Opiate Epidemic Task

Force: Naloxone

Workgroup Updates

Erie County Health Department

November 12, 2019

Narcan Trainings this quarter

(6.30.19 – 9.30.19) Continued naloxone trainings conducted by the department:

Community members - 634

Expanding TOTs - 67 trainers trained this quarter!

EMS Staff, Medical Students - 944

Library Staff and patrons- 17

School personnel including health staff, teachers, administrators,

building maintenance - 198

Volunteer firefighters - 67

Law enforcement - 364

Street outreach – Community Wellness staff – 68

Tertiary Prevention –2013 – present day total number trained - 26,564 Erie County residents trained

Total # trained for Narcan administration since 2013

2013 – 44

2014 – 904

First Responders - 904 Community – 0

2015 – 3614

First Responders – 1,739 Community – 1,875

2016 – 6,897

First Responders – 1,466 Community - 431

2017 – 6,477

First Responders – 1,346 Community – 5,131

2018 – 5,842

First Responders – 1,350 Community – 4,492

2019 – (Jan – June) – 2,786

First Responders – 1,084 Community – 1,702

What’s happening with

naloxone/Narcan usage in WNY

We continue to analyze the

data from the “naloxone

usage forms”

The following snapshot is

from both the Police/Fire

forms

What’s happening with

naloxone/Narcan usage in WNY

The following slides were created from the “opiate overdose reversal forms” that we collect from first responders specifically in the City of Buffalo

This has helped us understand the community affected

Each new batch of forms improves our data; so keep turning in those forms!

ECDOH

Last Updated 11/7/2019

ZIP Codes, Excluding Unknowns, N=2,394

0

50

100

150

200

250

11

58

11

20

15

13

08

41

40

04

14

00

61

40

10

14

01

21

40

24

14

02

51

40

27

14

03

11

40

32

14

03

31

40

34

14

03

61

40

43

14

04

71

40

51

14

05

21

40

55

14

05

71

40

59

14

06

71

40

68

14

07

01

40

72

14

07

51

40

80

14

08

11

40

85

14

08

61

40

91

14

09

21

40

94

14

09

61

41

02

14

10

51

41

08

14

11

11

41

20

14

12

11

41

27

14

12

91

41

31

14

13

21

41

39

14

14

11

41

50

14

17

21

41

74

14

20

11

42

02

14

20

31

42

04

14

20

51

42

06

14

20

71

42

08

14

20

91

42

10

14

21

11

42

12

14

21

31

42

14

14

21

51

42

16

14

21

71

42

18

14

21

91

42

20

14

22

11

42

22

14

22

31

42

24

14

22

51

42

26

14

22

71

42

28

14

24

71

43

04

14

44

51

45

10

Time of Overdose, 1-hour blocks, N=2,301

0 20 40 60 80 100 120 140 160 180

Midnight to 12:591:00 - 1:59 AM2:00 - 2:59 AM3:00 - 3:59 AM4:00 - 4:59 AM5:00 - 5:59 AM6:00 - 6:59 AM7:00 - 7:59 AM8:00 - 8:59 AM9:00 - 9:59 AM

10:00 - 10:59 AM11:00 - 11:59 AMNoon - 12:59 PM

1:00 - 1:59 PM2:00 - 2:59 PM3:00 - 3:59 PM4:00 - 4:59 PM5:00 - 5:59 PM6:00 - 6:59 PM7:00 - 7:59 PM8:00 - 8:59 PM9:00 - 9:59 PM

10:00 - 10:59 PM11:00 - 11:59 PM

Time (1 hr), excl. Unknown

Time of OD, by Year, N=2,2960 1 2 3

12 AM

1 AM

2 AM

3 AM

4 AM

5 AM

6 AM

7 AM

8 AM

9 AM

10 AM

11 AM

12 PM

1 PM

2 PM

3 PM

4 PM

5 PM

6 PM

7 PM

8 PM

9 PM

10 PM

11 PM

20140 50

12 AM

1 AM

2 AM

3 AM

4 AM

5 AM

6 AM

7 AM

8 AM

9 AM

10 AM

11 AM

12 PM

1 PM

2 PM

3 PM

4 PM

5 PM

6 PM

7 PM

8 PM

9 PM

10 PM

11 PM

20150 50 100

12 AM

1 AM

2 AM

3 AM

4 AM

5 AM

6 AM

7 AM

8 AM

9 AM

10 AM

11 AM

12 PM

1 PM

2 PM

3 PM

4 PM

5 PM

6 PM

7 PM

8 PM

9 PM

10 PM

11 PM

20160 20 40

12 AM

1 AM

2 AM

3 AM

4 AM

5 AM

6 AM

7 AM

8 AM

9 AM

10 AM

11 AM

12 PM

1 PM

2 PM

3 PM

4 PM

5 PM

6 PM

7 PM

8 PM

9 PM

10 PM

11 PM

20170 20 40

12 AM

1 AM

2 AM

3 AM

4 AM

5 AM

6 AM

7 AM

8 AM

9 AM

10 AM

11 AM

12 PM

1 PM

2 PM

3 PM

4 PM

5 PM

6 PM

7 PM

8 PM

9 PM

10 PM

11 PM

20180 10 20

12 AM

1 AM

2 AM

3 AM

4 AM

5 AM

6 AM

7 AM

8 AM

9 AM

10 AM

11 AM

12 PM

1 PM

2 PM

3 PM

4 PM

5 PM

6 PM

7 PM

8 PM

9 PM

10 PM

11 PM

2019

OD Weekly/ Daily Patterns, N=2,296

0

5

10

15

20

25

30

35

40

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Midnight to 12:591:00 - 1:59 AM2:00 - 2:59 AM3:00 - 3:59 AM4:00 - 4:59 AM5:00 - 5:59 AM6:00 - 6:59 AM7:00 - 7:59 AM8:00 - 8:59 AM9:00 - 9:59 AM10:00 - 10:59 AM11:00 - 11:59 AMNoon - 12:59 PM1:00 - 1:59 PM2:00 - 2:59 PM3:00 - 3:59 PM4:00 - 4:59 PM5:00 - 5:59 PM6:00 - 6:59 PM7:00 - 7:59 PM8:00 - 8:59 PM9:00 - 9:59 PM10:00 - 10:59 PM11:00 - 11:59 PM

OD's by Month, N=2,6312014 -2019

0

20

40

60

80

100

120

140

160

180

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4M

ay-1

4Ju

n-1

4Ju

l-1

4A

ug-

14

Sep

-14

Oct

-14

No

v-1

4D

ec-

14

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5M

ay-1

5Ju

n-1

5Ju

l-1

5A

ug-

15

Sep

-15

Oct

-15

No

v-1

5D

ec-

15

Jan

-16

Feb

-16

Mar

-16

Ap

r-1

6M

ay-1

6Ju

n-1

6Ju

l-1

6A

ug-

16

Sep

-16

Oct

-16

No

v-1

6D

ec-

16

Jan

-17

Feb

-17

Mar

-17

Ap

r-1

7M

ay-1

7Ju

n-1

7Ju

l-1

7A

ug-

17

Sep

-17

Oct

-17

No

v-1

7D

ec-

17

Jan

-18

Feb

-18

Mar

-18

Ap

r-1

8M

ay-1

8Ju

n-1

8Ju

l-1

8A

ug-

18

Sep

-18

Oct

-18

No

v-1

8D

ec-

18

Jan

-19

Feb

-19

Mar

-19

Ap

r-1

9M

ay-1

9Ju

n-1

9Ju

l-1

9A

ug-

19

Sep

-19

Oct

-19

No

v-1

9D

ec-

19

Opiate Overdose Reversal Count by Month

Survival for Transport to Hospital, excluding Unknowns, N = 2,490

2014 - Present

Last update: Thu 25 Jul 2019

93%

7%

Did person survive for transport?

Yes No

Age Breakdown, Buffalo Fire Department(Excluding unknowns excluded, percentage of known ages,

N=719)

0.0%

0.0%

1.7%

10.5%

16.7%

11.0%

10.7%

4.9%

3.9%

3.7%

2.1%

1.6%

0.9%

0.2%

0.0%

0.0%

0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0%

Under 10

10 to 14

15 to 19

20 to 24

25 to 29

30 to 34

35 to 39

40 to 44

45 to 49

50 to 54

55 to 59

60 to 64

65 to 69

70 to 74

75 to 79

80+

Age Breakdown, Buffalo Police Department(Excluding unknowns, percentage of known ages, N=433)

0.0%

0.0%

3.8%

13.2%

22.5%

16.4%

9.3%

5.7%

3.8%

3.6%

2.8%

3.8%

0.4%

0.2%

0.2%

0.0%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0%

Under 10

10 to 14

15 to 19

20 to 24

25 to 29

30 to 34

35 to 39

40 to 44

45 to 49

50 to 54

55 to 59

60 to 64

65 to 69

70 to 74

75 to 79

80+

Overdose Transport Sites• 2,355 entries (excluding Unknowns, refused transport, or deaths)

• Dates from May 2014 through Jul 2019

6177

1111919

13905854

446

30220

1121112

2959

59131

0 200 400 600 800 1000 1200 1400 1600

Bertrand ChaffeeBuffalo General Hospital (BGH)

Called by ER MDChildrens Hospital

Columbia Memorial HospitalCommunity General

DeGraff MemorialEastern Niagara

ECMCKenmore Mercy

Lake Shore HospitalLockport HospitalMedical examiner

Mercy HospitalMillard Fillmore SuburbanMount St. Mary's Hospital

N/ANiagara Falls Memorial

No transportrefused

Sisters HospitalSt. Joseph HospitalSt. Mary's Hospital

UnknownUnsure

Veterans AdministrationWomen and Children's Hospital of Buffalo

Notes

Overdose data is from forms completed by police

officers and firefighters after administering Narcan.

The database expands each time we enter more forms.

It is possible that multiple reports have been completed

for the same individuals at different time points (repeat

overdoses).

Additional Naloxone

Workgroup ActivitiesNew Project – “Community Narcan Access Sites”

Sparks of Hope

Good Shepherd Church

Assemblyman Sean Ryan – Grant St Office

St Bernadette Church – Orchard Park

Union Fire Hall – West Seneca

Our Lady of Victory Family Care Center

Reflections Recovery, Newfane

Restoration Society

The Genesis Center

Brant Town Hall

Unitarian Universalist Church of Buffalo

Erie County New York

Peer and First Responder

Response After Overdose

Utilizing ODMAP

ODMAP Platform

Creating a collaborative response to

the Opioid Overdose Epidemic in Erie

County NY between First Responders,

Public Health, and Peers in recovery

Where are we today

Lessons learned

Changes being implemented

Outcomes are from pilot implementation in

multiple local police departments, with strong

internal leadership and support for the project.

146 clients interacted with through OCTOBER 2019

8 local police departments currently participating

in referral project (1/3 of Erie County police

departments)

Outcomes:

So what happened?Two definite categories of clients with

defined success rates of initiated and

continued connection to care:

1. Direct referral to peer by law

enforcement – much higher preliminary

connection rate at 90 day point than

identification of client through overdose

event. Direct referral clients appear to

experience a disconnection to care

around the 60 day point, further

investigation of the data is needed.

2. Client identified through overdose event

that does connect to care appears to

stay connected through the 90 day

contact point more consistently, but at

a much lower rate. Supported by

associated research that suggests an

overdose event is not a reason to agree

to or feel that one needs treatment.

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

30 Days 60 Days 90 Days

Client connected to care or in treatment

ODMap Referrals

Exciting Results!

Cheektowaga, NY

0

20

40

60

80

100

120

140

160

180

200

2016 2017 2018 2019

Overdose Statistics

Overdoses Deaths

Year Overdoses Deaths

2016 167 16

2017 113 10

2018 63 5

2019 23 4

2019 Numbers are

Jan 1- June 30

THIS IS WHY WE DO WHAT

WE DO…….

WNY RESPONSE AFTER

OVERDOSE PROJECT

Goals

Reduced opioid overdose fatalities

Enhance pathways to connect those experiencing opioid addiction to treatment

Reduced stigma around opioid addiction

Narcan trainings by County, 9/30/2018 - 9/29/2019, n=37

Participants trained by County, 9/30/2018 - 9/29/2019, n=731

Connecting to treatment

MATTERS & peer support

Addiction hotline & peer support

Peer network

• 21/41 clients chose to have peer support

• 23 callers with Opioid Use Disorder given treatment info

• 9 callers (families & friends) given treatment info

• 12/6/2019 COPE of WNY meeting (Community of Peer Enrichment)

Narcan emergency boxes

Thank you!