By Patrick Riley
Naples Daily News
Collier County, Fla. — As an opioid epidemic tightens its grip on towns, cities, counties and states across the country, the Collier County Sheriff’s Office is turning to tech to try to stem the tide locally and prevent the rise of heroin overdoses.
Earlier this year, the law enforcement agency started using software — developed by federal officials — to track fatal and non-fatal heroin overdoses in Collier and create a real-time hot-spot map that shows first responders where the drug overdoses are occurring.
The Overdose Detection Mapping Application Program was created under the auspices of the High Intensity Drug Trafficking Areas program, a federal measure designed to provide resources to federal, state, local, and tribal agencies to coordinate activities to address drug trafficking in specifically designated areas of the country.
Nationwide, more than 145 agencies currently use the mapping program, but in Florida the Sheriff’s Office was the first.
“If we can’t see it, we can’t stop it,” said Sheriff Kevin Rambosk. “So if we don’t know what is occurring in our own community there’s no way we can try and prevent it from occurring.
“You can either stay out in front of a potential problem or you can come back and clean it up later. And our thought is always prevention.”
The program allows deputies to upload information from a suspected drug overdose to a database using a computer or mobile device. The information then populates the electronic map with color-coded dots that show where the person overdosed, whether the overdose was lethal and whether Narcan, the drug used to revive the patient, was administered.
In analyzing the data, the Sheriff’s Office and other first responders will be able to figure out where resources need to be allocated, Rambosk said.
Not only would the map show what areas are in need of Narcan to treat overdose patients, Rambosk said, but it would also help deputies spot trends faster — like tainted drugs flooding certain areas.
“If there’s all of a sudden an immediate influx of either overdoses or access to drugs that we may not have been aware of that are causing overdoses, because of tainted or bad drugs, we would be able to jump right in and identify that problem,” he said.
The map also allows deputies to pinpoint what areas of the county are most in need of early intervention and education, said Lt. John Poling of the Vice and Narcotics Bureau.
“We’ll hopefully be able to use it for more of our community engagement,” he said.
Since the program, which will only be accessible to law enforcement, public health officials and first responders, went live on April 14, the Sheriff’s Office has mapped 32 suspected heroin overdoses, including four that were fatal. But those numbers only represent overdoses that the Sheriff’s Office encountered.
To help complete the countywide picture of heroin overdoses, other agencies, including Collier EMS, will feed information into the system.
NCH Healthcare System is currently providing data to the Sheriff’s Office to be entered on the map, said Karie Partington, a Sheriff’s Office spokeswoman. The law enforcement agency will invite Physicians Regional Healthcare System to participate as well.
“A lot of times, unless there is a fatality, the Sheriff’s Office may not get all of the overdose data that are occurring that we actually see on our side,” said Chief of EMS Tabatha Butcher. “So having that EMS data piece is very beneficial for them to be able to track where these things are happening.”
Collier EMS plans to partner with the Sheriff’s Office on the program by Oct. 1, Butcher said.
“It could help us from a safety standpoint, because if we’re able to access and see where drug overdoses are occurring, you know, our paramedics and EMTs that are working in those areas will be able to know that maybe they need to have their guard up a little bit more,” she said.
The program would also allow the agency to stock vehicles in overdose-heavy areas with more Narcan than they ordinarily would, Butcher said.
“It helps our paramedics and EMTs be more prepared for what they’re about to walk into,” she said.
Starting Oct. 1, a new state law will require Collier EMS to report overdose data to the state. The overdose maps will make that easier, Butcher said.
“This will actually help us have an avenue to do that,” she said.
Though it is often difficult for first responders to determine what exactly a patient took, Butcher said, the agency has seen an uptick in overdoses.
“We’ve definitely seen an increase over this past year and a half of Narcan use and overdoses as a whole,” she said.
From Jan. 1, 2016, through May 10, 2017, Collier paramedics administered Narcan — the drug used to treat heroin overdoses — 402 times, or 0.8 times per day, according to an EMS medication usage report.
In 2015, EMS saw a 200 percent increase in heroin-related overdoses compared to 2014, with reported heroin overdoses increasing from 18 to 54 year-over-year.
Heroin-related deaths also rose in Collier.
From 2007 through 2013, deaths where the drug was present in the deceased’s body and fatalities that were caused by it totaled four, according to the Florida Department of Law Enforcement’s 2015 Medical Examiners Commission Drug Report.
In 2014 that number jumped to 14. The following year it decreased slightly to 11.
So far, in the first half of 2016, the number of heroin-related deaths in Collier totals four, according to FDLE’s 2016 Medical Examiners Commission Interim Drug Report, which was published in May.
To be sure, Collier’s volume of heroin overdoses has not yet reached the staggering levels other states or Florida counties have seen. The West Palm Beach area, for instance, led the state in heroin deaths in the first half of 2016 with 97, according to the FDLE data.
But it nonetheless amounts to a crisis, said Nancy Dauphinais, chief operating officer at the David Lawrence Center and a certified addiction professional.
“I would definitely say we have too many overdose deaths,” she said. “And they’re growing.”
Before users switch to heroin, they often start out with prescription painkillers, Dauphinais said.
“It might have been after a surgery, it might have been an injury, a car accident,” she said. “They start taking opiates (opioids), it relieves their pain and it creates a little bit of euphoria, a little bit of feel good.”
But some quickly develop a tolerance, she said, causing them to take more of the drugs to reach the same effects and block out the pain or “just feel normal.”
“Eventually it gets really hard to find that many pills,” Dauphinais said. So, users begin to snort or inject the drugs.
“And then it gets really expensive,” she said. “So folks are often introduced to heroin as a cheaper alternative to the prescription pain medications.”
Recovery can take a long time, but there are treatments that work, Dauphinais said.
“There is hope,” she said. “Recovery is available.”
The Sheriff’s Office hopes it never has to get to that point. That’s why officials, like Rambosk, are optimistic the proactive new program can help root out the problem before it reaches epidemic status.
And though, the focus is heroin for now, Rambosk and Butcher said they hope the mapping tool can eventually be used to plot all types of overdoses.
“I want to look at all of them, not just the heroin-related overdoses,” Rambosk said. “I think it would help us in our effort to intervene and prevent as we move along.”
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