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Overdoses: the ‘other’ public health crisis

The coronavirus is not the only public health crisis local officials are grappling with this year. The one, however, may have a connection to the other.

The Chautauqua County Board of Health met this week via Zoom and discussed what has been an uptick in the number of reported drug overdoses in 2020. Christine Schuyler, county public health commissioner, told board members that the county averaged about 19 overdoses a month last year for a total of about 230.

As of present, there have been 126 suspected drug overdoses within the county this year, with 46 reported in March alone. Of those that month, two resulted in fatality.

In April, 19 overdoses were reported, with four resulting in death. And in May, there have been 11 overdoses with no deaths recorded.

“Those are the ones reported through the overdose map system,” Schuyler told the board. “I think most anyone who works with this population knows that there are other overdoses that occur within our community that aren’t reported.”

Citing local law enforcement, Schuyler said drugs sold on the streets have been “laced heavily with fentanyl,” a powerful synthetic opioid several times more powerful than morphine. “That is a big contributor to the overdoses that we’ve seen.”

“Another public health crisis that continues,” she continued.

Tom Erlandson, county Board of Health president, remarked that there could be a connection between the ongoing COVID-19 pandemic and spike in overdoses.

Schuyler agreed.

“Absolutely I think we are seeing a scientific correlation, but we know that isolation is a trigger for those who are in recovery,” she said. “And not just substance abuse, but mental issues as well.”

The public health director said each case that comes through the OD map is handled by mental health and law enforcement officials, fatal or not. “They have been able to connect with every single one of them,” she said. “Many of them are known, people who have already been in recovery. So they increase their efforts with them and try to get them reengaged with treatment and any resources that they may need. So that response has been working well.”

Steve Kilburn, county Department of Mental Hygiene grants director, attributed the increase in overdoses during the coronavirus outbreak to a “phenomenon” happening across the country.

“It’s not unique to Chautauqua County,” Kilburn said in April. “The reasons are as complex as addiction. We have had reports that the drug supply on the streets has a very high level of fentanyl, which is a deadly drug.”

Kilburn said it’s not unusual for drugs to be laced with fentanyl, especially heroin. However, he said fentanyl now is being laced with cocaine and methamphetamine as well.

“One reason (for the overdoses) is people don’t know what they are taking,” he said. “A deadly amount of fentanyl is the No. 1 reason (for the overdoses).”

Andrew O’Brien, member of the county Health Board, asked if the pandemic is limiting local access to methadone, medication used for the treatment of drug addiction. He noted that many have to travel to Buffalo or Erie, Pa., for the medication.

Recent efforts to open methadone clinics in the county have hit a wall.

Robert Berke, county physician, addressed the “absolute nonsense that’s going on” in that patients were being transported to Buffalo to receive treatment. He said he recently spoke with state Sen. George Borrello, R-Sunset Bay, and state Assemblyman Andy Goodell, R-Jamestown, regarding the travel required for those seeking drug addiction treatment.

“They’ve just been sitting, caught between a rock and a hard place,” Berke said of efforts to open methadone clinics in Jamestown and Dunkirk, “and meanwhile we’re spending a fortune sending these people up to Buffalo where they have to travel (and) blow half a day to get a couple of pills and come back — can’t work because you’re traveling sitting in a setting where there’s just other people getting methadone and then leaving. The whole thing is completely dysfunctional and it makes no sense.”

Berke said he believes it costs $400 a day per person in transportation costs, with 70 to 80 people traveling each day. “Do the math,” he said, adding that it costs about $70 a day to transport each person internally within the county. “Millions of dollars being absolutely wasted, and these people spending at least half a day traveling so they can’t work. It just makes no sense.”

Dr. Elizabeth Kidder, a member of the board, said many of her patients went from going five times a week for treatment to three times a week during the pandemic. She said her patients described limited means of traveling and no social distancing within the methadone clinics.

“I worry about this high-risk population,” Kidder said.

It was suggested a letter be sent to Patricia Brinkman, county director of Mental Health, as well as the state Office of Alcoholism and Substance Abuse Services and state Health Department, to stress the need for local resources.

“Now is the time really to be pushing this forward and trying to get the services we need in our county,” Schuyler said.

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