Team reviewing overdose deaths makes recommendations

Written by Andy East for The Republic

A multi-disciplinary group reviewing local overdose deaths and suicides has started making its first recommendations that its members hope will help prevent future deaths.

The group, called the Bartholomew County Suicide and Overdose Fatality Review (SOFR) Team, has been meeting monthly for much of this year to review each overdose death and suicide in the county to examine what happened, what gaps may exist in local prevention efforts and develop data-informed prevention initiatives to prevent future deaths.

The SOFR team was formed late last year as local overdose deaths soared to their highest level on record and includes representatives from the Alliance for Substance Abuse Progress (ASAP), Bartholomew County Coroner’s Office, Columbus Regional Health and Centerstone, among others.

The first recommendations, which are based on detailed reviews of 10 deaths, involve enhancing efforts at getting people who survive an overdose into addiction treatment quickly and making harm reduction measures, particularly naloxone, more readily available to people, said ASAP Executive Director Sherri Jewett and other officials who are involved with the team.

Naloxone is a nasal spray often sold under the brand name Narcan that can temporarily reverse an opioid overdose.

“When the team meets, you identify those areas where you can make the biggest difference the fastest,” Jewett said. “…Those are the first two areas that the team is going to work on.”

As a result of the group’s recommendations, Columbus Regional Health has developed a mechanism through which CRH’s Treatment and Support Center (TASC) will be notified via email anytime that a patient is treated in the hospital’s emergency department for a drug overdose, said TASC Medical Director Dr. Kevin Terrell.

TASC, 2630 22nd St., provides a range of outpatient treatments for substance use disorders, including medication-assisted treatment in certain cases.

Once TASC receives notification, Terrell reviews each of the cases to determine the cause of the overdose, he said. If the cause is determined to be related to drug abuse, one of the center’s recovery coaches will contact the patient to talk to them about getting into treatment at TASC.

Before that system was put in place, TASC would largely rely on emergency department physicians and nurses to alert them, though the “competing priorities in a busy ED (emergency department)” can result in some patients falling through the cracks.

“A common scenario is the patient who arrives in the ED (emergency department) by ambulance after a fentanyl overdose. The patient received naloxone from law enforcement or EMS providers before they even get to the hospital,” said Terrell, who described the new system as a “safety net.” “By the time the patient arrives in the ED (emergency department), the acute crisis has already been managed. After seeing the awake and breathing patient, the physicians and nurses then have to turn their attention to the many other sick patients in the ED (emergency department). It’s too easy in the chaos of the ED (emergency department) to forget to refer these patients to TASC for (a) quick follow-up.”

“This is still a very new process,” Terrell added. “Of the patients I’ve received emails about, we’ve successfully gotten two to come to TASC. That number isn’t huge, but it could be life-saving for those two patients.”

Naloxone

Another recommendation from the team involves increasing access to naloxone and making people more aware of the drug, which is a nasal spray that can temporarily reverse the effects of an opioid overdose.

Currently, the nasal spray is available at the ASAP Hub, as well as in public plastic boxes outside the Hub, Bartholomew County Public Library and Centerstone’s Marr Road location, Jewett said.

Officials on the team have floated the idea of distributing naloxone to people who are getting out of the Bartholomew County Jail, though Jewett said they would need to make sure that local law enforcement is on board.

Bartholomew County Sheriff Chris Lane, for his part, said that is not something that his office is planning to explore at this point, adding that the sheriff’s department is more focused right now on the jail treatment program and other initiatives.

“I’m not saying that I don’t think it’s important for people to have access to Narcan,” Lane said. “…I just think there are a lot of other places that take care of that, and for a jail, I don’t know if that’s the right direction to go.”

Overdose deaths

The local team started reviewing deaths in February, a couple of weeks after a report from the Bartholomew County Coroner’s Office showed that drug overdose deaths soared to 39 last year – the highest annual total on record.

The most common drug involved in overdose deaths last year was fentanyl, which was detected in 27 of the 39 deaths, the report states.

Officials have largely attributed the historic rise in overdose deaths in the county in recent years to the increasing presence of fentanyl, a synthetic opioid that is more potent than heroin that officials say is increasingly being mixed with other drugs.

So far this year, overdose deaths in Bartholomew County are on a slower pace than last year, according to updated figures from the Bartholomew County Coroner’s Office.

As of Tuesday morning, there had been nine confirmed overdose deaths in the county, with another four suspected overdose deaths still pending toxicology results.

That would put the county on pace for roughly 14 to 20 deaths this year and would be the lowest annual total in several years.

There have been a total of 201 confirmed overdose deaths in Bartholomew County from Jan. 1, 2015, to this past Tuesday, including 103 deaths from 2020 to 2022, according to county records.

Jewett, for her part, said it is encouraging that there have been fewer deaths so far this year, but added that the SOFR team will continue to meet and review cases in hopes of uncovering other potential opportunities to strengthen the community’s response.

“All of the efforts in the community and the expansion of services and the things that have been done, we believe are impacting those (overdose death) numbers,” Jewett said. “And our goal with the SOFR team is to impact those numbers even more.”