Huge Narcan influx, treatment boost contributes to OD death drop in Hamilton County

Terry DeMio | Cincinnati Enquirer

Show Caption Hide Caption Narcan Distribution Collaborative gets the lifesaving overdose antidote into people’s hands. Since the Narcan Distribution Collaborative started last fall, Hamilton County has gotten 375 percent more kits of the lifesaving medication out into the public’s hands.

A massive influx of naloxone and concerted efforts to get addiction treatment quickly to those who ask for it appear to be contributing to a decline in the overdose death toll in Hamilton County.

"We have plummeting mortality rates, increased treatment," said Dr. Shawn Ryan, founder of BrightView Treatment Centers and an active member of the Hamilton County Heroin Coalition.

There are more "preliminary, positive results" of a countywide program rolled out last fall to attack the area's opioid epidemic.

The concept, embraced by public and private health officials, government entities, first responders and others, was to boost lives saved by inundating the region with the opioid overdose antidote Narcan and respond quickly to people asking for addiction treatment.

It may seem like a no-brainer for other medical conditions, but for addiction, such immediate treatment has been lacking for years.

"I am cautiously optimistic that we are definitely headed in the right direction," said Hamilton County Health Commissioner Tim Ingram. "It's everyone working together."

"This is a complicated issue," Ingram added. "It's a journey, although it feels like a race."

Here's a breakdown of what's happened since the effort started in Hamilton County:

In seven months, since a Narcan Distribution Collaborative formed under Hamilton County Public Health, the county has had a 375 percent increase in naloxone kits handed out.

In the first five months of 2018 compared to the previous year, there was a 34 percent drop in deaths, Hamilton County coroner's reports show.

Hamilton County has had a greater than 50 percent increase in treatment of patients with opioid addiction, comparing 2016 to 2017, according to the Hamilton County Mental Health and Recovery Services Board.

There's been a 33 percent drop in medic runs for overdose in the past six months compared to the previous six, Hamilton County Public Health surveillance data show.

In that same period, Hamilton County has seen a 36 percent decrease in overdose visits to emergency rooms, the health department surveillance data also show.

The University of Cincinnati is heading the tracking and research on the Hamilton County project. Its work is not yet complete.

Mortality is still "far above" the baseline of these deaths prior to the opioid epidemic, Ryan said.

But Ryan, president of the Ohio chapter of the American Society on Addiction Medicine, said he noted that if progress continues, the Hamilton County plan could end up as a model for other communities.

The treatment plan was initiated through Mercy Health's Cincinnati psychologist Navdeep Kang, who's since been named an Obama Foundation fellow for his leadership. It's the Mercy Health Addiction Treatment Collaborative, comprised of its hospitals and more than a dozen treatment clinics with matching protocol and goals.

"It is not sufficient to revive someone from an overdose," Kang said. "That is the first and necessary step. But then an immediate, compassionate conversation about entry into treatment must follow – with treatment available on demand to capitalize on opportunities when prospective patients want to enter recovery."

That's something that's been lacking across the country, experts say. And is life-threatening. If someone with heroin or fentanyl addiction is turned away or made to wait days or weeks for treatment, the relapsing condition is likely to pull them right back into drug use.

Hamilton County's newer collaboratives along with several long-standing programs providing naloxone and linking people to treatment have helped boost the response to the opioid crisis, Ryan said.

He initiated the idea of the huge Narcan effort locally. It was a first-in-the-nation effort, with AdaptPharma donating 25,000 doses of the antidote, heroin coalition leaders said. And with that new accessibility and the other preliminary results of the work being done, Ryan said, "We are wildly exceeding our expectations."

Still, he did not want to overstate early results.

"We are just now getting things going in the right direction and we still have a long way to go to overcome this crisis," Ryan said. "That is going to continue to take substantial work and funding for the next several years, along with significant and sustained efforts by all partners in the community."

Ending the opioid crisis will take numerous steps from all corners, Ingram said.

"This is about keeping people alive until we can get them treatment," the health commissioner said, "and educating children and adults about this serious, chronic disease, opioid addiction."

Here are more Enquirer stories about the opioid epidemic:

Heroin-addicted cry out for treatment now, but it's elusive

Surgeon General touts naloxone in Northern Kentucky

Fentanyl deaths up 1,000 percent since 2013

Hamilton County to boost Narcan by 400 percent

Seven days of heroin: This is what an epidemic looks like