2017 Jackson County Drug -Related Data Report. Heroin and Opioid Task Force Data Committee

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1 2017 Jackson County Drug -Related Data Report Heroin and Opioid Task Force Data Committee 1

2 TABLE OF CONTENTS Executive Summary... 3 Hospital Drug Overdose Data... 6 Medical Examiner Data Law Enforcement Heroin Log Data First Responder Narcan Dispense Data Police and Fire Overdose Dispatched Calls Drug Overdose Heat Maps Michigan Profile for Healthy Youth Data Recommendations Available Resources Acknowledgements

3 EXECUTIVE SUMMARY The United States is in the middle of an opioid and heroin epidemic. According to the CDC, between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled 1. Likewise, prescription opioid-related overdose deaths have more than tripled in the past 20 years 2. This is alarming as research in the last decade has linked prescription opioid abuse to higher rates of heroin abuse. At the state level, Michigan had a 13.3% increase in its drug overdose deaths from 2014 to 2015 (1,763 deaths in 2014; 1,980 deaths in 2015) 3 making our state one of nineteen states with statistically significant increases in drug overdose deaths. While national and state statistics are astounding, we realize our first priority is here in Jackson County. In order to make the greatest impact, we need a better understanding of what is happening in our community. Recognizing rising drug-induced deaths as a public health epidemic in the community, the Jackson County Task Force on Heroin and Prescription Drug Abuse formed a Data Collection Committee to help characterize and evaluate Jackson s drug abuse crisis. The goal of this committee is to conduct public health surveillance, develop a process for data collection, to format and create a report to be presented at the 2017 and future Jackson Drug Summits, and provide a template for future reports to be generated

4 EXECUTIVE SUMMARY In 2015, Jackson County had the 4th highest age-adjusted rate per 100,000 of drug-induced causes of death of the 6 counties listed below. This graph shows that in 2015, 30 of every 100,000 residents died of a druginduced cause of death in Jackson County. The data below include druginduced deaths that involve accidental or intentional use of narcotics (including opioid overdose related deaths), hallucinogens, biological substances or other unspecified drugs. Source: Centers for Disease Control and Prevention. National Center for Health Statistics. Underlying Cause of Death on CDC WONDER Online Database, released December, Data are from the Multiple Cause of Death Files, , as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at on Feb 16, :37:10 PM 4

5 EXECUTIVE SUMMARY Below is a snapshot of what the Data Collection Committee found: As of October 2017, Jackson County is on track to exceed 2016 s emergency department admittances for overdoses During a heroin-use crisis, white males between ages are most likely to appear at the emergency department During an opioid-use crisis, white males between ages are most likely to appear at the emergency department In 2016, 22 males were seen more than once in the emergency department for a heroin overdose; 12 females were seen more than once in the emergency department for a heroin overdose. As of October, 2017, 10 males and 1 female were seen multiple times in the emergency department Between 2014 and 2016, drug-related deaths in Jackson County increased 23% White males between ages presented the highest number of drug-related deaths In 2016, 24 deaths reported positive for either Fentanyl, Norfentanyl, Acetylfentanyl, Carfentanyl, Furanylfentanyl or u4470 in the blood Jackson County 911 Dispatch drug overdose call volume is increasing. Conversely, the interval between calls has decreased from 3 days average in 2015 to 2 days average in % and 7.1% of middle and high school students, respectively, reported taking a prescription drug not prescribed to them, including painkillers, during the past 30 days 75.3% and 78.5% of middle and high school students, respectively, reported that using prescription drugs not prescribed to them was of moderate or great risk 5

6 HOSPITAL DRUG OVERDOSE DATA Numbers are based on emergency department visit (chief complaints) and before any confirmed diagnoses are made. 6 Source: Henry Ford Allegiance Health Emergency Department

7 HOSPITAL DRUG OVERDOSE DATA Numbers are based on emergency department visit (chief complaints) and before any confirmed diagnoses are made. 7 Source: Henry Ford Allegiance Health Emergency Department

8 HOSPITAL DRUG OVERDOSE DATA Numbers are based on emergency department visit (chief complaints) and before any confirmed diagnoses are made. 8 Source: Henry Ford Allegiance Health Emergency Department

9 HOSPITAL DRUG OVERDOSE DATA Numbers are based on emergency department visit (chief complaints) and before any confirmed diagnoses are made. Asian Asian 9 Source: Henry Ford Allegiance Health Emergency Department

10 HOSPITAL DRUG OVERDOSE DATA Numbers are based on emergency department visit (chief complaints) and before any confirmed diagnoses are made. In most instances, these individuals were seen numerous occasions 10 Source: Henry Ford Allegiance Health Emergency Department

11 MEDICAL EXAMINER DATA The charts and graphs below were created by the Jackson County Health Department utilizing information shared by the Jackson County Medical Examiner s Office. This data represents deaths that occurred in Jackson County where the cause of death or contributory cause of death were a result of drug use and/or abuse. Total Number of Drug Related Deaths * Drug Deaths *as of November 1st, 2017 Detected in the System Cocaine* Fentanyl** Heroin*** *Cocaine or benzoylecgonine are present in the blood. **Fentanyl, Norfentanyl, Acetylfentanyl, Carfentanyl, Furanylfentanyl or & 4470 are present in the blood ***Heroin is confirmed positive by the presence of morphine in the blood and the presence of 6- monoacetylmorphine whether it be in the blood or urine. 11 Source: Jackson County Medical Examiner s Office

12 MEDICAL EXAMINER DATA Race Black White Other Race Other Black White Source: Jackson County Medical Examiner s Office

13 MEDICAL EXAMINER DATA Age At Time of Death by Year to to to to to to to to to to Age at Time of Death by Year to 9 10 to to to to to to to to to Source: Jackson County Medical Examiner s Office

MEDICAL EXAMINER DATA Gender 2014 2015 2016 2017 Female 24 27 39 21

14 MEDICAL EXAMINER DATA Gender Female Male Source: Jackson County Medical Examiner s Office

LAW ENFORCEMENT HEROIN LOG DATA The Law Enforcement Heroin Log is a

record opioid-related law enforcement responses.

15 LAW ENFORCEMENT HEROIN LOG DATA The Law Enforcement Heroin Log is a spreadsheet maintained by the Jackson County Office of the Sheriff to record opioid-related law enforcement responses. All law enforcement agencies are able to access the Log and can voluntarily submit data. These graphs display only what was entered into the Log. As a result, the data does not show a complete picture. 15 Source: Jackson County Office of the Sheriff Heroin Log

16 Unknown Deceased Upon Arrival Deceased/Dead Narcan Used/ Died Narcan Used/ Did Not Work Narcan Used 6x/Lived Narcan Used 4x/ Lived Narcan Used 3x/ Lived Narcan Used 2x/ Lived Narcan Used/ Lived Lived LAW ENFORCEMENT HEROIN LOG DATA Statuses refer to the condition of the person for whom the 911 call was made. Only one status is given per call per person. Because of differences in year-to-year reporting and the severity of a call, data can seem inconsistent. However, it is important to understand human responses to heroin or an opioid can vary from person to person. It also depends on what type of opioid was used (e.g., Fentanyl, Carfentanil). This data should only be used to paint a broad picture of law enforcement life saving efforts, as well as communicate the importance of calling 911 if you suspect an overdose. Lives can be saved NR* NR* 4 22 NR* 3 *This status was Not Reported in the heroin log 16 Source: Jackson County Office of the Sheriff Heroin Log

17 LAW ENFORCEMENT HEROIN LOG DATA Samples of evidence found on scene used to determine an opioid or heroin overdose as recorded in the Heroin Log: Cell Phones Heroin Kit Paraphernalia Needles Syringes Packaged Heroin Cotton Balls Pills Straws Admission of Use Spoons Pipes White Powder Needle in Ceiling Tile 17 Source: Jackson County Office of the Sheriff Heroin Log

FIRST RESPONDER NARCAN DISPENSE DATA The following data corresponds to Narcan (i.e., naloxone) doses administered by First Responding Agencies.

18 FIRST RESPONDER NARCAN DISPENSE DATA The following data corresponds to Narcan (i.e., naloxone) doses administered by First Responding Agencies. These agencies include fire, police, and public safety offices across the county. Data is accurate as of October 30, Please note this data does not reflect how many times Narcan was administered to any single individual. Total Number of Narcan Doses Dispensed by EMS Narcan Doses Gender Male Female Unreported Source: Jackson Community Ambulance Log

FIRST RESPONDER NARCAN DISPENSE DATA Race/Ethnicity Breakdown 2015 2016 2017 Black, Hispanic 0 1 0 Black, Non-Hispanic 19 32 29 Native American 1 1

19 FIRST RESPONDER NARCAN DISPENSE DATA Race/Ethnicity Breakdown Black, Hispanic Black, Non-Hispanic Native American Pacific Islander White, Hispanic White, Non-Hispanic Unknown/Unreported Source: Jackson Community Ambulance Log

FIRST RESPONDER NARCAN DISPENSE DATA Monthly Narcan Dispenses by EMS by Year 2015 2016 2017 January 14 23 33 February 16 21 27 March 24 39 51 April 23 41 53 May

20 FIRST RESPONDER NARCAN DISPENSE DATA Monthly Narcan Dispenses by EMS by Year January February March April May June July August September October November * December * 20 Source: Jackson Community Ambulance Log

FIRST RESPONDER NARCAN DISPENSE DATA Age at Time of Narcan Dispensed by EMS by Year 2015 2016 2017 0 to 9 0 2 0 10 to 19 13 14 14 20 to 29 55 118 99 30 to 39 52

21 FIRST RESPONDER NARCAN DISPENSE DATA Age at Time of Narcan Dispensed by EMS by Year to to to to to to to to to to Unknown Source: Jackson Community Ambulance Log

22 POLICE AND FIRE OVERDOSE DISPATCHED CALLS The data below may not reflect heroin overdoses specifically as the Dispatch system does not distinguish between drug types. Jackson County 911 Dispatch calls between drug overdoses are increasing, from 3 days average between calls in 2015 to 2 days average in Total Calls In 2016, 25 locations across Jackson County made more than one 911 call for a potential drug-related overdose. Most calls to a repeat location were not made on consecutive days. In fact, for most locations, several weeks passed between calls. Additionally, some repeat locations were businesses, such as the hospital, hotels/motels, gas stations, and stores. 14 days in 2016 had three or more calls to 911 for a potential overdose. These dates include: April 29 (3 calls); June 14 (3), August 4 (3); August 14 (3); October 10 (4); October 13 (5); October 15 (4); November 1 (3); November 2 (3); November 5 (3); November 25 (3); December 12, (4); December 20 (7); and December 17 (5) 22 Source: Jackson County Office of the Sheriff 911 Dispatch Log Source: Jackson Community Ambulance Log

POLICE AND FIRE OVERDOSE DISPATCHED CALLS The data below may not reflect heroin overdoses as the Dispatch system does not distinguish between drug types. This data is accurate as of October 26, 2017.

As with 2016 repeat locations, several weeks passed between calls. Additionally, some repeat locations were businesses, such as the hospital, hotels/motels, gas stations, and stores.

23 POLICE AND FIRE OVERDOSE DISPATCHED CALLS The data below may not reflect heroin overdoses as the Dispatch system does not distinguish between drug types. This data is accurate as of October 26, Total Calls As of October 26, 2017, 28 locations across Jackson County made more than one 911 call for a potential drug-related overdose. As with 2016 repeat locations, several weeks passed between calls. Additionally, some repeat locations were businesses, such as the hospital, hotels/motels, gas stations, and stores. 20 days in 2017 had three or more calls to 911 for a potential overdose. These dates include: January 13 (3 calls); February 17 (3); March 1 (3); March 14 (3); April 7 (3); April 11 (3); April 12 (3); May 13 (3); May 18 (3); May 22 (4); May 24 (4); June 6 (3); June 16 (3); June 29 (3); July 15 (3); July 19 (3); August 1 (3); August 3 (3); August 25 (4); October 2 (4) 23 Source: Jackson County Office of the Sheriff 911 Dispatch Log Source: Jackson Community Ambulance Log

24 DRUG OVERDOSE HEAT MAPS 24 Source: Jackson County Office of the Sheriff Heroin Log

25 MICHIGAN PROFILE FOR HEALTHY YOUTH DATA Jackson County Middle School Data Percentage of students who ever used a needle to inject any illegal drug into their body 7.2% Percentage of students who took painkillers such as, OxyContin, Codeine, Vicodin, or Percocet without a doctor s prescription in the past 30 days 2.5% Percentage of students who took a prescription drug such as Ritalin, Adderall, or Xanax without a doctor s prescription during the past 30 days 1.3% Percentage of students who took a prescription drug not prescribed to them, including painkillers, during the past 30 days 3.0% Percentage of students who were offered, sold, or given an illegal drug on school property by someone during the past 12 months 4.0% Percentage of students who reported using prescription drugs that are not prescribed to them as moderate or great risk 75.3% Percentage of students who reported their parents felt using prescription drugs not prescribed to them to be wrong or very wrong 97.9% Percentage of students who reported their friends felt using prescription drugs not prescribed to them to be wrong or very wrong 94.1% 25 Source: Michigan Profile for Healthy Youth

26 MICHIGAN PROFILE FOR HEALTHY YOUTH DATA Jackson County High School Data Percentage of students who have taken barbiturates without a doctor s prescription in the past 30 days 1.5% Percentage of students who used heroin one or more times during the past 30 days 0.8% Percentage of students who used a needle to inject any illegal drug into their body one or more times during the past 30 days 0.8% Percentage of students who took a prescription drug such as Ritalin, Adderall, or Xanax without a doctor s prescription during the past 30 days 4.6% Percentage of students who took painkillers such as OxyContin, Codeine, Vicodin, or Percocet without a doctor s prescription during the past 30 days 5.8% Percentage of students who took a prescription drug not prescribed to them, including painkillers, during the past 30 days 7.1% Percentage of students who reported using prescription drugs that are not prescribed to them as moderate or great risk 78.5% Percentage of students who reported their parents felt using prescription drugs not prescribed to them to be wrong or very wrong 97.0% Percentage of students who reported their friends felt using prescription drugs not prescribed to them to be wrong or very wrong 85.7% 26 Source: Michigan Profile for Healthy Youth

27 WE RECOMMEND The following are recommendations for all members of the Jackson County community 1. ALWAYS CALL 911 IF YOU SUSPECT AN OVERDOSE! You are protected under the Good Samaritan Law. It may save a life! 2. Talk to your friends and family about the dangers of overdosing, especially youth and young adults. It may save a life! 3. Ask your doctor if another pain management route is available besides an opioid. It may save a life! 4. Purchase a medication safety lock-box to store all medications with high potential for abuse. It may save a life! 5. Dispose of all unused and expired medications in a designated drop box location or use proper medicine disposal guidelines. It may save a life! 6. If you or a loved one are using an opioid (including heroin), obtain a naloxone kit from your local pharmacy to use in an emergency. No prescription is required, in most cases. It may save a life! 7. Do not hesitate to refer your loved one to a substance use disorder treatment center. You may have to broach the topic more than once, but it may save a life! 27

28 WE RECOMMEND The following are recommendations adapted from the Blue Cross Blue Shield of Michigan Taking Action on Opioid and Prescription Drug Abuse in Michigan for health care providers, government entities, and other social service agencies. 1. Promote safe prescribing practices: Train staff on up-to-date prescribing practices, routinely utilize the Michigan Automated Prescribing System (MAPS), and create access to non-opioid alternatives for pain management 2. Expand access to medication-assisted treatment (MAT) 3. Increase naloxone access by implementing naloxone distribution at SUD treatment facilities, primary care clinics, and pharmacies; or promote co-prescribing of naloxone for patients receiving chronic opioids. 4. Support and promote evidence-based programs that will address the opioid and prescription drug epidemic in your community, such as Breakout Drug Education and Most Teens Don t 5. Consider passing or supporting an ordinance to allow for harm reduction strategies, such as needle exchange programs, within the city limits and townships 28

29 AVAILABLE RESOURCES NALOXONE STANDING ORDER As part of their final recommendations, Governor Snyder s Prescription Drug and Opioid Abuse Task Force found that naloxone (Narcan) is a safe and lifesaving drug that should be more accessible. In 2016, Public Act 383 was passed giving the chief medical executive authority to issue a standing order that, in most cases, does not require a physician s prescription to dispense naloxone. When obtaining naloxone from a pharmacy, individuals will be provided with the steps for responding to an opioid overdose, as well as important information about where to go for treatment services. Pharmacies will be required to keep track of the amount of naloxone dispensed and will report these numbers to MDHHS on a quarterly basis. Jackson County Pharmacies Registered to Dispense Naloxone Advanced Care Pharmacy Services 2136 Robinson Rd. Suite 2 Jackson, MI Red Cap Pharmacy N. West Ave. Suite A Jackson, MI CVS- (Inside Target Store) 1076 Jackson Crossing Jackson, MI Center for Family Health Pharmacy* 505 N. Jackson St. Jackson, MI Rite Aid* 1733 Spring Arbor Rd. Jackson, MI Walgreens 1314 N. West Ave. Jackson, MI Walgreens 3040 E. Michigan Ave. Jackson, MI *Pharmacy requires a physician s prescription. 29 Source: Michigan.gov

30 AVAILABLE RESOURCES LOCAL TREATMENT RESOURCES Born Free 300 W. Louis Glick Hwy Jackson, MI Henry Ford Allegiance Addiction Recovery Center 2424 W. Washington Ave. Jackson, MI Henry Ford Allegiance Substance Abuse Services 2424 W. Washington Ave Jackson, MI Home of New Vision 407 W. Michigan Ave Jackson, MI LOCAL AND NATIONAL HOTLINES Henry Ford Allegiance Health Crisis & Referral Access Helpline Substance Abuse & Mental Health Service Administration National Helpline HELP(4357) Centers for Substance Abuse Treatment (CSAT) Substance Abuse Treatment Facility Locator FAMILY SUPPORT GROUP Families for HOPE (Heroin Opioid Prevention Effort) Meets at New Covenant Living Church 2405 W. Washington Jackson, MI **meetings vary, call for next meeting date and time 30

31 AVAILABLE RESOURCES JACKSON COUNTY PRESCRIPTION DRUG DISPOSAL LOCATIONS City of Jackson Police Department 216 E. Washington Ave, Jackson Every day: 6am 10pm Accepts All pills; No Liquids or Needles Weatherwax Pharmacy 105 N. Main St, Brooklyn Mon Fri: 8am 6 pm Accepts Non-Controlled Pills Only Grass Lake Village Hall 119 N. Lake St, Grass Lake Every day: 24 hours Accepts All Pills; No Liquids, Inhalants, Or Needles Center for Family Health 505 N. Jackson St, Jackson Mon-Fri: 8am 5:30pm Accepts All Pills, Liquids, And Patches; No Inhalants Jackson County Office of the Sheriff 212 W. Wesley St, Jackson Mon-Fri: 8am 4:30pm Accepts All Pills; No Liquids or Needles Michigan State Police Jackson Post 3401 Cooper St, Jackson Mon-Fri: 8am - 4pm Accepts All Pills; No Liquids or Needles Columbia Township Police Department 8500 Jefferson Rd, Brooklyn Mon Fri: 8am 12pm Accepts Pills, Liquids, and Needles NO NARCOTICS Prescription Pills: Everyday 24 hours Walgreens 1314 N. West Ave, Jackson Mon Fri: 6am 12 am Sat & Sun: 9am 9pm Accepts All Pills; No Liquids, Needles Or Inhalants 31

32 32 NOTES

DATA COMMITTEE The Heroin and Opioid Task Force Data Collection Committee is comprised of awesome data gurus from

Rhonda Rudolph, Co-Chair of the Data Collection Committee; Health Educator, Jackson County Health Department Sarah

Prevention Coalition Joe Beatty, Quality Data Analysis Manager, Huron Valley Ambulance/Jackson County Ambulance

Medical Examiner Jason Hammon, Lieutenant, Jackson County Office of the Sheriff/ 911 Dispatch Timothy Hibbard,

Abuse Prevention Coalition Debra Pemberton, Case Manager, Henry Ford Allegiance Behavioral Health Emma Sigman,

Officer, City of Jackson Police Department Richard Thoune, Health Officer, Jackson County Health Department and

33 DATA COMMITTEE The Heroin and Opioid Task Force Data Collection Committee is comprised of awesome data gurus from several agencies. Thank you to all who participated! Rhonda Rudolph, Co-Chair of the Data Collection Committee; Health Educator, Jackson County Health Department Sarah Allison, Co-Chair of the Data Collection Committee; Health Action Coordinator, Jackson County Substance Abuse Prevention Coalition Joe Beatty, Quality Data Analysis Manager, Huron Valley Ambulance/Jackson County Ambulance Wayne Bisard, Captain, Jackson County Office of the Sheriff Jill Glair, Administrative Assistant, Jackson County Medical Examiner Jason Hammon, Lieutenant, Jackson County Office of the Sheriff/ 911 Dispatch Timothy Hibbard, Sergeant, City of Jackson Police Department Courtney Page, Community Programs Assistant, Jackson County Substance Abuse Prevention Coalition Debra Pemberton, Case Manager, Henry Ford Allegiance Behavioral Health Emma Sigman, Substance Abuse Prevention Specialist, Jackson County Substance Abuse Prevention Coalition Tom Tinklepaugh, Officer, City of Jackson Police Department Richard Thoune, Health Officer, Jackson County Health Department and Henry Ford Allegiance Health Dawn Weeks, Business Operations Coordinator, Henry Ford Allegiance Health Derrick White, Detective/Lieutenant, Jackson Narcotics Enforcement Team/ Michigan State Police 33

34 34

Understanding the Opiate Epidemic

Understanding the Opiate Epidemic An opiate is a narcotic analgesic that depresses the central nervous system. Natural opiates are derived from the poppy plant. Synthetic opiates are manufactured drugs