Andy East | The Republic
With just a couple weeks left in 2023, Bartholomew County remains on pace to see its first annual decline in overdose deaths in several years, county records show.
As of last week, there had been 22 overdose deaths in the county this year, according to updated figures from the Bartholomew County Coroner’s Office. By comparison, the county saw record numbers of overdose deaths in each of the past three years, including a record 39 deaths last year.
Bartholomew County Coroner Clayton Nolting said fentanyl — a potent opioid that is increasingly being cut with other drugs, including counterfeit pills — and methamphetamine have been the drugs that were most frequently involved in overdose deaths this year.
Combination of factors
Local officials said it is hard to pinpoint exactly what may be driving the decrease in overdose deaths this year, though they suspect that it is likely a combination of factors ranging from increased availability of naloxone, a nasal spray that can reverse the effects of an opioid overdose, to increased capacity for treatment and awareness of fentanyl.
Nolting said it is “anyone’s guess” why overdose deaths have declined this year but hopes the trend continues.
“Most likely it’s a combination of factors, including high-profile arrests and convictions, wider use of Narcan and raised awareness that these drugs are killing in large numbers,” Nolting said. “Whatever the reason, our office welcomes the lower numbers and hopes the trend continues.”
Officials at the Alliance for Substance Abuse Progress, or ASAP, said the decline in overdose deaths this year was “in all likelihood” due a range of programs and resources in the community, including some 130 recovery residence beds.
“We believe it’s a culmination of all the activities that have been implemented at the community level, and that includes expansion of treatment programs and providers, all of the justice-involved programs that are out there for people that are in jail … the drug court and the recovery court, the expansion of recovery residences,” said ASAP Executive Director Sherri Jewett.
“Just really a number of activities that in all likelihood impacted these numbers and caused a decline,” Jewett added.
Additionally, Jewett said the Bartholomew County Suicide and Overdose Fatality Review (SOFR) Team and harm-reduction measures such as the distribution of naloxone and fentanyl test strips also likely contributed to the decline in fatal overdoses.
ASAP has distributed a record 4,749 doses of naloxone and 957 fentanyl test strips this year, Jewett said.
“(Naloxone) can save a life and has saved lives,” Jewett said.
The SOFR team is a multi-disciplinary group that reviews all overdose deaths and suicides that formed late last year and includes representatives from ASAP, Bartholomew County Coroner’s Office, Columbus Regional Health and Centerstone, among others.
The team examines each death to see what happen and what gaps may exist in local prevention efforts and develop data-informed prevention initiatives to prevent future deaths.
At the same time, officials at Columbus Regional Health’s Treatment and Support Center, TASC, are seeing their highest patient load to date, with just over 400 active patients, said TASC Medical Director Dr. Kevin Terrell, who emphasized that he is “pleasantly surprised” by the decline in overdose deaths.
“Based on reports from our patients, much of the fentanyl in our community comes in pill form — so called pressed pills or counterfeit pills,” Terrell said. “The pills my patients tell me about look exactly like pharmaceutically made oxycodone 30 milligram tablets. In fact, patients sometimes tell me they have been taking Percocet or oxycodone, but their urine drug tests say otherwise, because they are positive for fentanyl.”
“The fact that people continue to unknowingly take fentanyl and live to tell about it makes me even more surprised we haven’t had more overdose deaths this year,” Terrell added.
The most common drug people are seeking our help with at TASC is methamphetamine, followed closely by fentanyl, Terrell said. A distant third is alcohol, though the number of people seeking help for alcohol use is higher than it has been in the past.
Additionally, heroin has started to crop up occasionally in drug screenings again, but always along with fentanyl, Terrell said. It had been a couple of years since TASC officials saw any positive results for heroin.
The trends
The update from county officials comes a couple months after the Centers for Disease Control and Prevention released updated projections, estimating that just over 112,000 people in the United States died from overdoses during the 12-month period ending in May. That would amount to an increase from the estimated 109,261 deaths during the same 12-month period the year before.
In Indiana, estimated overdose deaths declined about 9.7% during the 12-month period ending in May compared to the same period the previous year.
The CDC’s predicted overdose deaths represent estimates that are adjusted for incomplete reporting.
As of Wednesday, overdose deaths in Bartholomew County were down this year about 43% compared to last year. However, some local officials still fear that the decline seen this year may just be temporary.
“Although I am always optimistic about the future, and I hope that 2023 is the beginning of a downward trend in overdose deaths, I really have no idea what to expect in 2024 or 2025,” Terrell said. “Of course, I’d be thrilled if we continue to see fewer and fewer deaths, but the cautious side of me can’t help but expect to see a rebound in (overdose) deaths next year.”
