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Opioid deaths decline statewide

Franklin and Essex counties, however, show no significant change

Hydrocodone, an opioid prescription drug, is seen behind the pharmacy counter at Kinney Drugs in Saranac Lake. (Enterprise photo — Chris Knight)

Overdose deaths in the state — outside New York City — dropped nearly 16% from 2017 to 2018, the first reduction in 10 years, according to the most recent County Opioid Quarterly Report from the state Department of Health’s Heroin and Opioid Task Force. However, that trend is not mirrored in Essex and Franklin counties — although the deaths here are too few to determine much in the way of trends.

The quarterly reports look at myriad heroin and opioid-related statistics such as overdoses, deaths, hospitalizations and naloxone administrations.

In total, the state counted 1,824 opioid-related deaths in 2018. In 2017, the state counted 2,170 deaths.

But according to the Department of Health’s online opioid data dashboard, there were no significant changes in Essex and Franklin counties. In Essex County, the number of deaths was 2 in each year. In Franklin County, the number of deaths was 3 in 2018 and 4 in 2017. The quarterly report says because these numbers are so low, they make it hard to determine trends.

“New York’s first reduction in opioid overdose deaths in over 10 years is an important milestone and demonstrates our work to combat this deadly scourge is working,” Gov. Andrew Cuomo said in a press release. “And while New York has taken the most aggressive actions to combat the opioid crisis of any other state in the country, the opioid epidemic continues to devastate too many families and we will not rest until we put an end to it once and for all.”

Opioids

Opioids are opium-derived medications used mainly for pain relief. They provide a morphine-like effect. Some of the more common brand-name opioids are OxyContin, Percoset and Vicodan. For example, let’s say you break a bone; a doctor might prescribe you OxyContin as a pain killer. When acquired legally, the medications tend to come in prescription bottles with an added sticker, saying, “CONTROLLED SUBSTANCE. DANGEROUS UNLESS USED AS DIRECTED.”

Locally

Essex County Department of Health Director Linda Beers said her group is still working on a new community health assessment, but that mental and substance-abuse disorders will be in the top priorities over the next few years.

“We picked that after looking over data we received from surveys to the public, stakeholders, the (county) Board of Supervisors, high schools,” she said. “Opioid abuse prevention is in there, but it also includes things like underage drinking and other addictions. We absolutely have some initiatives and focus areas we’re going to be working on under that goal.”

Beers said the state’s quarterly report is a good resource, but it can be difficult to get a full picture of the opioid situation in Essex County based on that alone.

She said the community health assessment will most likely be released in the first week of January.

Zach Randolph is the chief clinical officer at St. Joseph’s Addiction & Recovery Centers, a system of rehabilitation and treatment clinics in the North Country, based in Saranac Lake.

“As far as our inpatient treatments go, per year, we treat only 10 or 12 people, maybe less, from Essex and Franklin,” he said. “Every year we help about 400 people through inpatient treatment, and most of those are coming from more urban areas. Our outpatient treatment helps probably thousands of people a year.”

Naloxone

Naloxone is an anti-overdose drug. The most common brand is Narcan, which is a nasal spray. It’s often carried by police officers and emergency medical services. The quarterly report said there were 6,906 cases when emergency medical services had to administer naloxone in 2018.

Frank Whitelaw of Bloomingdale, an Essex County coroner and retired state trooper, said he always carries Narcan on his belt.

“It’s for myself and other first responders,” he said. “There have been instances where rescue personnel show up and have been contaminated and then they start going into respiratory distress or failure. I also carry it on my belt instead of leaving it in my car because heat and cold can ruin the effectiveness of the drug.”

Naloxone is not a complete cure. It works like an EpiPen for allergic reactions. You still need to go to the hospital after taking it.

“Depending on the dose of an opioid, Narcan will wear off, and whatever opioid is in your system will begin to act again,” Whitelaw said. “It’s just a quick save.”

Generic naloxone is an injection and costs between $20 and $40. Narcan nasal sprays can cost upward of $100 for two doses. Anyone can go into a drug store and buy naloxone over the counter. Whitelaw said he likes the availability of naloxone and would like to see it go further.

“Anybody who can get there hands on Narcan should,” he said. “It’s a great thing for anybody to have. You never know when someone is going to go down.

“I think that might be one of the reasons that we’re seeing a downtick in fatality numbers. It’s not so much a downtick in addiction or abuse, and I think we can attribute that to more than just first responders carrying it. It’s a good thing.”

Randolph said St. Joe’s offers naloxone training, where they provide free doses, but they don’t often garner a big attendance.

“You shouldn’t have to pay anything for (naloxone)” he said. “We try to do the training every chance we can. We did one recently at Lake Placid High School. That was a well-marketed, well-publicized invite that I think ran for almost two months, and you know how many people attended that night? It was about eight people, and two of those were my wife and son. That’s kind of the norm. We have these coalitions that put these events together. It really doesn’t get real until you or a loved one gets affected.”

Purdue Pharma is currently in some hot water in regard to producing its own naloxone product, Nyxoid. In 1996, Purdue released OxyContin, which is highly addictive and can cause overdoses, and now it wants to sell an anti-overdose drug. While yes, the drug is expected to counteract the effects of an overdose and help save lives, some health officials don’t like that Purdue wants to profit from curing a problem it helped cause.

Dr. Andrew Kolodny, who used to work for the New York City Department of Health and Mental Hygiene, recently told the Associated Press, “You’re in the business of selling medicine that causes addiction and overdoses, and now you’re in the business of selling medicine that treats addiction and overdoses? That’s pretty clever, isn’t it?”

“I think it’s kind of comical,” Whitelaw said. “It’s like trying to go from villain to the good guy.”

Randolph said he see both sides of the issue.

“You could also look at it as Purdue Pharma being one of the big pharmaceutical companies recognizing what has been introduced to society,” he said. “Is it a sign of good faith and are they really trying to help? Which I’m sure Purdue is framing it as. Can you look at it as a money-making effort? Certainly. I don’t look at it as a business. Unfortunately, my job security is really good in this field. That’s really sad. I don’t want to make a living off of that. My perspective is, I don’t care who’s making a life-saving, life-sustaining medication. I care that it’s out there, that it’s effective and that people can get it and use it to sustain life. If all the OxyContin in the world disappeared overnight, people would still find a way to abuse substances. I think that it’s more about getting people to realize that we need to sustain life in order to help treat life.”

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