WHITLEY COUNTY-- A report released on August 10 by the Kentucky Office of Drug Control Policy and circulated by the Commonwealth indicates lethal overdoses among Kentucky residents totaled 1,316 in 2019 -- a five percent increase from 2018. In May the Whitley County Health Department began using ODMAP to try to track in real time any overdose activity within Whitley County and the program is off to a successful start.
Information stated in a press release sent by the Governor's Office last week stated that according to resident cases autopsied by the Kentucky Office of the Medical Examiner and toxicology reports submitted by Kentucky coroners, the increase in the death toll is driven mostly by a rise in opioid abuse, fentanyl and fentanyl analogues.
"I share the concerns of so many that in this battle against COVID-19, which we must fight and must win, we cannot take our eyes off the increased risk of substance use and overdose deaths. I'm committed, with the Kentucky Office of Drug Control Policy, to monitor the trends associated with opioid and substance use and their impact on the public's health," Gov. Andy Beshear said. "Awareness is key to survival during most medical emergencies and, as I have seen firsthand, it is certainly true in the case of a drug overdose. If you find a loved one that has overdosed or even a complete stranger, knowing how to react may mean the difference between life and death."
In Whitley County when EMS respond to a call where an overdose is suspected, they enter basic data into the system that can monitored by officials at the health department.
"We realize this may not catch every overdose happening, but we needed a starting point," said Marcy Rein, Whitley County Health Department director. "What we have learned is that we have had 17 suspected overdoses since May, including 11 in May, four in June and two in July."
Two of those suspected overdoses were fatal. In 10 of those, a single dose of naloxone was administered. In six of them it took multiple doses of naloxone. In four of the cases, including one of the fatal cases, heroin was identified as the drug involved. In three cases, methamphetamine was identified.
"Naloxone doesn't work on methamphetamine, so we suspect it was contaminated with fentanyl or a derivative," said Rein. "Two cases identified prescription medications as the drug. The rest we were unable to identify the substance involved."
Rein said this is consistent with what she is hearing on calls with people both inside and outside of Kentucky, adding that on a recent webinar Dr. Richard Rawson from UCLA stated that nearly 100% of methamphetamine in the eastern U.S. is contaminated with fentanyl, compared to approximately 50 percent in the western U.S.
Workgroups have been formed and are meeting for each of the interventions the overdose grant is focusing on. Rein said the department has found excellent partners in the community and they continue to build relationships to help support existing work and to try new things.
"We hope to expand partners as well as develop a way to report our findings to the community," she added. "We are working on the paperwork side of our Overdose Fatality Review process - identifying data sharing agreements, protocols and team members so we can look at circumstances and find ways to prevent overdose"
Like the progression of most things, COVID-19 has made things more challenging for these workgroups.
"We have a plan to bring BOUNCE resilience training to Whitley County along with Handle with Care in our schools to help children impacted by substance use in their homes," said Rein. "We are challenged by COVID-19 and how to do those activities safely, so we continue to look for workarounds to keep moving forward."
Agreements and protocols are being put together to implement a Quick Response Team that will also be able to embed mental health and peer supports within local law enforcement and courts.
"Often a person with substance use disorder ends up in a bit of a washing machine repeating cycles of drug use, overdose, trouble with the law, jail, court, emergency rooms," added Rein. "These interventions will engage people who use substances after an overdose or early in their engagement with law enforcement or the justice system to provide continuity while they access recovery resources. There's an opportunity to get people out of the cycle so people recover and contribute to our community economically, socially and spiritually."
The harm reduction clinic at the Whitley County Health Department continues to serve many in the community. During their HIV testing event 80 participants were tested. In the last year the harm reduction clinic served 379 unique individuals.
"Our average number per month went from 122 between June and December 2019 to 187 since January. We've completed hepatitis A vaccination of 43 percent of participants and started it on another 10 percent. We've trained about overdose prevention and given out 344 naloxone kits in the last fiscal year," Rein said.
Again COVID-19 has made things challenging.
"We moved to a drive-thru model with limited services but found that we couldn't accomplish the education and prevention components well enough," Rein said. "We've moved service back inside our clinic so that we can focus on those things. We're planning another HIV testing event in the fall. We are hosting an Overdose Awareness Event on August 31 at Nibroc Park, 4-6 p.m. There we will have a "socially-distanced walk", overdose and recovery resources, and the Kentucky Department for Public Health and the Kentucky Pharmacist Association will be there to provide free naloxone and training to anyone who attends. People do not have to do the walk to take advantage of the resources or naloxone giveaway."
The 2019 Overdose Fatality Report was compiled with data from the Kentucky Office of the Medical Examiner, the Kentucky Injury Prevention & Research Center and the Kentucky Office of Vital Statistics. The report includes overview of the 2019 key findings and data regarding deaths by counties, age, drug and toxicology testing.