Getting out in front
Local organizations change approach to opioid disorder response
While opioid overdose deaths, and opioid-related deaths, increased from 2016-17 statewide based on Iowa Department of Public Health statistics, local officials with the Opioid Coalition said continued preparation to prevent the epidemic from taking hold in the area is necessary. There have been changes in some area organizations' approach toward identifying and preventing abuse. Some officials feel there are early indications the area may see an uptick in opioid abuse cases heading forward.
"We as an agency and an organization have really changed how we are approaching the opioid use disorder epidemic knowing that it is coming and knowing that we have to be prepared," Compass Pointe treatment specialist Kasey Fear said. "We have had a few cases of heroin use, not many, but enough that it is an indication. They have been talking about this for years, that the opioids were coming back. Now we are starting to see that. I do not think it is too far off that it is coming. We are doing the best we can with preparing for it."
Opioid abuse and treatment is handled through a number of local entities. The Opioid Coalition, also known as the Opioid Project, is made up of local hospitals, addiction treatment organizations such as Compass Pointe, Centers Against Abuse and Sexual Assault, Lutheran Services in Iowa and law enforcement, among others. They have coordinated their resources to address the opioid problem in the area currently and prepare for what might come.
Earlier this year, Iowa Gov. Kim Reynolds signed a law aimed at preventing "doctor shopping" and overprescribing. Fear said Spencer Hospital and Compass Pointe have responded with the help of state money by increasing training, using new technology to limit how medication is dispensed, working to set up Medicated Assisted Treatment providers in the area and making Narcan available to agencies which may use the drug to combat an opioid overdose. Compass Pointe has also changed their approach by reformulating how they question clients to better identify opioid abuse. Family services and opioid related patient services are available through Compass Pointe free of charge to qualifying clients.
"Doctor shopping can be a sign (of opioid abuse)," Fear said. "You may see them having lots of injuries, lots of ailments, lots of emergency room visits or they may be going to many different doctors. ... You see that they don't go to consistent doctor's offices or locations. Any signs of missing pills. When family members call in we say, 'Are there any medications in that home that can be abused?' People unknowingly keep their medications. Often times with opioid use disorder, they are more lethargic or have slower respirations."
While local officials are trying to remain vigilante, indicators over the last year have remained relatively consistent. On the state level, opioid related deaths increased from 180 in 2016 to 206 in 2017. According to the Iowa Great Lakes Drug Task Force, 3.5 grams of heroin were seized in 2016 compared to 0.51 grams in 2017. Heroin seizure statistics from the first half of 2018 remain relatively low at .25 grams.
"I believe our local law enforcement agencies will continue with the current strategy of readiness," Iowa Great Lakes Drug Task Force Director Casey Timmer said. "Although we have not seen the type of increases other areas have, we will still need to be sufficiently trained and equipped in the event there is an increase. The Iowa Great Lakes Drug Task Force has 13 member agencies who are committed to cooperatively investigating drug cases, sharing information and being ready for new trends in drug abuse."
Fear said increased awareness may be one factor that has contributed to relatively low abuse rates, but as a rural area, we are now just seeing the "natural progression." She pointed out the often sudden nature of an injury proceeding an opioid prescription makes anyone vulnerable in a unique way when compared to other substance abuse issues.
"When we did our community needs assessment, everybody addressed methamphetamine," Fear said. "Methamphetamine is a huge problem. Aside from alcohol, it is probably our drug of choice for persons served, but we don't see the overdoses like we see with opioids. Opioids are fatal."
Fear and Timmer agreed that local efforts through the Opioid Coalition have stalled. They are hoping to get the program back on track starting in October with more training and further coordination.
"There has been a lapse in the local Opioid Project, but I'm hopeful that the project will continue in the near future," Timmer said. "I'm confident that this issue continues to be a priority for many organizations in our area and there are ongoing efforts to increase our preparation level."