A recent study from the Indiana University Public Policy Institute showed a decrease of accidental opioids overdose deaths in Marion County from 2017 to 2018. While the study shows progress in federal, state, county and citywide efforts to combat the opioids crisis, it also displays areas where the crisis worsened.
Marion County’s accidental fatal opioids overdoses fell 11%, from 406 in 2017 to 361 in 2018. However, in 2018 opioids were still present in 78% of Marion County’s fatal overdose victims.
The largest declines in opioids-related death are from prescriptions, which dropped 25%, and heroin, which dropped 14%. This marks the first year opioids deaths in Marion County decreased since the IU Public Policy institute began tracking the numbers in 2010.
Phillip Huynh, a program analyst at the IU Public Policy Institute, was slow to attribute the drop in deaths to anything other than increased availability of naloxone, not a drop in opioids use. Police officers and emergency medical technicians (EMTs) now carry the life-saving drug, which is administered during an opioids overdose. However, people don’t need to be first responders to get naloxone. The Marion County Health Department provides one to two bottles of naloxone to anyone who takes a free one-hour training course on how to use the medicine. The classes are essential for anyone with a loved one using opioids, Dr. Virginia Caine, director of the Marion County Health Department, said.
“Naloxone is the only thing that I would say for sure is a significant contributing factor why these deaths are down,” Huynh said. “For everything else, we are still researching.”
In addition to more naloxone availability, Caine credits new regulations aimed at helping reduce the amount of opioids doctors prescribe. For example, the state passed a law this year stating every opioids provider in Indiana must have two hours of training in addiction treatment. Doctors who don’t take the course can’t prescribe the pain medication. The theory is doctors who take this training are less likely to overprescribe opioids, which can lead to fewer patients addicted to the drug.
“In the old days if you had knee surgery [providers] might give you two weeks of pain medications,” Caine said. “People would get addicted from that pain medication. Now they’re really trying to measure from a physiological standpoint just how many days you really need versus being so generous with giving lots of pain medication.”
Even though opioids deaths fell overall, overdose deaths from fentanyl increased 5%. The synthetic drug was present — even if it wasn’t the cause — in 54% of opioids deaths in Marion County in 2018, an increase from 46% in 2017. Overdose rates increased for fentanyl because the drug often is mixed into other drugs for a greater high. According to Caine, drug users often underestimate the strength of fentanyl and accidently mix in a fatal amount.
“We like to refer to this as the ‘waves’ of the opioids epidemic,” Huynh said. “It started off with prescription, and then prescription dropped. And then heroin increased, and then heroin slightly dropped, and then fentanyl increased. We are currently still in that fentanyl wave.”
While Huynh and Caine noted the wane in opioids deaths, both emphasize there’s still work to do. To further combat the opioids crisis, the Marion County Health Department plans to partner with new organizations such as churches, sororities, fraternities and business networking groups to spread awareness about the opioids crisis and the availability of naloxone.
“[The crisis] is definitely going to increase if we don’t do anything about it, if we don’t put any resources toward it,” Caine said. “This is not a problem that is going away.”
Contact staff writer Ben Lashar at 317-762-7848. Follow him on Twitter @BenjaminLashar.