level.”

Law enforcement and the county courts have programs already in place to intercept drug users and get them the help they need, said Bruce Langos executive director of the Montgomery County Sheriff’s Office Criminal Intelligence Center. Langos, also chair of the Montgomery County Drug Free Coalition, said groups at the table Wednesday need to hear more from those struggling with addiction and their families.

The community needs “addicts to stand up and tell us what’s wrong with the current services offered in the county. What gaps are there? What didn’t work and what did work?” Langos said. “If we start there we’ll learn a lot faster.”