Since 2010, more than 400 people have died of drug overdoses in Washington County, including 106 in 2016 alone.
That year, the Washington Opioid Overdose Coalition was formed to tackle the problem. And during the group’s quarterly public meeting held Oct. 15 in Peters Township, information presented indicated some positive results: The number of overdose deaths dropped to 97 in 2017, 74 in 2018 and 32 through the first half of 2019.
But while the numbers are trending in the right direction, county District Attorney Gene Vittone, who co-chairs the coalition, acknowledged that its efforts still have a long way to go.
“We have a goal of completely eliminating this threat from our community,” he said, “and we will continue to work until that goal is reached.”
The coalition – co-chaired by Cheryl Andrews, executive director of the Washington Drug and Alcohol Commission – includes representatives from various county health and public safety agencies and organizations, along with members of the recovery community, such as prevention specialists and treatment providers.
According to Vittone, the group is promoting 30 initiatives aimed at helping people who need it get treatment, investigating and prosecuting drug dealers, and employing prevention and education strategies to eliminate new users.
Regarding the decline in overdose deaths, he cited county officials’ actions following 2014 state legislation allowing emergency personnel to use naloxone, which blocks or reverses the effects of opioids.
“We moved quickly to use money taken from drug dealers to buy naloxone and get it to first responders so that they could save lives,” Vittone said. “We also installed medication drop boxes in police stations to eliminate dangerous drugs which were piling up in homes.”
One of the guest speakers at the public meeting, Dane Miller of the University of Pittsburgh Program Evaluation and Research Unit, provided numbers from the start of 2018 through the first six months of this year:
“A total of 1,317 naloxone kits have been distributed by the Washington County Drug and Alcohol Commission. Of those, 171 have been reported as being utilized. And of those, 95% of the administrations have been successful.”
Miller explained that the overwhelming majority of overdoses involve fentanyl, the synthetic opioid that is 50 to 100 times more potent than morphine.
“In 2019, fentanyl is showing up in approximately 73% of postmortem toxicology reports,” he said. And that percentage jumps to 85 to 90 when taking into account fentanyl-related substances such as the extremely powerful carfentanil.
By gender, males account for most overdose deaths in Washington County, between 60 and 70%. But Miller said the statewide ratio is about 75/25, male.
“Even though women are experiencing fewer than half of the overdose deaths in the county, they perhaps are at higher risk of an overdose death when compared to the rest of the state,” he said. “Information like this is crucial to combining public health and public safety in determining strategic steps to correct this problem and really get to the crux of why these things are happening.”
Compared with other parts of the state, though, Washington County has a higher availability of services for combatting substance use disorder, a term widely used to describe drug addiction.
“I want to emphasize that addiction is a disease. It’s chronic, but it’s treatable,” Dr. John Six, Greenbriar Treatment Center medical director, said. “We’ve known this for decades, but yet there is still an unfortunate stigma associated with substance use disorder – opioid use disorder, in particular – as a moral failing, and this could not be any more untrue.”
He spoke about the effectiveness that he and other professionals have experienced with medication-based treatment, in conjunction with or as an alternative to more traditional abstinence-based approaches.
As Six explained, treatment for opioid use disorder primarily employs one of three types of medications:
Methadone, a synthetic substance that has been available since the 1960s, reduces opioid craving and withdrawal. It is a Schedule II controlled medication, and as such, is heavily regulated and not easy to obtain.
- Buprenorphine – Suboxone, Bunavail and Zubsolv are brands – is more accessible, as it can be obtained through a family physician. Its effects are not as strong as methadone, and it has a reduced potential for respiratory depression and as such “is considered much safer for a patient to self-administer,” Six said.
- Naltrexone blocks the effects of opioids, including pain relief or feelings of well-being that can lead to abuse. Brands include Vivitrol and Revia, and the medication can be swallowed or injected.
“I will stress that no one size fits all,” Six explained. “There’s no reason someone can’t go between one and the other. So if abstinence-based has not worked and you are being successful on MAT, we would certainly encourage that.”
Another speaker at the public meeting was Steven Denhup, regional intelligence manager for the U.S. Drug Enforcement Administration. While he acknowledged Washington County’s continued reduction in overdose deaths, he provided a fairly grim report on what types of substances are becoming prevalent in Western Pennsylvania.
“We’ve seen a drastic increase in methamphetamine,” he said about the highly addictive stimulant. “Washington County now, for the past three months, has seen an increase in drug seizures of methamphetamine. So it is here, and it’s being mixed with other drugs.”
Cocaine also is on the rise, Denhup said, as supplies increase in Colombia and other South American countries that permit unlimited growing of coca plants.
“Two years ago, we saw production go up,” he explained. “It’s about two years to get the cocaine to the streets here in the United States, and now we’re seeing it.”
DEA agents also have noticed more activity in the Pittsburgh area by fentanyl traffickers from the Dominican Republic, who usually are based in and around Philadelphia and New York City.
“They definitely know there’s a market here and are continually trying to pump up the market,” Denhup explained.
Heroin, which in the past came mainly from other countries, now is a threat from Mexico.
“Instead of buying Colombian heroin and moving it to the United States, they actually made the raw product themselves, then brought it to the United States,” Denhup said. “And that has really bumped up the heroin purity, as well as heroin supply on the East Coast, which then got here to Pittsburgh.”
The Washington Opioid Overdose Coalition meets monthly at the Washington County Courthouse Jury Lounge. For more information about the group, visit www.overdosefreepa.pitt.edu/washington-opioid-overdose-task-force.