In 2017, drug overdoses were responsible for the death of five Indiana residents every day.
The state health department statistics show the year to be the worst of the opioid epidemic to this point. In that same period, 35 Johnson County residents died from overdoses, in addition to the 215 people treated in the county for non-fatal overdoses.
Indiana officials worked to control the ever-changing epidemic, trying to grasp how drugs are impacting communities and how to prevent people from dying. They’re hoping a new $21 million grant provides new weapons for that fight.
The Indiana State Department of Health announced the grant as a way to help the state, local communities and hospitals track overdoses more quickly and efficiently. With more up-to-date data at their grasps, health officials can detect the types of drugs that are posing the biggest threat to the public, and communities that are being the hardest hit.
For three years, the state will receive more than $7.1 million annually to address the overdose problem and allow local leaders to develop programs to address the opioid crisis.
"We’re working on all of these different strategies to help tackle this epidemic," said Katie Hokanson, director of the division of trauma and injury for the state health department. "This really is an evolving epidemic, so we can’t let up now. Now is the time to take as many resources as we can, to really put an end to it."
The Indiana health department has spent the past four years greatly improving its data tracking and response system through a variety of methods. This and other efforts to address the opioid epidemic appear to be having an impact. In 2018, preliminary data from the CDC shows that the number of overdose deaths in Indiana decreased from the year before, something that had not happened in at least 20 years. The state showed a 12 percent decline in the number of overdose deaths, from 1,808 to 1,584.
But that modest success shows why this grant money comes at a vital time, Hokanson said.
Indiana had requested funding from the CDC to pay for numerous programs that focused on better quality, comprehensive and timely data surveillance, Hokanson said.
"The goal was really to utilize this data to really drive prevention efforts at both the state and local level," she said.
One focus for state officials is collecting data from hospital emergency departments. Officials are already working with hospitals to get information each time they treat someone suspected to have a drug overdose.
The state health department can see trends and patterns emerging in that data and can determine the impact on a particular county or even a single hospital, Hokanson said.
The CDC grant will expand that monitoring to smaller hospitals and clinics to increase how quickly officials can see those patterns, allowing them to notify local officials.
"Having all of this information allows us to monitor the activity around these overdoses. The epidemic is evolving and changing, so if we don’t have this data, we can’t identify best practices and prevention," Hokanson said.
Currently, the only way that the Johnson County Health Department can track overdoses is if it results in death, and is stated as an overdose on the death certificate, said Betsy Swearingen, director of the department. The county has previously been awarded a state health department grant to distribute naloxone, known more commonly as Narcan, to counter the effects of opioid overdose.
The county department provides that Narcan to local first responders, who then report back whenever one is used. Otherwise, the county does not have the mechanisms to monitor overdoses, Swearingen said.
The new CDC grant also will be used for a program called Extension for Community Healthcare Outcomes. Officials connect local physicians with specialists to provide the most up-to-date information about treating public health issues — in this case, drug misuse and overdose.
With so many different communities dealing with the opioid epidemic, this allows for greater connection and collaboration among those who have found success with local-level programs, Hokanson said.
"You have all of these providers around the state, but not all of them might be up to date on the latest and greatest best practices," she said. "What could we do to convene subject-matter experts, give these providers education and information, and then walk through a case study so they now feel more empowered and informed when dealing with these types of situation."
Part of the grant funding will allow individual communities to apply for and implement those same successful programs in their own area. Johnson County officials, and others, will have an opportunity to apply for those funds over the three-year length of the grant, Hokanson said.
Other projects include expanding connection to the state’s prescription drug monitoring program to small physician practices, adding online opioid prescribing courses for post-overdose treatment protocols for emergency departments, and offering harm-reduction training for law enforcement. Funds will also be used to help the Family and Social Services Administration to connect people with care, particularly by helping to pay for ride-share transportation to get people to treatment centers.
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Overdose prevention grant
What: Funding provided by the Centers for Disease Control to help Indiana prevent and detect drug overdoses.
Amount: More than $21 million over three years
What will it fund:
- Collect better, more timely data on overdoses treated at hospital emergency departments so health providers can respond to emerging threats more quickly.
- Enhance Indiana’s INSPECT, the state’s prescription drug monitoring program, to provide health records electronically to small physician practices and improve real-time access to patient prescription histories.
- Create online opioid prescribing courses for dentists and post-overdose treatment protocols for emergency departments.
- Partner with the Indiana Family and Social Services Administration to support transportation costs for rides to treatment centers.
- Provide harm reduction training to law enforcement.
- Partner with the Indiana Department of Corrections to train inmates as peer educators to decrease rates of hepatitis C among high-risk populations.
Information: in.gov/isdh
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Indiana overdose deaths
2018 (preliminary): 1,584
2017: 1,852
2016: 1,518
2015: 1,236
2014: 1,152
2013: 1,049
2012: 999
2011: 957
2010: 923
2009: 903
2008: 818
— Information from the Centers for Disease Control and the Indiana State Department of Health
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