Fentanyl runs rampant

A review of recent drug overdose deaths has found that — once again — grief and a history of trauma, especially in childhood, were nearly universal among victims. And young Hancock County children continue to be left behind when parents fatally overdose. And, as has been the case for several years now, fentanyl remains the leading contributor in local overdose deaths. Three confirmed accidental drug overdose deaths, and 85 overdose visits to the hospital emergency department, have been recorded among Hancock County residents so far in 2022. Hancock Public Health's Bloodborne Infectious Disease Prevention Program (BIDPP) staff provided the figures on Wednesday. The figures for a full year were 240 overdose ER visits in 2021 and 232 in 2020. Nineteen deaths were confirmed by death certificate in 2021, and 22 were confirmed in 2020. Twenty-three 2022 deaths are pending a coroner's ruling, of which eight are suspected to be overdoses. As of the end of May, BIDPP had 77 registered participants. Staff have distributed 29,330 syringes, and participants have reported 21,002 syringes disposed of safely with provided sharps containers. A Hancock Public Health fact sheet notes that since reported disposals don't happen until people return, this number will always be somewhat less than the number distributed. A total of 45 fentanyl test strips, and 651 Narcan kits, have been distributed through BIDPP. Participants in the program reported 161 overdose reversals. Five participants have been referred for substance use disorder treatment and two for mental health treatment. Trauma and drug use The health department's overdose fatality review team gathers information from hospital records, behavioral health providers, EMS, fire departments and law enforcement. Information from interviews of next of kin, as well as coroner's reports, is also brought to the meeting. The team's annual report for 2021 states that 18 unintentional drug overdose deaths were reported in 2021, of which 15 involved opioids. There are five deaths for which cause of death is pending. A total of 20 unintentional drug overdose deaths were reviewed by the team during its meetings in 2021, though most of the deaths actually occurred in 2020. And the total does not include one fatality reviewed by the local team, where the cause was "difluoroethane inhalation huffing," as this code is not covered in Ohio Department of Health overdose data. Fentanyl was listed as the primary or contributing cause of death in 95% of the cases reviewed in 2021. This compares to 95% of 2020 cases and 80% of 2019 cases. When all the overdoses since 2015 are considered, 65.12% were positive for fentanyl, so the percentage has risen in recent years. Stimulant use was indicated in 45% of overdose death cases reviewed in 2021, compared with 43% of 2020 cases and 40% of cases in 2019. In all 2021 cases where information was available, the deceased "had experienced a significant loss or trauma in childhood or adulthood," the report states. The same trend was found in 2020 and 2019 cases. "This reinforces the continuation of the 'trauma-informed care' initiative as well as the expansion of the current availability of grief/loss treatment," the report states. Childhood trauma, in particular, "continues to be a theme in virtually all cases," the report states. In cases reviewed during 2021, there was an indication that EMS had left behind a Narcan kit from a previous overdose in two cases. In two cases, it was indicated that family or support people had Narcan, and in one of those cases, a family member attempted to use the Narcan to revive the person who overdosed but was unsuccessful. Three of six people whose overdose deaths in 2021 were reviewed and included in this report had been released from the Hancock County Justice Center five days or less prior to death. The report states that "in several cases, there was an indication that the family and/or treatment provider felt the decedent had been 'doing well,' meaning they felt the person had been abstinent and stable in their recovery so were not an overdose risk." Since 2019, EMS had reported seeing more previously "functional addicts" who moved to more severe addiction and other drugs due to isolation or being off work, the report states. And, "generally, the effects of the isolation and loss brought on by the pandemic are just beginning to be seen." Many young children have been left behind after the overdose death of a parent, the report states. In its most recent Institutional Review Board approval through the University of Findlay's School of Pharmacy, the task force added the ability to review suicides to its scope of work as it has been acknowledged there is some crossover. "During next-of-kin interviews, it has been noted that several cases had a history of suicidal thoughts or risk factors for suicide," the report states. Two UF pharmacy students are scheduled to begin conducting research on some of the team's data beginning in August. Project DAWN The health department also collected data on fatal overdoses from 2015 through 2021. The racial breakdown of the 129 overdoses was 93.8% white, 6.2% Black, 5.43% Hispanic, 0.78% American Indian or Alaska Native, with none reported among Asian or Native Hawaiian/Pacific Islander residents. The average age of the person who fatally overdosed was 36, with a minimum of 18 and a maximum of 63. The health department has recorded 32 new hepatitis C cases this year. It has distributed 1,293 Project DAWN kits to the general public, as well as 63 to first responders. Project DAWN kits are free, and are funded through a state grant. Contact Hancock Public Health to obtain a kit. Free kits by mail are also available through www.naloxoneforall.org/hro To reach BIDPP, contact Gary Bright at 419-581-9055, Jamie Decker at 567-250-1109 or Sharona Bishop at 440-753-8540. Arthurs: 419-427-8494