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!