Shortly after 7 p.m. on Tuesday, the Carroll County Health Department posted a special alert to its Facebook page.
“There were eight potential overdoses in the past 24 hours throughout Carroll County,” the alert read. “This could be due to a number of causes, but such spikes are often related to heroin or cocaine laced with fentanyl or carfentanil. … Fentanyl and carfentanil are synthetic opioids and even a very small amount can be deadly.”
The overdoses and their potential cause, street drugs laced with potent synthetic opioids, were hardly new. Officials have been warning of this risk for years and the impact can be seen in the most recent statistics from the Carroll County Sheriff’s Office, which reported a total of 42 overdoses in September, a 7.2 percent increase over the 39 recorded in September 2017. Six of those overdoses were fatal, compared with five fatalities in September 2017, and just two deaths in August 2018.
Neither was the alert, in and of itself a new thing, according to Carroll County Health Officer Ed Singer, who noted the Health Department has previously sent out similar warnings, including in January, when four overdoses were reported within several days.
But Tuesday’s alert came as part of a new package of harm reduction efforts by the Health Department, Singer said, beginning with more real-time monitoring of the substance using community in Carroll through a new data source, emergency medical dispatches made available through Carroll County Emergency Manager Doug Brown. Singer said the Health Department has been using the data for about three months.
“This is very different than Sheriff’s Office data because this is all the dispatches the 911 center is running,” Singer said. “Law enforcement may not have been involved with a lot of these dispatches.”
The Health Department has also been working with Carroll Hospital to get a sense of what number of overdoses is a significant increase over the average, according to Sue Doyle, director of the Health Department’s Bureau of Prevention, Wellness and Recovery.
“It’s more than four,” as far as the hospital is concerned, Doyle said. “We’re making a conscious effort to set some threshold numbers.”
So when Brown called Singer around 6 p.m. Tuesday, according to Singer, “a spike of eight to me sounded like something we needed to do something about immediately.”
An alert was the decided course of action, but the information in the alert was a topic of discussion, according to Doyle.
“A lot of that information is a harm reduction message,” she said. “It’s, make sure you don’t use alone, make sure you’re buying from the same dealer, make sure you have a safety plan.”
That, and a basic message that something has changed in the supply of illegal drugs, according to Singer, and that the risk has changed.
“Obviously, we don’t want people using substances they shouldn’t be using, but we realize people are out there,” he said. “If there is something that’s more deadly that’s out there than what we’re normally seeing, we see a spike in overdoses, we think that getting word out is helpful in getting people to be a little bit more cautious about what they are doing.”
Those alerts, when posted on Facebook, receive a lot of engagement, according to Singer — much of it positive, some of it less so.
“It’s interesting to watch our Facebook page and watch the comments you get back and forth and people who don’t really understand the disease of addiction,” he said. “What they say about it, and the number of people that will chime in, whose lives have been touched by this, who will try to set them straight.”
“You have a disease that was treated as an acute illness for the last 50 years, and now everybody is saying it’s a chronic disease,” Doyle added. “This is an ongoing condition like diabetes or heart disease. We’re more about that model now.”
To help people understand that new model of addictions as chronic illness, the Health Department will be working with Carroll Hospital and The Partnership for a Healthier Carroll County on an anti-stigma campaign to begin sometime in early 2019, according to Doyle.
“We’re going to do some PSAs and some billboards and things like that,” she said. “Because the more this is in people’s faces and the more we talk about it like we do breast cancer and heart disease and diabetes, the more people recognize that people do have problems of this nature.”
Another initiative that is just in the early planning stages is working with EMS to provide training in naloxone, the opioid drug antidote medication, to family members of people who have overdosed, been revived by EMS, but refused transport to the hospital or further treatment.
All such efforts are aimed at reducing the number of fatal overdoses first, and, hopefully, following more treatment, the number of nonfatal overdoses as well, according to Singer.
“As long as the person is living and breathing, we have an opportunity to try and help them with their disease,” he said. “If they are not living and breathing, we don’t.”