As if living through a pandemic wasn’t bad enough already, 21 families lost a loved one to a fatal overdose last year. Most likely, opioids such as heroin and/or fentanyl were involved. While we are consumed with COVID-19 vaccinations, opening schools and getting our lives back to some sort of normal, someone overdoses in Cayuga County almost every day. These overdoses involve a variety of substances and they may not all be fatal, but they signify an outcry that we cannot afford to ignore.
Over the last year, the local HEALing Communities team has remained focused on saving lives, improving access to opioid treatment and providing timely linkage to these services. Collaboration with community partners, such as health care and recovery providers, people who have suffered from opioid use disorder and criminal justice agencies, was crucial to coordinate efforts. Collecting data in different settings was vital to give us a real-time and countywide picture of what we were up against. When we realized in April 2020 that we had lost already nine people to overdoses, which was the same amount of lives we had lost in all of 2019, we knew we had to act fast. We feared worse as this was only the beginning of a public health crisis that quickly revealed its devastating impact on people suffering from mental health and substance use disorders.
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Keeping people alive with Narcan
The local HEALing team responded swiftly to the fact that virtually all Narcan training and distribution has come to a halt due to social distancing, and has found creative ways to distribute the opioid overdose-reversing nasal spray during a pandemic. Within a few short weeks, we set up the web page cayugacounty.us/narcan, where people could get trained on Narcan and request a free kit be mailed to their home. Data confirmed that this distribution method helped us reach all parts of the county, which was not the case before, when in-person training happened mostly in and around Auburn. To date, 358 community members were trained and received Narcan in the mail.
At the same time, the Cayuga County Sheriff’s Office, with equipment support from HEALing Communities, started Narcan training for Cayuga County Jail inmates and provided them with a free kit upon their release from jail as they are at high risk for overdose due to a lowered tolerance level. To date, 106 jail inmates were trained and provided with Narcan.
The HEALing Communities team analyzed law enforcement data to determine overdose hot spots in Auburn and the rest of the county. This data informed our in-person outreach in specific neighborhoods and communities that have experienced high volumes of overdoses in the past. We mobilized volunteers and organized four of these pop-up Narcan distribution events in Auburn and one in Moravia. To date, 218 community members were trained and received Narcan at these events.
More outreach is planned in the coming months, starting from 10 a.m. to 2 p.m. Saturday, April 24, at Kinney Drugs in Moravia, hosted by the Drug Free Community Coalition and the sheriff’s office.
Through this multi-pronged outreach, training and distribution approach, we trained a total of 682 people to date and provided them with free Narcan. Over 41% of participants have witnessed an overdose in the past and more than a third have stated that they are concerned about someone else overdosing. This tells us that Narcan is getting into the right hands and has real potential to save someone’s life.
This is also underscored by actual data reported to the Overdose Detection Mapping Application Program that shows virtually no bystander Narcan administration in our county in the months before our initiative, but since May 2020, overdose witnesses have potentially saved 41 people with Narcan. Together, overdose witnesses and first responders have saved 73 lives. Our data shows that when Narcan is available during an opioid overdose emergency, 90% of the time the person lives.
Post-overdose outreach and access to recovery services
With our community partners the Auburn Police Department, Cayuga County Sheriff’s Office and Auburn Community Hospital, we are solidifying processes for post-overdose outreach. The goal is for overdose victims to be connected to peer services at Nick’s Ride 4 Friends. Peer advocates, in turn, are able to help them navigate local treatment resources and link them to the appropriate services.
Improving access to a variety of treatment options in our county and a timely referral are critical in supporting someone who is ready to seek help. Same-day initiation of medication for opioid use disorder was an identified gap in our community. These medications can help people be successful in their recovery by lowering the risk of relapse, increasing the time they stay in treatment, lowering the risk of overdose death and improving their lives and relationships with others. Stigma in the treatment and recovery community, however, is among the barriers for people who are seeking and could benefit from these medications.
HEALing Communities has addressed stigma and myths around what recovery “should” look like through a number of communications campaigns. We are now offering same-day MOUD initiations through an experienced on-call prescriber who has helped 28 patients start their recovery. If you or a loved one want to find out more about how to access MOUD locally, please call a peer at (315) 253-3945. Collaboration with the Auburn Community Hospital emergency department has led to some ER physicians providing bridge scripts for patients until they are able to see a local treatment provider for ongoing care. The Cayuga County Community Mental Health Center is working to integrate MOUD services and several patients have already been referred and treated by a clinic prescriber. You can call the clinic directly at (315) 253-0341 to set up an appointment. All these efforts aim to close gaps in the system and improve the timely access to life-saving medications.
Overdoses are still increasing at an alarming rate
While overdoses of all substances have increased by 16% from 2019 to 2020, fatal overdoses more than doubled. In 2019, 25% of all overdoses involved opioids. In 2020, this rate has increased to 30%. In 2019, we saw an average of 15 reported overdoses per month. Since COVID-19, the average has increased to 18 per month. For January and February 2021, 51 overdoses have been reported, which translates into alarming 26 overdoses per month. Tragically, we have already lost five community members to overdoses this year. These are frightening numbers, indicating an upward trend that many communities around the country experience. More importantly, the numbers represent people who deserve our empathy and care and our best efforts as a community to make help available and easily accessible — without stigma, prejudice or undue barriers. Just imagine for a moment: What if it was your child? How many phone calls should it take to get care, and how quickly should it be available?
Monika Salvage works for the Cayuga County Mental Health Department as the project director for the HEALing Communities Study, a multi-year, multi-state research study to reduce opioid overdose deaths through the implementation of evidence-based practices. If you are interested in learning more or getting involved, please call (315) 253-1522 or email email@example.com.