By SARA ARTHURS
Overdose deaths are decreasing, but there’s still a lot of work to do.
The Hancock County Board of Alcohol, Drug Addiction and Mental Health Services outlined phase two of the Hancock County Strategic Plan to End Overdoses while meeting with The Courier on Wednesday.
The strategy divides those using drugs into three “floors,” each of which requires a different approach.
The first floor includes those who are more eager to seek treatment on their own.
The second floor is those at more risk, who may accidentally end up in jail or the emergency room, perhaps as overdose survivors or being arrested for driving under the influence.
The third floor is the most difficult population to reach: people who don’t want help. This population will need “extraordinary outreach from the collective community,” not only to help them, but safeguard public health as a whole, a strategic plan report states.
ADAMHS Board Executive Director Precia Stuby said it used to be that people would say, “There’s an addict,” without making a distinction between people who were at different places in their drug use.
But just as stage I cancer is treated differently than stage IV, someone on the first “floor” should be approached differently than the second or third floor, she said.
“There’s no one size fits all,” Stuby said.
Zach Thomas, ADAMHS director of wellness and education, said the same idea applies to prevention strategies.
If you tell children about the dangers of drugs, they are less likely to use them. But some children are, because of family history, at higher risk and may need a different approach.
The plan states that each of the three floors “should have an identified priority and defined prevention, early intervention, treatment and recovery strategy.”
The plan also calls for:
• Ensuring that sufficient medication is accessible for both substance users and mental health, including buprenorphine, naltrexone, naloxone “and possibly higher tolerance medication, (e.g. methadone). Wait lists for such treatment should not exist. Individuals seeking care should not be turned away without stabilizing treatment and connections to ongoing care.”
• Continuing to grow the treatment workforce, including working with the University of Findlay, Focus and other groups.
• Integrating behavioral health screening and checkups into all medical specialties and medical care; as well as child and family treatment.
• Defining a community policy/advisory paper on the use of medical marijuana and other cannabis-based products.
• Working to “strengthen families through prevention, early intervention, treatment and recovery,” since “nothing will reduce overdose and substance use more than the prevention of the problem’s onset.”
Nationally, the opioid overdose epidemic is beginning to slow, but the Centers for Disease Control and Prevention doesn’t expect a sustainable decrease until about 2025, said Michael Flaherty, a clinical psychologist and an adviser to the ADAMHS board about its “Recovery Oriented System of Care” initiative.
Overdose deaths in Ohio are decreasing, too, he said, and the state — particularly hard hit — has “done a lot to face the problem.”
But while there are reasons for “some optimism,” there are also concerns. More people are now using other drugs like cocaine and amphetamines, and “overcontrol of things like pain management” remains a concern.
There have been 29 emergency room visits in Findlay due to overdoses so far in 2019, compared to 248 in all of 2018 and 297 in 2017, according to ADAMHS figures.
There have been no confirmed Hancock County overdose deaths yet in 2019, compared with 17 in all of 2018 and 30 in 2017.
There has been one confirmed suicide death this year, compared with 12 in 2018 and nine in 2017. However, there are five 2018 deaths and four 2019 deaths still being investigated, which could be ruled overdose or suicide.
Flaherty said suicides are increasing among men, and he is particularly concerned about older men and veterans.
Among deaths from suicide and overdose, Stuby said there is a common thread “related to loss,” such as a divorce, a job loss or the anniversary of the death of a friend.
So they are trying to weave grief and loss care into other types of mental health care. Century Health/Family Resource Center recently trained 12 staff members in grief and loss services.
There have been 18 new hepatitis C cases in 2019, compared to 109 in all of 2018 and 107 in 2017. There were 55 county residents living with HIV and five new HIV diagnoses in 2017. Figures for 2018 are not yet available.
Both these illnesses can be spread by intravenous drug use, but they can also pose a risk to public health overall — something the “third floor” strategy must address, Flaherty said.
There were 339 naloxone kits distributed in 2018 and 367 people trained in how to use them to reverse an overdose. There were nine known reversals of overdoses through these kits in 2018.
So far this year, there have been 85 kits distributed and 64 people trained.
The Hancock County Opiate Task Force has determined that the scope of its work should expand more broadly to include addiction in general. So, they recommend renaming it the Hancock County Opioid and Addictions Task Force.
In addition, “it is imperative that cultural humility and the recognition of health disparities be a driving force behind all initiatives,” the report states. “Without sensitivity and attention given to the most underrepresented and vulnerable populations, even the most robust system of care will fail to meet the needs of the entire community.”