Drug crisis

Forums offer local residents chance to brainstorm about new ideas to deal with overdose epidemic.

During a year of record deaths from drug overdoses in the Miami Valley and across Ohio, glimmers of hope also exist as organizations and local governments have begun to find solutions that might make a difference.

More than 30 news organizations statewide have partnered to share those solutions and help communities think about which ones might be adaptable locally.

Your Voice Ohio will be holding forums next month in Dayton, Middletown, suburban Cincinnati, Wilmington and Washington Court House to brainstorm with local residents about new ideas for combating the drug crisis.

In 2017, some encouraging evidence suggests that the innovative solutions shared across the state might have helped to turn the tide.

In Montgomery County, overdoses took the lives of at least 560 individuals, or 211 more than in 2016. Deaths spiked early in the year with a high of 81 in May, but fewer than half that number died in each of the last six months, held to 30 in November. In Sep- tember, Dayton police went two consecutive days without responding to an overdose call.

That positive momentum has been the result of all community resources working together, Montgomery County leaders say, most notably through the Community Overdose Action Team.

“There will not be only one solution to solving the opioid crisis. It will take a collaborative effort of the entire community that includes law enforcement, first responders, treatment and recovery, the court system, the hospitals, and many other health care and social service agencies,” said Dan Suffoletto, spokesman for Public Health — Dayton and Montgomery County.

Streamlining services

The Community Overdose Action Team, formed in late 2016, grew to more than 200 people from 100-plus organizations in the past year, working on eight focus areas from increasing treatment accessibility to decreasing the illegal supply of drugs.

More than 3,100 people in Montgomery County got treatment last year through services that became more streamlined, according to Montgomery County Alcohol, Drug Addiction & Mental Health Services.

Expanded services include 24/7 outpatient detox through Samaritan Behavioral Health; a new CrisisCare expansion offering those revived with Narcan immediate entry to treatment; doubling the number of residential detox beds through Nova Behavioral Health; new recovery housing for pregnant women; and expanded access for jail inmates already in treatment to continue with funding from ADAMHS.

Funding for these new and expanded services was more than $3.5 million from the Montgomery County Human Services Levy.

Community Overdose Action Team fostered partnerships that led to a $50,000 grant to dispense free prescription pill disposal bags, a network of drug dropoff locations and the distribution of overdose-reversal drug Narcan to more police officers and members of the public than in any past year.

The federal Drug Enforcement Administration launched its “360 Degree Strategy” in the county during 2017 to not only crack down on dealers, but also help curb the over-prescribing of pain pills and put a greater emphasis on drug prevention through community outreach, relationship building and public service announcements.

The Miami Valley Bulk Smuggling Task Force was formed about five years ago and includes officers from the Montgomery County Sheriff’s Office and other local, state and federal agencies. By August, it had taken almost 200 pounds of heroin and fentanyl off the streets and seized more than 6,000 prescription pain pills. The R.A.N.G.E. Task Force kept another 19 pounds of heroin and fentanyl from reaching users.

Using data

Hamilton County has led the way in using data to better track and learn new ways of responding to overdoses. Since 2015, EMS calls for overdoses have been mapped.

“There were remarkable geographic trends and times of day and week,” said Leigh Tami, Cincinnati’s director of the office of performance and data analytics.

They found that overdoses peaked on Wednesday afternoons, specifically about 2 p.m., and particularly on the near west side. The time of overdoses — afternoon, middle of the week — by itself caused everyone to shift thinking.

Medic units, which had been run ragged by about one overdose call each hour, were rescheduled and moved to neighborhoods with the greatest need at specific times. In some cases, EMS units roved in neighborhoods rather than return to stations. Response time was reduced, as well as staffing costs, resulting in better care and more efficient use of taxpayer dollars.

Cincinnati first responders also learned to be less aggressive in reviving victims. They discovered using less naloxone, the overdose reversal drug commonly known by its brand name Narcan, led to higher rates of hospitalization where doctors could encourage treatment or counseling. Too much naloxone and the victim went into painful withdrawal, became angry, ordered paramedics to go away and intervention opportunities were lost.

Though in the heart of the crisis, Hamilton County’s death rate is lower than 14 other Ohio counties since 2010, most of them along the Ohio River and in the Miami Valley.

While local counties don’t all collect data in the same way as Cincinnati, many use the state’s EpiCenter alert system, which sends out alerts to local health officials when an unusually high number of overdoses is occurring in a certain area. Local fire departments are tracking the neighborhoods where overdoses are occurring and altering their staffing accordingly.

And drug court dockets in 33 counties are directing users to intervention rather than jail using the power of shared data among agencies.

“The relationship is great in that it’s a whole bunch of different entities working together,” said Allison Rambo, executive director of The Nest Recovery Homes in Wilmington. Some of women at her facility are there through the Clinton County drug court. Their treatment teams, including counselors, medical professionals, treatment staff, probation officers and the judge meet every two weeks to check on progress.

“There’s a lot of accountability, but the other thing I love about it is there’s so much positivity,” Rambo said.

Volunteers take action

Another solution being implemented with great success in places like Toledo and here in the Miami Valley is the formation of so-called rapid response teams.

These teams meet with overdose survivors to provide counsel and information about treatment options.

Montgomery County’s team is called Getting Recovery Options Working .

The team is comprised of sheriff ’s deputies, medics, social workers and clergy members. Now the team often includes a peer recovery specialist.

Montgomery County began 2017 with no certified peer recovery specialists — sometimes called recovery coaches. These are individuals who have overcome addiction themselves and are trained to support others through treatment and recovery. Starting this year, 40 such individuals are working in Montgomery County.