West Virginia University’s chief economist estimates the opioid epidemic has cost the state economy nearly $1 billion from deaths, lost or underperformed jobs and public resources.
John Deskins, director of WVU’s Bureau of Business and Economic Research, says the estimate includes $322 million in productivity lost from fatalities, $316 million in productivity lost from addicted people working below peak levels and $320 million tied up in health care, addiction treatment and police, courts, jails and prisons.
West Virginia recorded 884 overdose deaths last year, most involving at least one opioid, with 558 fatalities through mid-October this year.
Deskins says the state economy has improved from the dip in the energy industry over the past two years, but says progress would be greater without the strain from the drug epidemic.
Paramedics and police are already in the hotel room when Kyle Simpson walks in.
“What happened?” he asks.
A 37-year-old man in the room is barely conscious–just revived by the overdose reversal medication NARCAN.
Law enforcement officers survey the scene. They’ve found more heroin “rocks” on a table. One officer interviews a crying woman who was with the man when he stopped breathing.
“He overdosed on heroin. He snorted it,” a paramedic responds.
Simpson is an Operations Major with Louisville Metro’s Emergency Medical Services. He says this won’t be the only scene like this tonight due to the opioid crisis.
“It has taken effect, and it has got a hold on this city.”
First responders like Simpson have learned a lot about how to deal with the epidemic. But he says he could use more data to better track overdoses.
“We could maybe establish patterns and maybe put an end to this.”
Tracking the Crisis
The Louisville Metro EMS is moving to new data tracking technology to make better use of the information they get from each overdose call.
“We need to know let the hospitals know that they’re going to be seeing an increase,” Public Information Officer Mitchel Burmeister said. “We need to make our EMS responders aware and our police and fire responders aware. And then we need to get the word out to the community.”
After a spike in overdoses earlier this year, federal officials approached LMES about adopting a program created by the Washington/Baltimore High Intensity Drug Trafficking Area.
Credit J. Tyler Franklin
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Louisville Metro EMS dispatchers.
The city previously tracked overdoses events with data pulled from multiple sources which wouldn’t provide immediate results.
The new program —provided at no cost to Louisville Metro– will have first responders enter accurate data into an easily navigated interface. That will update the agency’s private database in real time.
“We want to make sure that the data that we are collecting for this heroin epidemic is consistent and coordinated,” Burmeister said.
Louisville’s project is among a handful of efforts in the Ohio Valley aimed at filling surprising gaps in the information available about the scope and impact of the crisis. For all the attention the epidemic has received, timely, reliable data are often lacking.
Public health researchers have started to sound the alarm about impediments to information vital to their work to better understand the opioid epidemic and inform public policy decisions.
Researchers say federal funding cuts threaten some important national data sets and others are not being regularly updated. Some information sources kept by law enforcement agencies are not made available to researchers.
Dan Ciccarone with the University of California San Francisco has studied heroin use for nearly two decades. He said that in that time it has become more difficult for him to get law enforcement information on the type and nature of drugs agents have seized.
“We need some cross-pollination,” he said. “We need to get the information to other people.”
Law enforcement and public health researchers both want to find solutions to ending the opioid crisis. But they don’t speak the same language when it comes to their methods.
Ciccarone said enforcement agencies have the raw data researchers need to study things such as the potency and production of heroin. But the agencies tend to keep that information to themselves, perhaps out of concern that drug users or producers might exploit it.
“Maybe you don’t tell the users, then,” Ciccarone said. “Maybe you just tell emergency doctors. They might want to know if a new brand of fentanyl came in last week. All I’m saying is, we’re not doing enough.”
Other numbers gathered by state and county governments are often simply not timely or complete enough to keep up with the pace of a rapidly changing epidemic.
For example, data on overdose deaths in Kentucky, Ohio, and West Virginia are presented on different time periods and levels of detail. Overdose victims might be identified according to place of residence in one set of data, but by place of death in another. Different state agencies also follow different criteria for reporting information about the specific drugs involved in an overdose case. Such inconsistencies make it tough to get a full, regional picture of the toll the epidemic is having.
Insight into ODs
An innovative project in Cincinnati shows how better data can help.
The city’s Open Data Portal gathers data from various departments in order to track everything from government spending to trash pickup.
The city’s data department was also interested in overdose data in the local EMS logs. As part of the public Cincy Insights online project, Chief Data Specialist Brandon Crowley designed an interactive map that showed the overdose EMS calls by neighborhood while protecting private information.
“It makes sense that if we’re interested in looking at it, we’re sure the public would be interested in looking at it,” Crowley said.
As in Louisville, the idea first came after a dramatic series of overdose events in 2016. Originally, Crowley said, the city simply wanted citizens to see what was going on in their neighborhoods. But then local entities combating the opioid crisis took an interest in the data.
By tracking the times that overdose calls came in, first responders were able to look for patterns and anticipate when they need staff on hand. By tracking locations of the calls, the city hopes people who lead treatment programs will learn where their services are needed most.
“We recognize a visualization is not a panacea for this epidemic,” Crowley said. “But we realize that it can be used as a tool to help us lessen the number of events.”
The project has gained attention from outside Cincinnati as well, with other municipalities inquiring about how they could set up their own system.
Crowley said he believes that with the right technical knowledge and infrastructure, rural Appalachian communities can also develop similar inexpensive tracking systems.
The city hopes to add new data sets to the page. By teaming up with area hospitals and treatment centers, for example, they could track the outcomes of overdose events and the effectiveness of treatment.
Tracking Treatment
States are making efforts to fill in the data gaps as well.
West Virginia Gov. Jim Justice recently signed H.B. 2620, creating a state Drug Control Policy office.
Part of the office’s responsibilities will be to create a data repository in order to seamlessly share data among multiple state agencies.
“This will help us surpass a couple of the challenges that we have identified over the past few years in being able to both collect data in a uniform basis as well as then report it out in a timely and transparent manner,” State Health Officer Dr. Rahul Gupta said.
Dr. Gupta said data-driven work is important to making informed decisions regarding the opioid crisis.
Many agencies across the bureau are collecting different data sets related to understanding the problem. But Dr. Gupta would like to seem them more aggressively assimilate data related to prevention and treatment.
The agency recently did a study on a May, 2016, event in Huntington in which 26 people overdosed in the span of a few hours.
“What we found was, of these people that went to the hospital with an overdose, none of these people actually entered a treatment program,” Dr. Gupta said.
“What data will help us with is to be able to create programming for individuals that fits the needs of individuals.”
A Proactive Approach
Dan Ciccarone said this type of data will be essential to getting a well-rounded look at the opioid crisis.
Without a better understanding of the drugs, Ciccarone believes the approach to the crisis will continue to be reactionary, rather than proactive.
Researchers writing in a 2015 white paper identified a dozen data sets that were severely lacking just regarding the use and abuse of prescription opioids. Those included information categories such as “Thwart Rate of Forgery and Doctor Shopping Attempts” and “Prevalence of Drug-Seeking Behaviors.”
The authors of the white paper called on a “variety of sources, including federal agencies, proprietary systems, national organizations, academic institutions, industry, and state and regional government agencies” to step up their efforts to collect much needed data.
The new information systems in cities like Louisville and Cincinnati won’t fill every gap, but here in ground zero of the nation’s opioid crisis, every bit of data helps.
ReSource member station WFPL reporter Jacob Ryan contributed reporting for this story.
The number of reported overdose deaths that occurred last year in West Virginia has continued to rise.
Citing data released Wednesday, the Charleston Gazette-Mail reports that at least 844 people died in the state of drug overdoses in 2016.
That number is a 15 percent increase over 2015’s tally of 731 drug deaths, West Virginia’s previous all-time high.
Fatal overdoses related to fentanyl, an opioid that’s 100 times stronger than prescription morphine, have fueled a 46 percent increase of overdose deaths in the state in just four years. Drug traffickers often mix fentanyl with heroin.
The West Virginia Health Statistics Center compiles the state’s overdose data from death certificates certified by the chief medical examiner. Additional deaths are expected to be added to the total in the coming weeks.
Fatal drug overdoses in West Virginia continued to rise last year, as its overdose death rate still far outpaces any other state.
Citing a Feb. 13 analysis by the West Virginia Health Statistics Center, The Register-Herald reports that at least 818 people in the state died of drug overdoses in 2016 — four times the number that occurred in 2001 and a nearly 13 percent increase over last year.
About 86 percent of the deaths in 2016 involved at least one opioid.
State officials say the data may change as more death certificates are recorded.
Bureau for Public Health Commissioner Dr. Rahul Gupta says fewer opioids are being prescribed, but addicts have been turning to the cheaper alternative of heroin, which is often contaminated with extremely potent fentanyl.
Meanwhile, 1,728 West Virginians died from overdoses of these two powerful painkillers.
Who let it happen? Investigative reporter Eric Eyre, of the Charleston Gazette-Mail, answered our questions about his series on The Front Porch.
(Caution: This week’s podcast contains a vulgar slang word.)
1. What was the biggest surprise for you?
Drug wholesalers shipped enough painkillers to provide 433 pills for every man, woman and child in the state, Eyre said. And in parts of the southern West Virginia coalfields, the numbers were even higher.
“I was surprised that some of the smallest pharmacies had some of the biggest numbers,” Eyre said. For example, nearly 9 million hydrocodone pills to one pharmacy in Kermit, W.Va., population 392.
“In Oceana, one pharmacy received 600,000 – 700,000 oxycodone pills a year. The Rite Aid six blocks away gets 6,000.”
2. Did the drug wholesalers do anything illegal?
“They have a legal obligation to report these suspicious orders to the (federal) Drug Enforcement Agency,” and to the state Board of Pharmacy, Eyre said.
For years, none of them did. But after a lawsuit was filed by former state Attorney General Darrell McGraw, some wholesalers began to send suspicious order reports to the Board of Pharmacy.
3. What did the Board of Pharmacy do with those reports of suspicious orders from the drug wholesalers?
They put them in a box, Eyre said. They did not tell law enforcement or even tally the information on a computer.
Eyre asked the board’s director about this: “He said the law does not prescribe what they’re supposed to do with the suspicious report, only that they’re supposed to be filed.”
Now, the board is considering sharing these with the State Police or Attorney General.
4. How do the drug wholesalers defend themselves?
“They say these are licensed pharmacies. These are licensed doctors. The responsibility should be with the boards that licensed those two groups,” Eyre said.
5. This investigation looked at the time period of 2007 – 2012. What’s happened since then?
On many levels, there’s been a crackdown on illegal use of prescription opioids, Eyre said. Hydrocodone was reclassified to make it harder to prescribe. State officials are tracking prescriptions more closely.
The number of overdoses from hydrocodone and oxycodone have leveled out and maybe declined a bit. But they’re being replaced by drugs like heroin and fentanyl.
6. What’s the relationship the flood of pain pills and today’s heroin epidemic?
“The pain pills set the stage,” Eyre said, for illegal drugs like heroin and more powerful synthetic opioids like fentanyl.
Now, those drugs are causing more and more overdoses.
7. What’s been the reaction to your story?
“Since this article came out, I have gotten emails from all over the country, saying they had an overdose in the family,” Eyre said.
“The other set is lots of emails from people who grew up in West Virginia, and worry about the state.”
8. What’s the historical context?
Front Porch co-host Rick Wilson says, “It reminds me of the Opium Wars, in which Great Britain went to war with China to have a free market in drugs.”
9. How did this even happen?
“When there’s a drug epidemic in a poor community, it’s not that big a deal. But when it crosses over to affect middle and upper class people, it’s a tragedy,” Wilson said.
10. What Bible verse best sums up the lessons from this series?
From Wilson: Matthew 18:6 – “If anyone causes one of these little ones to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea.”
“The Front Porch” is a place where we tackle the tough issues facing West Virginia and Appalachia with some of the region’s most interesting thinkers.
WVPB Executive Director Scott Finn serves as host and provocateur, joined by Laurie Lin, a conservative lawyer and columnist, and Rick Wilson, a liberal columnist and avid goat herder who works for the American Friends Service Committee.
An edited version of “The Front Porch” airs Fridays at 4:50 p.m. on West Virginia Public Broadcasting’s radio network, and the full version is available above.
Share your opinions with us about these issues, and let us know what you’d like us to discuss in the future. Send a tweet to @radiofinn or @wvpublicnews, or e-mail Scott at sfinn @ wvpublic.org
The Front Porch is underwritten by The Charleston Gazette Mail, providing both sides of the story on its two editorial pages. Check it out: http://www.wvgazettemail.com/
An Ohio man was accused of distributing an elephant sedative to people, which, according to federal prosecutors, resulted in about two dozen overdoses in a West Virginia city.
On Monday, prosecutors charged 22-year-old Bruce Lamar Griggs of Akron, Ohio, with distributing carfentanil and fentanyl, local news organizations reported.
According to the Centers for Disease Control and Prevention, carfentanil is an elephant sedative that is 100 times more potent than fentanyl. Fentanyl is an opioid used as part of anesthesia to help prevent pain.
In September, the DEA issued a public warning about the health and safety risks of carfentanil.
“DEA, local law enforcement and first responders have recently seen the presence of carfentanil, which has been linked to a significant number of overdose deaths in various parts of the country,” the DEA’s release stated. “Improper handling of carfentanil, as well as fentanyl and other fentanyl-related compounds, has deadly consequences.”
Griggs was charged Aug. 26 with heroin distribution in connection with 27 overdoses that resulted in two deaths on Aug. 15 in Huntington, West Virginia.
Prosecutors also filed a motion for a guilty plea hearing on Monday. The date for the hearing has yet to be released.
