Not surprisingly, the coronavirus pandemic did not help efforts to tackle the opioid epidemic in Hamilton County in 2020. The Hamilton County Addiction Response Coalition (HC ARC), formerly known as the Hamilton County Heroin Coalition, issued its 2020 annual report Friday.
The coalition reports pandemic-related stress and isolation proved to be challenges for it and for people living with addiction.
"The epidemic of addiction did not take a break," says Hamilton County Commissioner Denise Driehaus, executive chair of HC ARC. "Pandemic-related stress and isolation made the difficult work of HC ARC even more difficult in 2020."
Total overdose deaths decreased in 2020 but remain higher than 2015 levels when numbers began spiking. Hamilton County preliminarily reports 432 overdose deaths in 2020. These numbers are not finalized and could change, according to Newtown Police Chief Tom Synan.
"Those are not numbers, those are people," Synan says emphatically. "Those are people and they leave behind friends, families and loved ones, and it's what inspires us to ask ourselves 'What more can we do?' and 'What can we do better?' "
"To have a trend that did not go up during the pandemic as it did in so many communities is an achievement, a sobering achievement," Driehaus says.
Stay-at-home orders and lockdowns at the start of the pandemic created a disruption in the drug supply chain, especially the fentanyl chain. HC ARC members worried overdoses and overdose deaths might spike as things opened back up and people regained access to drugs. Particularly concerning is what might happen to people who lost built-up tolerances to fentanyl while that supply chain was interrupted.
Synan says HC ARC made a concerted effort to prepare and curb spike predictions.
"What it was was recognizing fentanyl supply disruption, pre-planning for pre-lockdown, pre-planning for lockdown and coming out of lockdown, and being able to adapt and recover is what really allowed us to stabilize," he says.
The African American Engagement Workgroup (AAEW) reports Black males continued to have the highest overdose death rate (deaths per 100,000) in 2020. The AAEW says coalitions in four hard-hit communities are making progress, with two now in place in Avondale and Lockland and two more in progress in Bond Hill and Walnut Hills.
"The AAEW decided to work with specific entities in the neighborhoods," the report reads. "Members intentionally chose points where Black community members congregate and serve as places of trust. Three churches have received naloxone training by AAEW members and presentations about overdoses."
At first stymied by pandemic restrictions, response groups within the coalition report being able to "bounce back" and learn "valuable lessons and strategies that will enhance current progress and make better system-wide connections in 2021."
For example, the Interdiction Committee, which focuses on law enforcement (supply reduction) and diversion programs, intends to expand programming in early 2021 by launching a Hotspot Initiative. This entails focusing on areas hardest hit by addiction.
"We will be changing the goalpost with an emphasis on success being defined as a reduction in overdoses and overdose deaths, a reduction in the community factors that impact those with substance use disorder and the community, and to get more individuals back into the system of care and into long-term recovery supports," the annual report states.
The county-wide Quick Response Team (QRT), which operates two days per week, received federal assistance that will allow it to expand tofive days per week. That funding runs through Sept. 2023. Likewise, the Hamilton County Mental Health and Recovery Services Board received $3.1 million (with authorization for an additional $3.1 million) from Ohio to expand recovery programs such as workforce help, treatment services, and outreach programs to under-served communities.
"Realizing the pandemic might be hiding the true effects of the opioid epidemic, staff developed a mail-order Narcan project to ensure access to the lifesaving drug was not compromised," writes the Harm Reduction Committee. "With this, a texting service for Narcan was also implemented to arrange for pick-up or mail order."
The group is targeting fentanyl, a dangerous additive in many illicit substances, with test strips available in entertainment venues. Also, it's beefing up its syringe exchange project.
The Cincinnati Fire Department is trying something new, too. It's partnering with an opioid use disorder treatment center to divert patients from emergency rooms and go straight to treatment. District Chief Carstell Winston says patients who are determined to not need emergency medical intervention after an evaluation will instead be taken to a facility where they can be monitored and receive treatment without the cost of an ER visit.
"This would be strictly those patients who would request help," Winston says. "So many of the times, the patient will end up walking out of the ER and they just haven't gotten anything. If they want to get the help, we will transport them right there to the addiction center to get that help. ... So often they just get checked out at the ER and then they leave. This way they can at least try to get the help they really need by being transported there."
