Overdose, suicide rates holding steady
Recovery efforts in Howard County preventing increases seen statewide
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Howard County Coroner Dr. Steven Seele recently disclosed the fatality statistics for overdoses and suicides in the second quarter of 2023. The numbers show both rates levelling off locally despite the rise in fatalities statewide.
Seele said that the second quarter ended with 14 suicides and 20 confirmed overdose deaths. Both fatality rates are slightly higher (two each) than those in 2022. While the numbers are trending in the wrong direction, there is no indication that the problem is growing unchecked. Things like Narcan availability and newer mental health treatment and addiction recovery options may be staving off some of these tragedies.
“But the third quarter can totally change the landscape,” Seele cautioned. “You just never know.”
According to Dr. Matt Oliver, CEO of Turning Point System of Care, Howard County’s latest numbers show that local efforts have been successful in limiting the impact of overdoses.
“We're holding steady, but I think that's because of the infrastructure that we're building out in Howard County,” said Oliver. “That's not the same story across the state. I think we're making a difference because we're holding the overdose rate steady versus having it accelerate.”
By comparison, the state of Indiana sees a person hospitalized for drug overdose every two and a half hours, costing taxpayers $1.4 billion a year, Oliver said.
“We basically are seeing overdoses statewide at a rate that we've not seen before,” said Oliver. “And that's because of the potency of the drugs out there now. We’re seeing pills that are illicitly manufactured and much more potent than ones we used to see.”
Oliver explained that prior to 2010, overdoses in Indiana were due mostly to heroin. Other synthetic opioids were limited. In 2014-2015, prescribing habits changed.
“The state basically said. ‘we're coming after the pill doctors,’” said Oliver.
When the prescription medication path was restricted, it opened the door for IV heroin and the synthetic market. And things quickly spiraled out of control.
“Everybody's doing heroin,” said Oliver. “Mothers who are respectable, who you'd never think about shooting up IV heroin, are doing it because they can't get the painkillers.”
Soon, heroin wasn’t enough. The dealers began lacing the drug with synthetic fentanyl as they learned to manufacture it. They also cut it with methamphetamine, OIiver said. In both cases, overdoses spiked.
Fentanyl is certainly the drug of choice in Kokomo today. The heroin outbreak has subsided, and Seele contended that the shift in the market has everything to do with economics.
“Why is fentanyl popular now versus heroin?” asked Seele. “The reason that happened is because of the drug cartels. They’ve cut the opiate farmer out of the process. They can manufacture fentanyl synthetically for pennies on the dollar.”
But the presence of other, deadly drugs in the manufactured fentanyl makes little economic sense. As Seele stated, “if drug dealing is a business, it's the only business that they go out of the way to kill their customer.”
When it comes to drug overdoses, Seele is always prepared for the worst. He explained that overdose deaths typically come in waves, and they directly correlate with the emergence of a “bad batch” of street drugs, typically fentanyl.
“We’re finding things like horse tranquilizers, xylazine,” said Seele. “With manufactured street fentanyl there's always a bunch of junk and trash in there with it.”
Seele believes the presence of these other drugs is likely due to dealers down the supply chain cutting the fentanyl with other substances to increase their profit margins. Normally, the substance used in that process is Benadryl, as it is cheap, plentiful, and carries low risk. But other drugs like xylazene offer a new challenge. Unlike fentanyl, the tranquilizer isn’t negated by Narcan. And in large enough doses, respiratory depression can happen.
“Very seldom do I ever have a drug overdose come back with just strictly one substance,” said Seele. “But usually the level of fentanyl is enough to kill anyway, regardless of these other substances. I just don't get that world. I don't understand it.”
The presence of these tainted drugs is just one reason why conducting an autopsy in a suspected overdose case is important. Autopsies have shown local authorities that xylazine first appeared in Howard County in 2018, for instance. Conclusive knowledge on a cause of death gives law enforcement needed insight into what is taking place on the street. An autopsy also brings peace of mind to loved ones and can impact court cases.
“Everything on the surface appears to be that it's an overdose, but we’ll do an autopsy,” said Seele. “There’s no way for us to really know without one. Just because there's a bag of dope laying on the floor next to the body doesn't mean that's what's in the body, right?
“And half the time, we don't know what the stuff in the bag is. We assume it probably has fentanyl in it. But at same time, there's all kinds of stuff showing up nowadays. So, we have to send it to a toxicology lab. What happens if we have a toxicology report come back weeks later negative for drugs? I've got a body now that's been cremated, or it's in the ground. What am I going to do now? I don't have a cause of death.
“There have been some new court cases coming along with people charged with dealing resulting in death. You have to support (the cause of death), so that's why we have to spend the money to do those autopsies.”
Overdoses are up across the state, but not in Howard County. What is being done locally to make a difference? Oliver chalks it up to services being offered that didn’t exist when fentanyl hit the scene.
“The more you get into sustained recovery solutions, like housing and sober living, that's supported and has more access to peers, I think you see some difference,” said Oliver. “And I think you could say recovery is easier when life is easier. If you work with somebody who's lived a similar experience, you generally are able to navigate life and recovery a bit easier.”
Turning Point opened its doors with a full array of services last year, providing the recover solutions Oliver highlighted. But the organization is moving forward and is introducing an expansion of services that could lower overdose and suicide rates.
“We'll be working with our community mental health center partners, whether it's Community Howard Regional Health or Four County, to manage an integrated mobile crisis response,” said Oliver. “Four County does on-site deployments. Community Howard is working with us on crisis peers who will be placed in the emergency departments.
“We'll have the stabilization center and crisis observation chairs here, allowing us to make sure when people come into the hospitals experiencing a non-fatal overdose, we want to make sure that they get engaged with a peer who can help them think about recovery planning and options, giving them care somewhere that's appropriate, but mainly saying, you've got somebody who can walk side by side with you and engage with you.”
Oliver added that Turning Point will follow up monthly to review non-fatal overdoses and determine whether the new intervention services have an impact.
If you or a loved one are struggling with an addiction or a mental health issue and need help, Turning Point is available to provide support and resources. Contact them by calling 765-860-8365 or visit www.turningpointsoc.org .