Fewer deaths but addiction still a problem here

Statistics from the Connecticut State Medical Examiner’s office show that while overall accidental overdose deaths from opioids declined slightly in 2018, deaths involving the powerful opioid fentanyl have increased sharply.

Statewide accidental intoxication deaths (not including cases of pure alcohol overdose) increased steadily from 357 cases in 2012 to 1,038 cases in 2017, before dropping a bit with 1,017 cases in 2018.

Cases involving any opioid rose from 298 in 2012 (83% of the total of accidental intoxication deaths) to 961 in 2017 (93%). There were 948 such cases in 2018, a smaller number but the same percentage of accidental intoxication deaths at 93%.

Cases involving fentanyl in any death went up sharply from 14 in 2012 (14% of the total) to 75 in 2014 (13%) to 483 in 2016 (53%) and 760 in 2018 (75%).

The use of speedballs — an opiate used together with cocaine — is on the increase. There were 50 cases of deaths involving heroin plus cocaine in 2012; that number went up to 169 in 2017. 

In 2018, the number dipped to 134.

In 2012 there were two fentanyl plus cocaine deaths statewide;  in 2018, the number rose to 270.

Sharon hit hardest

In the Northwest Corner, accidental intoxication deaths (not including alcohol) hit Sharon the hardest, with 14 deaths in the 2012-2018 period. North Canaan is next on the list with 11, followed by Salisbury (four), Cornwall and Kent (one each), and none in Falls Village.

Here are the same data for other nearby towns and cities: Torrington, 114; New Milford,44; Winchester, 19; Litchfield, two; Goshen, Warren, Barkhamsted and Norfolk, one each.

Pamela George is the director of the emergency department (ED) at Sharon Hospital. In a telephone interview Thursday, Aug. 15 (along with Jim Hutchinson, Patient Navigator), she was asked what the ED is seeing recently as regards opioid overdoses.

George said the situation has not changed: “sporadic overdoses, mostly heroin, all unintentional.”

George didn’t have statistics handy. She said the ED hasn’t had an enormous number of overdose cases, perhaps five in the last year. She speculated that the number might have dropped a bit because of increased awareness of the dangers of opioid use, more resources to combat addiction and less stigma attached to addiction in general.

Narcan as an aid

Of those patients who do make it to the ED, George said most have been revived with Narcan by the time they arrive at the hospital, so they are awake and alert enough to be able to speak with the medical staff about what they took and how much. 

Narcan is a drug that temporarily counteracts the effects of opioids. It is easily administered, with proper training, by almost anyone. Police officers, firefighters and emergency personnel now carry Narcan as part of their standard equipment.

Narcan is not a “silver bullet,” however. The revived patient still needs to get to the hospital, and sometimes it is necessary to administer another dose en route.

“Narcan is a huge help,” said George. “Without Narcan, more patients would not survive.”

George said the hospital has a program that allows people without health insurance to get Narcan. People with insurance can get a prescription for Narcan.

The need for treatment

When an opioid overdose patient gets to the ED,  George said, the patient is stabilized and monitored “to make sure they don’t rebound.”

She noted that the half life of Narcan is shorter than that of heroin and fentanyl, so the monitoring is necessary.

Generally it requires several hours at least before the patient is out of immediate danger.

The hospital has several resources to use to try and get the patient into drug addiction treatment, George said.

Patients are referred to treatment centers nearby (in both New York and Connecticut). They may be visited by social workers who make the case for treatment.

“A lot of times patients aren’t ready but that doesn’t mean we don’t make the attempt.”

Sometimes patients check themselves out against medical advice.

The ED gets its share of alcohol overdoses, too. George said it is not unusual for a patient suffering from alcohol overdose to begin the detoxification process at the hospital and then transfer to one of the nearby facilities that offer detox and additional treatment.

Asked how ED personnel can determine what drug or drugs an overdose patient has taken, George said a toxicity screen is a standard part of the treatment process, but the immediate treatment for a heroin overdose is the same as for a fentanyl overdose.

Hutchinson added that there are test strips available to the public now, allowing heroin addicts to determine if their drugs contain fentanyl.

Pain management

George was asked how the ED handles pain management medication for people who are not addicts.

She said Sharon Hospital is “very judicious” about prescribing opioid medications for pain. Patients receive such drugs for a maximum of three days, accompanied by warnings about the potential for addiction. And the hospital uses non-opioid alternatives such as intravenous Tylenol and Lydocaine patches.

Hutchinson said that “recovery coaches” — addicts in recovery who meet with patients and try to steer them toward treatment — are available from the McCall Foundation in Torrington and from the Council on Addiction Prevention and Education (CAPE) in Poughkeepsie.

“They are super useful,” he said. “We need someone to do the hand off, to bridge the gap between us and the next place.”

Sharon Hospital also offers mental health first aid classes. These classes are free and open to the public (go to www.healthquest.org/sharon-hospital/events).