SOUTHERN INDIANA — A Southern Indiana health official says drug overdoses have leveled off in the area since a spike earlier this month, but health leaders continue to monitor overdose activity and improve services available for those using.
In early March, the Clark County Health Department issued a notification the area had experienced an increase in overdoses — five to six in a five-day span — what the area normally experiences in about a month's time.
While toxicology reports are still pending, the notification stated the increase could be due to strains of drugs with higher fentanyl content.
The recent spike was the largest of the year, and the first to be caught in real time using a new notification system the county has implemented. Previously, officials could look only at past monthly data to see where and when an increase in overdoses had occurred. Clark County Health Officer Dr. Eric Yazel said the notification system allows first responders, law enforcement, people who use intravenous drugs, and their friends and family to be aware of a potentially more deadly strain of drugs.
"Now the challenge is how often do we utilize [the notification system] and what threshold do we set," Yazel said. "Because if we start sending out a notification every week, people are going to stop listening."
But in the weeks since the spike, the state has reported overdose numbers that line up with what Yazel and others in the area were seeing.
"I feel like it was definitely not a false alarm, from the data I'm seeing."
Clark County previously reported that the number of overdoses in 2018 were the lowest in five years. But Yazel said those overdoses can carry more risk of death due to the increase of fentanyl — a synthetic opioid 50 to 100 times stronger than morphine — being found in heroin and methamphetamine supplies in the area prior to the spike.
If there's a sudden spike in overdose deaths, Yazel said, it's a good indicator there's been an increase in fentanyl content "because that's kind of the one variable that keeps changing, at least lately," he said.
But the county is continuing to look for ways to improve treatment options for those in addiction and to help prevent the health complications and death that can accompany intravenous drug use.
The Clark County needle exchange program, known as The Interchange, opened in 2017. It uses harm-reduction methods: free clean needles and supplies, education, and health and counseling options for its clients. Yazel said the program is now seeing above an 80 percent exchange rate for the syringes.
With the increased potency of drugs in circulation, he and other health officials are considering adding fentanyl-testing strips to the list of services people can get at the needle exchange.
But he's said there's some risk and liability involved, and he wants to talk with health officials in other areas who use the strips to make sure it's both a safe and responsible approach.
"You're liable for the quality of that product if you're handing it out," he said. "We have to make sure we have the appropriate risk management and that we're distributing a product we trust."
The Louisville Metro Syringe Exchange Program has been using the strips since the beginning of the month through a federal grant for opioid response tactics. Community liaison Matt La Rocco said the strips have been received well by program users. He reported that he's heard accounts of people who had tested their drugs and ditched them when fentanyl was present.
"The majority of people, they want to get their money's worth and they'd like to get high, but they're not interested in dying any time soon," he said. "We do have people who say 'I'm not using this because a $20 bag of meth is not worth dying over.'"
Working with people in addiction for 10 years, these responses didn't come as a shock to him — that many people he talks to want to make behavioral changes to help lessen the risk of their drug use.
"They are moms and dads and brothers and sisters and they recognize the value of their role and relationship with others," he said. "They absolutely do care about their health and the people around them and the well-being of the community, and they are taking steps to mitigate as much as possible the harm they cause themselves and others because of their drug use."
Yazel said Clark County has come a long way since the opioid epidemic struck the area and the nation several years ago — there are fewer new users and fewer overdoses — but it still has a ways to go.
"We need to have better programs to get people transitioned from an emergent overdose situation into a more stable treatment situation," he said. "We still have a lot of work as far as getting people in recovery back into normal every day life.