Health CareThe following entities provided data for the Health Care Section of the Community Assessment:

Jefferson County CAD System

Samaritan Medical Center

Jefferson County Medical Examiner’s Program

Jefferson County CAD SystemJefferson County, NY, Fire and Emergency Management Overdose/Poison

Incident Calls 2011-2014 • 2011 – 349 overdose/poison incident calls.

• 63 (18.1%) in the City of Watertown • 286 (81.9%) in Jefferson County

• 2012 – 349 overdose/poison incident calls.• 95 (27.2%) in the City of Watertown• 254 (72.8%) in Jefferson County

• 2013 – 309 overdose/poison incident calls.• 85 (27.5%) in the City of Watertown• 224 (72.5%) in Jefferson County

• 2014 – 286 overdose/poison incident calls.• 73 (25.5%) in the City of Watertown• 213 (74.5%) in Jefferson County

• Conclusions:o Overdose/poison incident calls fluctuate, and increased in the City in 2012 largely due to the widespread availability of bath

salts/synthetic marijuana. It is projected that greater City activity has occurred since 2012, even with the mitigation of bath salts/synthetic marijuana.

o From a population-base comparison perspective, overdose/poison incident calls fluctuate but are typically slightly higher in the City of Watertown vs. the rest of Jefferson County.

o Jefferson County total population –

• 22% City of Watertown • 78% Non-city residents

Jefferson County, NY, CAD SystemFire and Emergency Management Overdose/Poison Incident

Calls 2011-2014

2014

2013

2012

2011

0 50 100 150 200 250 300 350

City IncidentsNon-City Incidents

Samaritan Medical CenterHospital Emergency Department Data

All Drug Overdoses 2011-2014

2011 – • 164 ED Drug Overdose Visits

– 107 (65.2%) ED visits related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid.

– 57 (34.8%) ED visits related to suicide and self-inflicted injury.

2012 – • 137 ED Drug Overdose Visits

– 105 (76.6%) ED visits related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid.

– 32 (23.4%) ED visits related to suicide and self-inflicted injury.

2013 –• 188 ED Drug Overdose Visits

– 134 (71.3%) ED visits related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid.

– 54 (28.7%) ED visits related to suicide and self-inflicted injury.

2014 – • 239 ED Drug Overdose Visits

– 175 (73.2%) ED visits related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid.

– 64 (26.8%) ED visits related to suicide and self-inflicted injury.

Samaritan Medical CenterHospital Emergency Department Data,

all Drug Overdoses, 2011-2014

2011 2012 2013 20140

50

100

150

200

250

300

Suicide and Self-Inflicted InjuryAccidental Poisoning by Drugs, Medicinal Sub-stances, and Biologicals; and by Other Solid and Liquid Substances, Gases, and Vapors

Samaritan Medical CenterHospital ED Data, Opioid vs. all other

Drug Overdoses, 2011-2014• Most current drug overdoses in the community are from substances other than opioids.• 2011 –

– 44 (26.8%) ED visits due to opioid overdose. • 10 Accidental; 34 Suicide attempt/Self-inflicted injury.

– 120 (73.2%) ED visits due to all other substance overdose. • 97 Accidental; 23 Suicide attempt/Self-inflicted injury.

– 164 – TOTAL VISITS• 2012 –

– 30 (21.9%) ED visits due to opioid overdose.• 15 Accidental; 15 Suicide attempt/Self-inflicted injury.

– 107 (78.1%) ED visits due to all other substance overdose.• 90 Accidental; 17 Suicide attempt/Self-inflicted injury.

– 137 – TOTAL VISITS• 2013 –

– 13 (6.9%) ED visits due to opioid overdose.• 8 Accidental; 5 Suicide attempt/Self-inflicted injury.

– 175 (93.1%) ED visits due to all other substance overdose.• 126 Accidental; 49 Suicide attempt/Self-inflicted injury.

– 188 – TOTAL VISITS• 2014 –

– 26 (9.8%) ED visits due to opioid overdose.• 8 Accidental; 18 Suicide attempt/Self-inflicted injury.

– 213 (90.2%) ED visits due to all other substance overdose.• 167 Accidental; 46 Suicide attempt/Self-inflicted injury.

– 239 – TOTAL VISITS

Samaritan Medical CenterHospital ED Data, Opioid vs. all other Drug Overdoses

2011-2014

2011 2012 2013 20140

50

100

150

200

250

300

Opiod OverdosesAll Other Drug Overdoses

Samaritan Medical CenterHospital Inpatient Data, all Drug Overdoses

2011-2012

• 2011 – – 23 (21.3%) Inpatient stays related to accidental poisoning by drugs, medicinal substances, and biologicals;

and by other solid or liquid.– 85 (78.7%) Inpatient stays related to suicide and self-inflicted injury.– 108 – TOTAL STAYS

• 2012 – – 28 (30.8%) Inpatient stays related to accidental poisoning by drugs, medicinal substances, and biologicals;

and by other solid or liquid.– 63 (69.2%) Inpatient stays related to suicide and self-inflicted injury.– 91 – TOTAL STAYS

• 2013 – – 44 (32.8%) Inpatient stays related to accidental poisoning by drugs, medicinal substances, and biologicals;

and by other solid or liquid.– 90 (67.2%) Inpatient stays related to suicide and self-inflicted injury.– 134 – TOTAL STAYS

• 2014 – – 36 (27.9%) Inpatient stays related to accidental poisoning by drugs, medicinal substances, and biologicals;

and by other solid or liquid.– 93 (72.1%) Inpatient stays related to suicide and self-inflicted injury.– 129 – TOTAL STAYS

• Suicide and self-inflicted injury cases have a high likelihood for hospital admission.

Samaritan Medical CenterHospital Inpatient Data, all Drug Overdoses

2011-2014

2011 2012 2013 20140

20

40

60

80

100

120

140

160

Suicide and Self-Inflicted InjuryAccidental Poisoning by Drugs, Medicinal Sub-stances, and Biologicals; and by Other Solid and Liquid Substances, Gases, and Vapors

Samaritan Medical CenterHospital Inpatient Data, Opioid vs. all other

Drug Overdoses 2011-2014

• 2011 – – 41 (38%) Inpatient stays due to opioid overdose.

• 3 Accidental; 38 Suicide attempt/Self-inflicted injury.– 67 (62%) Inpatient stays due to all other substance overdose.

• 20 Accidental; 47 Suicide attempt/Self-inflicted injury. – 108 – TOTAL STAYS

• 2012 – – 34 (37.4%) Inpatient stays due to opioid overdose.

• 5 Accidental; 29 Suicide attempt/Self-inflicted injury.– 57 (62.6%) Inpatient stays due to all other substance overdose.

• 23 Accidental; 34 Suicide attempt/Self-inflicted injury.– 91 – TOTAL STAYS

• 2013 – – 27 ( %) Inpatient stays due to opioid overdose.

• 4 Accidental; 23 Suicide attempt/Self-inflicted injury.– 107 ( %) Inpatient stays due to all other substance overdose.

• 3 Accidental; 104 Suicide attempt/Self-inflicted injury. – 134 – TOTAL STAYS

• 2014 – – 33 (25.6%) Inpatient stays due to opioid overdose.

• 7 Accidental; 26 Suicide attempt/Self-inflicted injury.– 96 (74.4%) Inpatient stays due to all other substance overdose.

• 29 Accidental; 67 Suicide attempt/Self-inflicted injury.– 129 – TOTAL STAYS

Samaritan Medical CenterHospital Inpatient Data, Opioid vs. all other Drug

Overdoses 2011-2014

2011 2012 2013 20140

20

40

60

80

100

120

140

160

Opiod OverdosesAll Other Drug Overdoses

Samaritan Medical CenterHospital Inpatient/ED Data,

all Drug Overdoses by Zip Code 2011-2012

• 2011 –– 13601 zip code area 113 (41.5%) – Outside the City area 159 (58.5%)– TOTAL PATIENTS 272

• 2012 – – 13601 zip code area 125 (54.8%)– Outside the City area 103 (45.2%) – TOTAL PATIENTS 228

• Drug overdose inpatient/ED patients who lived in the 13601 zip code increased 10.6% from 2011 to 2012.

• Drug overdose inpatient/ED patients who lived outside the City area decreased 54.4% from 2011 to 2012.

Samaritan Medical CenterHospital Inpatient/ED Data, all Drug Overdoses

By Zip Code 2011-2012

2012

2011

0 50 100 150 200 250 300

13601Non-13601

Jefferson County, NY, M.E. ProgramDrug Overdose Deaths 2010-2014 - Total Deaths

• 2010 – 8 drug overdose deaths.• 2011 – 18 drug overdose deaths.• 2012 – 16 drug overdose deaths.• 2013 – 14 drug overdose deaths.• 2014 – 16 drug overdose deaths (projected).• M.E. program data demonstrate a 125% increase

in overdose deaths from 2010 (8) to 2011 (18). • Overdose deaths were 8 in 2008 and 9 in 2009.

Jefferson County, NY, M.E. ProgramDrug Overdose Deaths 2010-2014 - Total Deaths

2010 2011 2012 2013 2014

8

18

16

14

16

Total Drug Overdose Deaths

Jefferson County, NY, M.E. ProgramDrug Overdose Deaths 2011-2014 – Manner of Death

• 2011 Manner of drug overdose death:– 9 Unknown– 3 Suicide– 6 Accidental– 18 - TOTAL

• 2012 Manner of drug overdose death:– 1 Unknown– 3 Suicide– 12 Accidental– 16 – TOTAL

• 2013 Manner of drug overdose death:– 2 Unknown– 3 Suicide– 9 Accidental– 14 - TOTAL

• 2014 Manner of drug overdose death:– 1 Unknown– 3 Suicide– 12 Accidental– 16 - TOTAL

Jefferson County, NY, M.E. ProgramDrug Overdose Deaths 2011-2014 – Manner of Death

2011 2012 2013 20140

5

10

15

20

AccidentalSuicideUnknown

Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Location of Death

• 2011 – – 9 deaths in the City of Watertown.– 9 deaths in Jefferson County/non-City.

• 2012 –– 8 deaths in the City of Watertown– 8 deaths in Jefferson County/non-City.

• 2013 – – 5 deaths in the City of Watertown.– 9 deaths in Jefferson County/non-City.

• 2014 –– 10 deaths in the City of Watertown– 6 deaths in Jefferson County/non-City.

• 50% of overdose deaths in Jefferson County are occurring in the City of Watertown. From a population perspective, this suggests more drug abuse activity in the City vs. countywide.

• Jefferson County total population –– 22% City of Watertown – 78% Non-city residents

Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Location of Death

2014

2013

2012

2011

0 2 4 6 8 10 12 14 16 18 20

City of WatertownJefferson County/Non-City

Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Lethal Toxicology• 2011 –

– 15 (83.3%)deaths due to opioid overdose.– 3 (16.7%) deaths due to other drug overdose.– 18 - TOTAL

• 2 unresponsive at first responder arrival; CPR performed.• 16 deceased on scene.

• 2012 –– 13 (81.3%)deaths due to opioid overdose.– 3 (18.7%) deaths due to other drug overdose.– 16 - TOTAL

• 3 unresponsive at first responder arrival; CPR performed.• 13 deceased on scene.

• 2013 – – 7 (50%)deaths due to opioid overdose.– 7 (50%) deaths due to other drug overdose.– 14 - TOTAL

• 4 unresponsive at first responder arrival; CPR performed.• 10 deceased on scene.

• 2014 –– 11 (68.8%)deaths due to opioid overdose.– 5 (31.2%) deaths due to other drug overdose.– 16 - TOTAL

• 4 unresponsive at first responder arrival; CPR performed.• 12 deceased on scene.

• Majority of drug overdose deaths in Jefferson County are attributed to opioids.• Majority of cases are found to be deceased on scene.

Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Lethal Toxicology

2011 2012 2013 20140

2

4

6

8

10

12

14

16

18

20

Other DrugOpioidDeceased on Scene

Data Limitations

• Jefferson County Dispatch-assigned overdose/poison incident calls are an indicator of the community problem. However, dispatch overdose/poison incident assignments do not take into account the number of calls out for psychiatric, cardiac, respiratory, and other conditions where the cause may be eventually overdose/poison-determined. Dispatch-assigned calls are not amended for true conditions after-the-fact. There are likely greater numbers of actual overdose cases than those captured in the CAD system. Likewise, overdose/poison calls could be an allergic reaction to a legally prescribed drug.

• Hospital inpatient and ED data could only be obtained from Samaritan Medical Center. However, because SMC experiences the highest volume of cases, it is felt this data is a good indication of community activity.