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DEA: Fulton County is No. 1 for fatal overdoses in Pennsylvania

Written by Becky Metrick/Chambersburg Public Opinion | Aug 11, 2017 1:14 PM
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Photo by AP Photo/Mel Evans

(Undated) -- Eleven. 

That number may not seem earth-shattering, but it gave Fulton County the highest rate of fatal overdoses based on population among all 67 counties in the state last year. 

The ranking comes from the Drug Enforcement Agency's Analysis of Overdose Deaths in Pennsylvania report from 2016, done in partnership with the University of Pittsburgh.

Rates were calculated per 100,000 residents for each county. With just 14,900 residents, Fulton County has no where near that. When calculations were done to account for the difference, the analysis found that Fulton County would have experienced just more than 74 overdoses per 100,000 people. 

That's a 267 percent increase from 2015. 

That puts little, rural Fulton County over top the state's biggest cities.

Philadelphia County, which topped the list in 2015 but fell to fifth in 2016, had 59.9 fatal overdoses per 100,000 people. Allegheny County, home to Pittsburgh, came in sixth, down from 10th in 2015, with 52. 9 fatal overdoses per 100,000.

Franklin County made its own jump up the list, going from 49th in 2015 to 36th, with a death rate of 26.1 people per 100,000.

York and Adams counties ranked higher on the list, at 25th (29.2 fatal overdoses) and 29th (27.6), respectively. Lebanaon County was near the bottom of the pack, at 61st (12). 

All 67 of Pennsylvania's counties were included in the analysis, but there was a three-way tie for the lowest death-rate spots.

Officials weigh in

Officials with Fulton County Medical Center expressed surprise that their county passed Philadelphia in the DEA report. 

They even believe the number of overdoses - 11 - was under-reported. 

Elizabeth Gotwals, coordinator of Project Sustain An Abuse Free Environment, (Project SAAFE) said the number may be larger in reality for a couple reasons. 

In cases where the cause of death is cardiac arrest or respiratory arrest, it is not always clear that some form of opiate - which the report says is the most common type of drug found in overdoses in 2016 -  was involved.

"Do I think there were more in 2016 than were reported? Absolutely," Gotwals said. "Do I think there were more in 2015 than were reported? Do I think they've caught us at 11? I think at that point in time it's on it's way down."

READ: Major bust highlights growing fentanyl problem across Franklin County

Gotwals said some changes were made to the law where "unattended deaths" could be tested for blood and urine, where they previously might not have been, and that those may be considered an overdose once those tests are done.

While many places, like Franklin County, saw their numbers sky-rocket because of heroin and fentanyl, the data shows that in Fulton County the more frequent drug present in fatal overdoses was oxycodone. These drugs fall into the opiate/opioid category. 

On the ground

President Donald Trump on Thursday declared the opioid epidemic a national emergency, and said the administration was drafting papers to make it official. 

It's been a long time coming. The people working on the ground in hospitals and on drug task forces have first-hand experience of the problem, and have been doing what they can to battle it and educate the public about it along the way.

FCMC;s director of emergency medicine, Dr. Douglas Stern, said he has seen a lot of people come to the emergency room with symptoms of withdrawal, and he has noticed fewer people attempting to get prescription drugs.

Stern said this concerns him as well, because when they're not coming in for the regulated-but-still-dangerous prescription medications, they may be seeking more dangerous alternatives.

"It just makes me pause to think where all those people are going now," Stern said. "I know they're not all recovered, they're not all in Suboxone (a medication for opiate/opioid addiction) programs, because there's not enough programs out there."

That's not to say they aren't trying. In fact, within their own community, Gotwals, Stern and others believe the crisis more realistically hit at the end of 2015 and early 2016.

At Chambersburg Hospital in Franklin County, this year nalaxone has been used 98 times just between this April and July, according to data provided by Summit Health (earlier data was not available Thursday). The number includes doses administered at the hospital as well as doses given to restock the supplies of police departments and emergency personnel units. 

Nalaxone is a medication that stops an overdose caused by heroin, fentanyl, prescription painkillers or other opiates/opioids. It is administered at hospitals, is in the hands of many police and emergency personnel, and can even be purchased over the counter. 

Depending on how much of a substance an overdosing person took, nalaxone sometimes has to be administered multiple times before it works. District Attorney Matt Fogal said that so far this year, local police have successfully administered nalaxone 20 times out of 22 total times using it. 

Franklin County Coroner Jeff Conner said he projects there have been 14 overdose deaths so far in 2017, with some toxicology results pending for confirmation on cause of death.

Project SAAFE and other programs in the area have worked to get as many resources to the community as they can, at every level.

FCMC has worked a "safe hand-off" protocol into its emergency room, which guides people who come in for overdoses toward counseling and other help. 

However, there is a greater need for rehabilitation programs than are available, Stern said. 

"It's very difficult to get someone placed in the drug rehab program, right out of the emergency department. It's almost impossible, actually," Stern said. "I would say, it almost takes a miracle for a person to be placed, directly out of the emergency department, and that's where we have people falling through the cracks."

Staff at FCMC do what they can to treat the symptoms in the meantime, but will still spend hours trying to find a bed in rehabs all over the region.

The medical center also increased the number of Alcoholics Anonymous, Narcotics Anonymous, and Nar Anon -  a group for friends and family of addicts - to six, which is something they didn't have in 2015, Gotwals said. 

Gotwals credits the use of naloxone in the community as helping. Renee Grimm, an office manager, assistant and counselor with Gotwals, recently held several naloxone training sessions, prompted by recent overdoses of an even more dangerous drug, carfentanil, showing up in other areas of the state.

"We would like to see every household have Narcan in their home, because it's not just for people in active addiction," Grimm said, referring to the brand name of nalaxone. 

Having the overdose-reversal drug on hand can be helpful in other situations, such as when a child gets into a child-safe container and takes something they shouldn't, or when an elderly person accidentally takes too much of their medicine. 

"So we advise everyone to have it in their house," Grimm said. "Even if you only get the occasional prescription for an injury, surgery, whatever."

'People matter'

Gotwals said the FCMC staff sometimes get asked why they keep fighting for people who overdose again and again, saved by nalaxone each time.

"If you had somebody come into the emergency department in cardiac arrest, and they went out and came back, would, after the third revival or restart, would you decide that the fourth time you're not going to do that?" Gotwals said. "And how is that really any different?"

"It's not. If it was my kid, I'd do it 50 times," Stern said.

The community is aware of the problem, Stern thinks, especially those who have dealt directly with the problem. There is some denial, but the community is learning. And more importantly, the group hasn't lost hope, as Overdose Task Force Leader Erin Pistner said. 

"I think you always have hope. I think that's the ultimate goal," Pistner said.

Upon seeing Fulton County's overdose death rating, she wasn't discouraged. "For me it gives me more of a drive because people matter. Doesn't matter what their story is, they matter. 

This article is part of a content-sharing partnership between WITF and Public Opinion Online.

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