WEST CHESTER >> Last week, a West Goshen police officer saved the life of a 26-year-old woman by using Narcan, an FDA-approved nasal spray used to treat opioid overdose. For police departments in Chester County, it’s a common occurrence.
Hundreds of lives have been saved by Narcan, also known as naloxone, since it has been put to use by municipal and state police in Chester County.
Incredibly, for Americans under 50, the leading cause of death used to be injuries caused by accidents. Now, it’s drug overdoses.
“It has really gotten bad,” said Patricia Allen, a Psychiatric Mental Health Nurse Practitioner and executive director of Medical Services for Summit Behavioral Health. “There’s an epidemic of drug-related overdoses here now.”
Indeed there is. Last year, nearly 20 out of 100,000 people in Chester County died of a drug-related overdose, according to recently released figures by the U.S. Drug Enforcement Agency. And it’s worse in nearby counties. In Delaware County, nearly 37 out of 100,000 people died, and in Montgomery County, nearly 29 out of 100,000 people died.
In Chester County last year, 97 people died of drug-related overdoses, said Cathy Vaul, program specialist for Chester County Department of Drug and Alcohol Services. The vast majority of the victims – 77 percent – were white males.
Though some, like Delaware County, saw a slight reduction in drug overdose deaths from 2015 to 2016, 78 percent of Pennsylvania counties had overdose death rates higher than the national average.
Last week, President Donald Trump declared the opioid addiction crisis an emergency.
“We’re going to spend a lot of time, a lot of effort, and a lot of money on the opioid crisis,” he said. “We’re going to draw it up and we’re going to make it a national emergency.”
According to the DEA report, 4,642 drug-related deaths occurred in Pennsylvania last year, a 37 percent jump from the year previous.
That’s 13 deaths every day.
Fentanyl the problem
But most alarming is that half of those who died had the presence of fentanyl in their systems. Allen said fentanyl is 100 times more powerful than heroin. “People really have to understand what’s out there right now,” she said. “This is only going to get worse before it gets better.”
The DEA report specifically mentioned fentanyl as a major component to the problem.
“Because fentanyl is so potent, it can cause a much higher rate of overdose death than heroin, despite lower user rates,” the report said. “Additional indicators reported by law enforcement indicate that users are now seeking out fentanyl instead of unknowingly purchasing fentanyl disguised as heroin, and street-level traffickers are openly marketing fentanyl to customers instead of disguising it as heroin.”
Not surprisingly, fentanyl is much less expensive to produce and acquire than heroin.
The report found prescription opioids were present in 25 percent of toxicology reports, and 95.3 percent of reporting counties. Oxycodone was reported most frequently. The figures were taken from death reports of the state’s coroners and medical examiners.
One of the key findings of the report was that the presence of an opioid, illicit or prescribed by a doctor, was identified in 85 percent of drug-related overdose deaths.
Earlier this year, Chester County’s hospitals received a $25,000 boost to help combat the opioid and heroin crisis. All five of the county’s hospitals got $5,000 to support each hospital’s warm hand-off program, which helps to ensure that those who have experienced an overdose are referred directly to treatment and counseling.
“Too often, addicts just want to walk out of the hospital and go back to the drugs that almost killed them,” said Chester County District Attorney Tom Hogan. “The warm hand-off protocol is a way to have the hospitals, volunteers and county agencies work together to gently redirect those who have just been saved and get them into rehab and counseling. We want to fix this problem, not save one at a time.”
Gov. Tom Wolf recently signed into law Senate Bill 1368, which calls for a medical training facility to implement key opioid-related curriculum. The curriculum would establish: further education in pain management; multimodal treatments for chronic pain that minimize the use of a controlled substance containing an opioid; instruction on safe methods of prescribing a controlled substance containing an opioid that follows guideline-based care; and identification of patients who have been identified as at-risk for developing problems with prescription opioids.
“I anticipate that we will see further legislative action in the near future to provide our communities the resources they need to fight addiction,” said state Sen. Tom Killion, R-9, who sponsored the bill.
Other drug-related bills recently signed into law include: House Bill 1699, which limits the prescribed amount of opioids to a seven-day supply in emergency rooms and urgent care centers; Senate Bill 1367, which limits the issuance of opioids to minors and provides for further restrictions if opioids are prescribed to minors; and Senate Bill 1202, which provides for continuing education requirements in pain management, for prescribing opioids as well as addiction treatment. The bill also requires physicians to check the state’s newly created Prescription Drug Monitoring Program Database each time a patient is dispensed an opioid drug.
Drugs target young
The report stated 30 percent of drug-related overdose deaths occurred in the 25- to 34-year-old age group, which showed a 970 percent increase in fentanyl presence. Those aged 15 to 24 saw a 380 percent spike in the presence of fentanyl compared to other age groups.
The three most affected age groups – from age 25 to 44 – account for approximately 40 percent of the population but suffered 75 percent of overdose deaths last year.
The report was prepared by the DEA in an effort to provide municipalities and law enforcement with more date to draw from in combating the opioid epidemic.
Peter Pitts, a former FDA commissioner, claims pharmacy benefit managers are the driving force behind the opioid crisis. Pitts said that for years, the federal Food and Drug Administration has encouraged the development and use of “abuse-deterrent formulations” of prescription opioids. ADFs are more difficult to physically alter – crush for snorting or dissolve for injecting – than traditional pills.
“As a result, ADFs help curb abuse and overdoses,” Pitts said. “ADF version of OxyContin, for instance, led to a 65 percent decrease in snorting, a 56 percent decrease in smoking, and a 51 percent decrease in injection among patients with a history of abusing the drug, according to a report by the Institute for Clinical and Economic Reform.”
But pharmacy benefit managers, Pitts said, refuse to cover the vast majority of ADFs. Their decision impacts more than 266 million Americans insured by employers, unions, or government programs like Medicare Part D, he added.
County officials take aim
Chester County commissioners are firmly behind the battle to curb the opioid epidemic.
Chester County’s Color 5K held late last year in West Chester – attended by 770 people – raised funds and raised awareness of the problem. A second Color 5K is scheduled for the morning of Saturday, Nov. 4.
“I know that we won’t cure addiction forever by our actions, but by working together in this way we can and will make a significant dent in the level of the crisis here in the county,” said Commissioner Kathi Cozzone.
Commissioner Terrence Farrell said he too is dedicated to programs that take aim at the opioid dilemma. He said he recently attended a meeting in Washington, D.C. attended by thousands of county officials from around the country, and when talk centered on the opioid and heroin crisis, officials often cited personal examples and told how it was getting out of control.
“But Chester County was one of just a few counties doing something positive, like the Color 5K and the programs initiated by the task force,” Farrell said.
PRO-ACT Chester County recently announced plans for a community event aimed at raising awareness of the substance abuse crisis in Chester County. “Building Community, Sharing Hope will be an event that honors International Overdose Awareness Day and provides an evening of fellowship, hope and stories of survival as well a remembrance for those we have lost to this disease,” said John Gailey, PRO-ACT Chester County Advisory Board Chair. The event takes place at the Charles A. Melton Community Center, 501 East Miner Street in West Chester, this Thursday from 5:30 p.m. to 8:30 p.m.
The event will feature a buffet dinner, several keynote speakers, audience sharing and a moment of silence and luminary ceremony to remember the victims of the disease of addiction. This event is free to the public but registration is required.
Librarians pitch in
Librarians in Chester County are starting to learn how to help defeat drug overdose deaths in the area.
On Thursday, library staff from several locations will gather at the Penn Township Building for training on the use of Narcan. Ethan Healey of Good Fellowship Ambulance and staff from the Chester County Department of Drug and Alcohol Services will conduct the training.
All library directors in Chester County have been urged to send staff for training on how to handle drug overdoses in their workplaces. Some libraries are planning their own training events, while several libraries in the eastern and southern reaches of the county are coming together for the event on Thursday.
Other participants include Oxford Public Library and Kennett Library. Kennett’s staff has also had an introduction to the subject from Andy Rumford of Kacie’s Cause. Rumford’s daughter, Kacie, died of an overdose in 2013; Andy found his daughter’s body on her bedroom floor. The family has since created Kacie’s Cause to spread awareness and information about the drug epidemic locally.