Drug crisis in Ohio: What solutions are making a difference?

Credit: DaytonDailyNews

Lt. Jonathan Pirk of the Springfield Fire/Rescue Division provides instruction on how to administer naloxone using a syringe of water on a training dummy. No naloxone was used in the making of this video.

Credit: DaytonDailyNews

During a year of record deaths from drug overdoses in Springfield 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.

MAP: Where drug overdose deaths happen in Clark County

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

Clark County saw at least 101 suspected drug overdose deaths as of mid-December, including 90 confirmed and 11 pending autopsies, Clark County Coroner Dr. Richard Marsh said. The majority have been caused by fentanyl, an illegal synthetic opioid that’s 50 times more powerful than heroin.

Of the 101 suspected deaths, 79 happened during the first six months of the year. During that same time period, the Springfield Police Division and Clark County Sheriff’s Office responded to a total of 732 overdoses — nearly 75 percent of the overdoses this year.

MORE: Churches unite to open recovery house in Springfield for addicts

Clark County has had a drug coalition of some form for several years, Clark County Health Commissioner Charles Patterson said. The most successful iteration — Clark County Ohio Substance Abuse Prevention & Treatment Coalition — was established along with the most recent Community Health Improvement Plan in January 2016. Representatives from across the community, including health care, churches, law enforcement, are all members of the coalition.

“While we have resources in the community, the only way to move the needle is with the collaboration,” Patterson said. “Everybody you can imagine is at the table and they all play a key role.”

Streamlining services

Nearly $700,000 in grant money has been awarded this year to pay for several new programs throughout Clark County, including treatment, law enforcement and recovery. President Donald Trump recently declared the drug crisis a public health emergency, meaning more money could be allocated to battle the epidemic.

One of the most promising practices here has been the new warm hand-off program, where a person treated for an overdose at Springfield Regional Medical Center emergency room can immediately speak with a therapist and peer support specialist who can help them seek treatment, rather than watching them leave the hospital and return to the same environment.

If that person wants treatment, McKinley Hall treatment center can then take them to a first-of-its-kind off-site safe house until treatment is available, Patterson said. About $213,000 in federal money was spent to create and operate the facility.

RELATED: Overdose deaths affect western Clark County, rural areas, too

“We’re separating the individuals with the disease from risk factors, which could cause them to continue with that disease,” Patterson said. “It doesn’t cure the disease, but it’s a separation from the people, the places, the lifestyle. It gives them an opportunity to disengage from that.”

Recovering addicts in Clark County have had great success with Vivitrol, a drug that blocks opioids from interacting with the receptors in the brain and eliminates the experience of feeling high. Of the 103 people in McKinley Hall’s medication-assisted treatment program, 76 percent are using the drug. Several have been on the drug for at least two years, CEO Wendy Doolittle said, and she expects more usage in the coming years.

“If you’re on Suboxone, you’re sitting with people who are on Vivitrol and you’re looking at how productive they are, you’re watching the walk that they’re walking,” she said. “They say, ‘I’m ready to go on Vivitrol.’ That’s how (McKinley Hall’s) culture has evolved. I don’t think that’s happening in a lot of other places.”

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.

RELATED: Clark County Jail inmates to learn about life after addiction

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.

In Clark County, the Springfield Police Division also received a $100,000 grant to develop a response team to assist overdose survivors. The grant was used to hire an opiate diversion officer, Meredith Freeman, to work hand-in-hand with treatment specialists to get drug users into treatment.

She’s also tracking people who overdose more than three times but aren’t seeking treatment — allowing them to be charged criminally under the 9-1-1 Good Samaritan Law.

RELATED: DeWine: ‘Never seen anything like’ drug crisis hitting Ohio

Now local leaders are looking to the future and what recovering addicts will need most to stay clean — a job.

A new workforce development program was launched in Clark County earlier this year to help those in recovery find sustainable employment and educate employers about drug-free work place strategies.

Ohio Attorney General Mike DeWine, who’s running for governor, has been holding several Ideas for Advocacy conferences across the state, most recently looking at ways addiction treatment can be worked into services for survivors of trauma.

“I am committed to continuing the aggressive work of finding solutions and bringing people together to share what we know is working, so that we can help as many Ohioans as possible, as fast as possible,” DeWine said.

Staff Writers Katie Wedell and Chris Stewart contributed to this story.

Need help right now?

Crisis hotline: Dial 2-1-1 to be connected to mental health and addiction services in Champaign and Clark counties.

Needle exchanges: By exchanging used syringes for new IV drug users are less likely to develop infections or contract HIV or hepatitis C. Each time there is an exchange, a health official has an opportunity to provide counseling; and each time a needle is returned, that’s one less potentially deadly object in a fast-food parking lot or park. Clark County doesn’t have a needle exchange.

Exchanges can be found at the following locations:

• Montgomery County CarePoint, 937-496-7133, phdmc.org

• Vogel Health Center, 6175 W. Third St. in Dayton on Tuesdays from noon to 5 p.m.

• Mt. Olive Baptist Church, 502 Pontiac Ave. in Dayton on Thursdays from 9 a.m. to 3:30 p.m.

• Life Enrichment Center, 425 N. Findlay St. in Dayton on Fridays from 9 a.m. to 3:30 p.m.

• Cincinnati Exchange Project, serving Butler County, 513-316-7725

• Greene County SafeTrade, 937-374-5600, Fridays 1 to 4 p.m., 600 Pierce Drive in Fairborn.

How to go

Your Voice Ohio forums will be held throughout the region. All sessions are free to attend, but because of limited seating, people are asked to RSVP online. To register go to: https://www.eventbrite.com/e/the-opioid-epidemic-in-dayton-tickets-42137498392

Dayton — 2 p.m. Sunday, Feb. 11, Main Library, 215 E. Third St.

Middletown — 6:30 p.m., Monday, Feb. 12, MidPointe Library, 125 S. Broad St.

East Cincinnati — 6:30 p.m., Tuesday, Feb. 13, Madisonville Recreation Center, 5320 Stewart Ave., Cincinnati.

Wilmington — 1 p.m., Sunday, Feb. 18, Wilmington Municipal Building, 69 N. South St.

Washington Court House — 6:30 p.m., Monday, Feb. 19, The Lafayette Room, 133 S. Fayette St. South.

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