Trumbull tracks overdoses to help with responses

WARREN — When the heroin epidemic started taking hold in local communities a few years ago, first responders in police and fire departments, ambulance companies and hospitals saw the first effects. But there wasn’t a system in place to centralize the numbers to help officials track and combat accidental overdoses.

While Trumbull County officials said they where acutely aware of what was going on, the only centralized statistics available were from the coroner’s office.

However, not every overdose is lethal.

To more accurately track trends and create a measured response to the epidemic, the Trumbull County Combined Health District added a new codifier to a system that had already used for years to help track upticks in the flu and other communicable diseases, said Sandy Swann, director of nursing for the district.

“This is a public health crisis. As an agency responsible for public health services, we absolutely need to get involved in this,” Health Commissioner Frank Migliozzi said.

Data can help the district form a targeted response, Migliozzi said.

Now, the tracking system, EpiCenter, has an overdose category that alerts its users when emergency rooms log “overdose” as a patient’s chief issue.

The system does not identify the person, only certain markers such as zip code, sex and age, Swann said.

When the system notices trends, it sends alerts to health district employees who review the cases and make sure the trigger went off because of a real abnormality.

The alerts could notify officials of a bad batch of fentanyl-laced heroin, Swann said.

If there is a surge of people in the hospital to treat overdoses, the district can begin sending alerts out to other people in the system who do their part to respond, including law enforcement agencies like the Trumbull-Ashtabula Group Law Enforcement Task Force.

One of the contacts is April Caraway, executive director of the Trumbull County Mental Health and Recovery Board. If an alert goes off, Caraway coordinates with treatment centers to ensure staff is on hand in hospitals to connect the patients to services that can help them break the addiction, and connects with detoxification facilities in the Valley to see if they are prepared to handle a wave of people who may decide enough is enough.

But, Caraway said many who overdose leave the emergency rooms as soon as they are able and they don’t stick around perhaps because they are afraid of getting criminal charges.

“According to Coleman (staff) and hospital staff, the majority of people won’t talk with a counselor and leave the emergency department as soon as they are able,” Caraway said.

The alerts don’t tell the district if the person who overdosed died, or catch people who didn’t end up in a hospital after being revived.

Another new system the district implemented is the Poison Death Review Board, which concentrates on studying the details of people who died from an accidental overdose, Migliozzi said.

“It’s an epidemic, but by looking at the data and identifying what groups are most affected, we can create prevention strategies,” said Swann.

A 15-month $130,000 grant the district was awarded earlier this year through the Ohio Department of Health could be renewed at $90,000 for two 12-month periods if the program still has funding.

The “multi-faceted” grant is helping the district with several projects aimed at prescription drug overdose prevention, Migliozzi said.

In addition to keeping first responders stocked with naloxone, a opioid overdose reversal drug, the district is also making sure people who overdosed leave the emergency room with a kit of the nasal spray to have on hand at home, Migliozzi said.

The district is also talking with doctors in the area’s hospitals about their prescribing habits, and encouraging them to prescribe alternatives to the highly addictive opioid-based pain killer, Migliozzi said. The district also wants doctors to make sure they are helping their patients who are on opioids to stop taking them when their prescriptions run out.

“That is one of the biggest problems in the county, when their prescriptions are cut off, when they quit cold turkey, they end up turning to street drugs,” Migliozzi said. “But when their doctor is helping them, weaning them off the drug before the prescription runs, out, they might be less likely to turn to street drugs.”

Migliozzi said the district is also encouraging doctors to make full use of the Ohio prescription drug monitoring system, which tracks prescriptions and can be used to discern if a person is doctor shopping to get pain killers.