Representatives from local law enforcement, the Arkansas Health Department, treatment facilities, business leaders, and State Rep. Jon Eubanks met in Paris last week to discuss opioid overdose prevention in Logan County.
The meeting, according to Tanya Baumgartener of the host Paris Area Chamber of Commerce, was to provide educational material to the local officials and begin the creation of an advisory committee. The Paris Health Council will oversee the committee.
Among the educational material was statistical analysis of the county which shows harrowing data including the county ranking high in drug overdose deaths, a high percentage in those with a depressive disorder diagnosis, and a high number of naloxone administrations — Naloxone, or Narcan, is a nasal spray that reverses the effects of an overdose.
Where are we?
Sydney Lewis-Suttles, a statistician with the Arkansas Foundation for Medical Care, stated Logan County ranked as having the 14th highest calculated risk for opioid related deaths in the state in 2019.
The number of deaths related to drugs takes its toll, Logan County Sheriff Jason Massey said, adding he thinks it is a factor in why officers leave the profession.
Nonetheless, Lewis-Suttles said, Logan County had five or less reported opioid related deaths in 2018.
That she said, can be attributed to inconsistent reporting by coroners where a cause of death is listed as heart failure, which may have actually been attributable to opioids.
State Drug Director Kirk Lane, who closed the meeting imploring those in attendance to create a change in the issue here, and said state officials are working with coroner’s associations in hopes of creating uniform cause of death designations and procedures and have gotten 60 counties coroners to make a change. However, Logan County is not among them.
Lewis-Suttles also said the overdose rate for all drugs in Logan County is 36.8 per 100,000 persons — the county has slightly a population of about 22,500 — well above the state rate of 14.1.
According to the Arkansas Prescription Monitoring Program, in 2018 there were 102.1 opioid prescriptions written per 100 Arkansans. In Logan County the rate was 123.7 prescriptions per 100 people.
The depressive disorder diagnosis rate in Logan County, Lewis-Suttles said, is almost three in 10 at 29.4 percent.
The naloxone administration rate, statistics show, have Logan County at 110.4 people per 100,000 while the state rate is 95.8 per 100,000.
Perhaps more frightening is data collected from most sixth and eighth grade, and sophomore and senior students each year in the Arkansas Needs Assessment Survey.
The 2018 data shows 3.7 — the highest category value — occasions in which a student in the county reported having misused a prescription drug in the last 30 days and 8.3, again the highest category, who reported having ever done so.
Make the drug of choice heroine or an opiate and 0.5 reported occasions of having used one in the last 30 days and 0.8 in their lifetime, both the second highest category.
How did we get here?
Dr. Cheryl May, the director of the Criminal Justice Institute, opened the meeting with an overview of the “opioid crisis” on both a national and state scale.
May quoted statistics including that the United States accounts for less than 5 percent of the world’s population but consumes 80 percent of the opioids.
She noted that if the number of opioid overdose deaths per day were occurring in jumbo jet crashes, the public would be up in arms demanding something be done, yet little is being done on opioids.
Lane recounted instances of an Ethiopian airline’s jet crashing in consecutive weeks, resulting in the airline being shuttered.
Opioid deaths occur more often than car crashes and gun violence combined, May said.
May noted, as did Lewis-Suttles, in 1996 pain factors were taken into account when patients were questioned about treatment satisfaction and, if pain meant a lower rating, a pill was an easy fix and prescriptions made “like they were candy.”
They did so, May said, without divulging how addictive the products are.
The addicts then turned to heroine — the Mexican cartels came to the rescue, May said — because it was a cheaper, better high.
In 2013, May said, Fentanyl, a synthetic opioid, became the biggest concern because of its potency.
She displayed a packet of a sweetener that contained one gram of material. That amount of Fentanyl, May said, could get 1000 people high, and would likely kill half.
The product, she said, is being liquefied and laced into other drugs like heroine and uses are dying unknowingly and because the drug can be absorbed through breathing or skin contact, emergency personnel are at risk as well.
Where do we go?
May also spoke to the goals of a prevention program.
She highlighted a prescription monitoring program in place which she said is working. The goal is to prevent “doctor shopping” for acquire even more medications.
Prescribing guidelines have also been created, though they are not mandated.
May said the CJI has acquired a grant that allows distribution of Naloxone kits which first responders like fire, paramedics and law enforcement will have two nasal doses of the antidote — May said the drug has no effect if the person being administered the spray is not suffering from an opioid overdose — nitrile gloves to prevent absorption by emergency personnel, a face shield, and an information card to be given to the person saved.
To participate in the program those carrying the kits are required to report any such usage for accurate data tracking and the entity must have a medical director.
There is also a two-hour online course requirement. Massey said he has completed the course as has a majority of his staff.
May said it is also imperative those prescribed opioids ask questions of their doctor concerning risks and side effects to seek alternatives.
May also pushed the drug take back program, which Lane helped to institute.
There are biannual events in October and April but the Booneville Police Department, Logan County Sheriff’s Office, and Paris Police Department also have take back receptacles open 24/7.
There is also a free smart phone app called nARcansas which provides a variety of information and can walk someone through administering a Naloxone kit — which can be purchased legally as well. May said the app is undergoing an update in which voice direction will be an option.
Finally, the legislature has adopted the Joshua Ashley-Pauley “Good Samaritan” Law which protects anyone from prosecution if they call 911 for someone who is overdosing.
The law came about, May said, because friends were reluctant to seek help for an overdosing individual, essentially choosing to allow him to die instead.