Overdose Crisis Update

Overdose deaths dropped nearly 40 percent in 2018.

UPDATE: This story and graphic have been updated to reflect that 86 deaths occurred as a result of overdoses in 2017, not 84 as originally reported.

It is nowhere near the end of the fight, but deaths resulting from drug overdoses fell nearly 40 percent in 2018.

In total, 52 people died as a result of a drug overdose in the county in 2018, compared to the current peak of 86 in 2017, according to data provided by Cumberland County Coroner Charley Hall.

Last year, overdose deaths dropped to the lowest level since 2015 in the county, but remain nearly double the level reached in 2013 and heavily out of step with historic levels.

“We looked as a benchmark, in 2004 there were four overdose deaths in Cumberland County,” said Jack Carroll, executive director of the Cumberland-Perry Drug and Alcohol Commission. “I’d like to roll back a couple decades here where we’re back to when there is an overdose death it’s an anomaly.”

Carroll said he was thrilled to see the number of overdose deaths dropping and said there is likely not just one explanation for the decline.

Carroll highlighted increased access to substance abuse treatment in the county, including the decision by Gov. Tom Wolf to opt into Medicaid expansion, increased access to medication-assisted treatment like methadone and the implementation of a medication-assisted treatment program at Cumberland County Prison using Vivitrol.

In March, Cumberland County began a first in the state Opioid Intervention Court for people entering the criminal justice system with opioid use disorder.

The intensive six-week program targets people who use opioids near the point when they are charged and provides treatment meant to serve as a foundation for prolonged recovery as they move through the criminal justice process.

A 2018 review of coroner and court records by The Sentinel found more than half the people who died of a drug overdose in the county in 2017 were involved in the criminal justice system at the time of their death.

Carroll also attributed the decline in deaths to the proliferation of the overdose reversing drug naloxone.

Police departments in the county began carrying naloxone in late 2015, according to Carroll. The state recently offered free naloxone kits through state health centers, and in 2015 Pennsylvania Physician General Rachel Levine issued a standing order for naloxone to be available for purchase at pharmacies without a prescription.

The RASE Project has also begun offering free naloxone kits to the community through training events.

In 2018, police in Cumberland County reversed 69 overdoses using naloxone, according to data provided by Duane Nieves, director of field operations and chief of Geisinger Emergency Medical Services, which provides naloxone to county police departments.

Only one patient who was administered naloxone by Cumberland Goodwill EMS in 2018 died on scene, according data provided by Cumberland Goodwill EMS Assistant Chief Nathan Harig.

While naloxone is being used to reverse what may be fatal overdoses, use of the drug is also down in the county, indicating that the drop in deaths may also be attributed to fewer people overdosing altogether.

The number of patients receiving naloxone from both Cumberland Goodwill EMS and police across the county fell by more than 30 percent in 2018.

Other possible explanations for the drop in overdose deaths include long-term efforts by the state and county to reduce the oversupply of prescription opioids and increased community awareness of the overdose crisis.

Carroll said programs like the state’s prescription drug monitoring program, new prescribing guidelines and medication collection boxes have helped lower the supply of prescription drugs. This in turn may be leading to fewer people beginning to use opioids.

However, reducing the supply of prescription drugs may have hastened the transition of some people who were already addicted to use heroin or other more lethal drugs.

“We knew that this was going to be an issue, that we were going to push addicts in a direction that was going to be more deadly,” former physician general Dr. Carrie DeLone told The Sentinel in 2017.

While the drop in deaths is welcome news, Carroll said his greatest fear is that declining numbers of overdoses and deaths will cause political leaders to lose focus on the overdose crisis.

“We got into this problem across a decade or more,” Carroll said. “I’m convinced it’s going to take us a decade or more to get out of it.”

Fewer people dying from drug overdoses may also not mean that fewer people are using drugs. Some may have switched or begun using drugs that are less likely to cause an overdose death but can still carry heavy consequences.

For example, from the beginning of 2013 to the end of 2015, there was one overdose death attributed to cocaine in Cumberland County, according to coroner’s records. There were seven cocaine-related overdose deaths between 2016 and 2017 and that might be increasing.

In 2016, a total of nine overdose victims tested positive for cocaine, according to coroner reports. That number doubled to 18 in 2017.

“If you’re addicted alcohol, if you’re addicted to cocaine, if you’re addicted to any substance, you either will get into treatment and get help or you will end up in jail or dead,” Carroll said. “That’s that cold, harsh reality of the disease of addiction. There will still needs to be ready access treatment and services.”

“We got into this problem across a decade or more. I’m convinced it’s going to take us a decade or more to get out of it.”—Jack Carroll, executive director of the Cumberland-Perry Drug and Alcohol Commission

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Email Joshua Vaughn at jvaughn@cumberlink.com. Follow him on Twitter at @Sentinel_Vaughn.