Opiate Epidemic Task

Force: Naloxone

Workgroup Updates

Erie County Health Department

August 6, 2018

Trainings this quarter

(4.1.18 – 6.30.18) Continued naloxone trainings conducted by the department:

Community members - 780

Expanding TOTs - 6 trainers trained!

EMS Staff, Medical Students - 87

Library Staff- > 4

School personnel including health staff, teachers, administrators,

building maintenance - 166

Volunteer firefighters - 123

Security staff: Colleges, malls - 233

Law enforcement - 227

Street outreach – Community Wellness staff – 11

What’s happening with

naloxone/Narcan usage in WNY

We’re analyzing the data

from the “naloxone usage

forms”

Both the Police/Fire

forms; a snap shot

follows

What’s happening with

naloxone/Narcan usage in WNY

The following slides were created from the “opiate overdose reversal forms” that we collect from first responders specifically in the City of Buffalo

This has helped us understand the community affected

Each new batch of forms improves our data; so keep turning in those forms!

0

20

40

60

80

100

120

140

160

180

1158

112

015

1308

414

004

1400

614

010

1401

214

025

1402

714

031

1403

214

033

1403

414

036

1404

314

047

1405

114

052

1405

514

057

1405

914

067

1407

014

072

1407

514

080

1408

114

085

1408

614

091

1409

414

096

1410

514

108

1411

114

120

1412

114

127

1412

914

131

1413

214

139

1414

114

150

1417

214

174

1420

114

202

1420

314

204

1420

614

207

142

08

142

09

142

10

142

11

1421

214

213

1421

414

215

1421

614

217

1421

814

219

1422

014

221

1422

214

223

1422

414

225

1422

614

227

1422

814

247

1430

414

445

First Responder Reports of Overdose Response – ZIP Code, Excluding Unknowns, N=1,7902014 - 2017

Reversal Time of Dayexcluding Unknown, N=1,759

2014 - 20170 20 40 60 80 100 120

Midnight to 12:59

1:00 - 1:59 AM

2:00 - 2:59 AM

3:00 - 3:59 AM

4:00 - 4:59 AM

5:00 - 5:59 AM

6:00 - 6:59 AM

7:00 - 7:59 AM

8:00 - 8:59 AM

9:00 - 9:59 AM

10:00 - 10:59 AM

11:00 - 11:59 AM

Noon - 12:59 PM

1:00 - 1:59 PM

2:00 - 2:59 PM

3:00 - 3:59 PM

4:00 - 4:59 PM

5:00 - 5:59 PM

6:00 - 6:59 PM

7:00 - 7:59 PM

8:00 - 8:59 PM

9:00 - 9:59 PM

10:00 - 10:59 PM

11:00 - 11:59 PM

Overdose Transport Sites• 1,558 entries (excluding Unknowns)

• Dates from May 2014 through Nov 2017

3

134

1

1

1

1

7

17

937

50

37

4

43

223

8

1

6

8

1

2

22

40

5

2

1

2

1

0 100 200 300 400 500 600 700 800 900 1000

Bertrand Chaffee

Buffalo General Hospital (BGH)

Called by ER MD

Childrens Hospital

Columbia Memorial Hospital

Community General

DeGraff Memorial

Eastern Niagara

ECMC

Kenmore Mercy

Lake Shore Hospital

Lockport Hospital

Medical examiner

Mercy Hospital

Millard Fillmore Suburban

Mount St. Mary's Hospital

N/A

Niagara Falls Memorial

No transport

refused

Sisters Hospital

St. Joseph Hospital

St. Mary's Hospital

Unknown

Unsure

Veterans Administration

Women and Children's Hospital of Buffalo

Notes

• Overdose data is from forms completed by police officers and firefighters after administering Narcan.– The database expands each time we enter more

forms.

– It is possible that multiple reports have been completed for the same individuals at different time points (repeat overdoses).

• Death data is from the Medical Examiner’s office.

Additional Naloxone

Workgroup Activities

Grants to fund expanded efforts –

1. CARA funding received from BJA to coordinate and

streamline naloxone reporting and linkage to treatment

responses at time of overdoses, currently recruiting and

training Peers and law enforcement departments – 4

additional police departments have signed on as partner sites.

Creating additional response after overdose programs now,

cohort of 12 peers engaged in capacity building training

through partnership with GROUP Ministries currently.

2. Collaborating with local treatment and prevention providers

to implement OASAS Coalition grant, recently awarded.

4. Year 3 OOP funding from NYSDOHAI in process, billboard

campaign in place, next years message is one of recovery

Additional Naloxone

Workgroup Activities

New Project – “Community Narcan Access Sites”

6 to date, more coming on board

Sparks of Hope

Roadhouse Tattoo

Good Shepherd Church

Assemblyman Sean Ryan – Grant St Office

St Bernadette Church – Orchard Park

Union Fire Hall – West Seneca

Additional Naloxone

Workgroup Activities

Response After Overdose Peer Response Pilot with Cheektowaga

Police Department in collaboration with REAP workgroup

Established September 1, 2019

Utilizes “ODMAP” program and police report system

Creates partnerships with law enforcement, public health,

peers in recovery

Provides peer support for linkage to treatment (MAT) for

individuals experiencing an overdose within 1 -5 days

depending on the individual situation

ODMAP Platform

ECDOH Response after Overdose Program –

ODMAP Screenshot

Additional Naloxone

Workgroup Activities

Preliminary results

from Cheektowaga

Response After

Overdose

Pilot Project

Outcomes to Date

September 1, 2017 – July 16, 2018

54 clients total identified through ODMAP after overdose and

direct referrals from law enforcement officers in the Town of

Cheektowaga, NY

39 of these individuals were identified after overdose using

ODMAP

15 of these individuals were identified through direct referral from

law enforcement when identified through associated crimes and

interactions

Outcomes to Date

11 in treatment at the 60 day follow up point

Treatment breakdown as follows:

Methadone – 5

Suboxone - 6

19 additional in treatment at the 90 day follow up point

Treatment breakdown as follows:

Methadone – 10

Suboxone – 8

Inpatient rehab – 1 – walked early in treatment and transitioned to methadone outpatient

1 still in jail on warrant pick up

6 flat out refused treatment offers, we will continue to follow up with them every 30 days

10 recent cases actively working with peer to identify program to meet individual needs – work schedule, school schedule

6 are speaking with the peer currently, have not turned down treatment but are not yet ready to commit

Families have become both a support and a barrier

Law enforcement is very helpful in tracking down individuals who provide false names, numbers, etc

Cluster of 5 individuals referred from officers, peer working with individuals on personal plans – 2 to suboxone, 3 not ready for TX but willing to accept harm reduction services, will follow up at the 30, 60 and 90 day points to re offer services.

One individual lost to overdose death, had been in jail, detoxed from methadone, was released and found dead in a hotel within 48hrs of release.

Outcomes to Date

Additional police department participation

Buffalo – 800 + officers

Depew

Lancaster

Evans

Village of Hamburg

Town of Hamburg

Angola