Long before President Donald Trump declared the opioid crisis a national public health emergency, local authorities were dealing with the fallout.

Drug overdose deaths had risen precipitously over several years as local authorities sought answers – both to why this was happening and how to stop it.

In Bethlehem alone, reported overdoses increased from 79 in 2015 to 209 in 2018, according to Health Bureau Director Kristen Wenrich.

Meanwhile Lehigh County Coroner Scott Grim said there were 183 drug-related deaths under his jurisdiction in 2018, a number which may rise as pending toxicology tests are completed.

And yet, these deaths may be only a fraction of what we’d expect to see if not for agencies across Pennsylvania – including Bethlehem police, fire and EMS – all including training and use of the life-saving drugs Narcan (or Naloxone).

A report recently released by Police Chief Mark DiLuzio indicates his officers administered Narcan in 72 overdose incidents in 2018, and only one person died later at a medical facility. He said the fire department administered it 15 times, and city paramedics administered it 115 times.

Lansford Borough Police Chief Jack Soberick said his department has frequently used Narcan to counter the effects of opioid overdoses. “We were not the first department to use it in Carbon County, but certainly used it probably more than all the departments combined,” he said. “It’s a tool in our arsenal.”

Soberick added, “Contrary to misconception, we weren’t going back to the same addicts over and over again and saving them. “Usually when we got that call, it was somebody known to us as a user.”

Soberick said he believes the solution has to be a “multipronged” approach.

“We make arrests, we enforce the law, we try to assist people in any way possible to help get people into rehabs,” he said. “Our job is to help break that cycle.”

Schuylkill County coroner David Moylan said the opioid crisis is real.

“Our problem has not lessened,” Moylan said. “We’re deluged with opioid intoxication cases.”

So many cases

“If the president wants to declare a national emergency, I’d declare it on the opioid crisis,” Moylan said. “It’s an emergency crisis.

“There’s so many of these cases that we can’t autopsy them all,” he said. “We’re going to present this to the Centers for Disease Control and Prevention.”

Moylan added, “We have a tool to try to stem this epidemic. We need to take this tool that the lawmakers have given us and use that to control the delivery.”

“It’s an epidemic,” he said. “Essentially you’ve got to find where the source is, where the pathogen is, and eradicate it.”

Moylan explained that in his role as a coroner, he must determine the cause of death, and then figure out the manner.

“These aren’t natural deaths,” he said. “Could it be an accident? Yeah I can see an accident, but most of them aren’t accidental.”

Carbon County Coroner Robert Miller said he isn’t sure what the answer is.

“I really don’t know what the answer is. They’re trying to rehab and stuff like this,” Miller said. “I don’t think these people listen. They know what drugs can do to their system. I don’t think that they care.”

Miller said that in 2015, the county had 18 overdoses for illicit drugs, 18 in 2016, 28 in 2017, and 29 last year, along with two cases pending.

“We’re not that bad in Carbon,” he said. “Some of these numbers in other counties are astronomical.”

Miller said he attributes that to Carbon County having such a high elderly population.

“Fifties and 60s and up, we don’t see many overdoses there; it’s mostly 30s and 40s,” he said. “I don’t know what the answer is; it’s a mixture.”

Getting treatment

Last year, state Rep. Doyle Heffley, R-Carbon, sponsored a bill that would create a detoxification bed registry to facilitate treatment for drug addiction.

Under the bill – which passed the House unanimously – the Department of Human Services would develop and administer an Internet-based detoxification bed registry to collect, aggregate and display information about available beds in public and private inpatient psychiatric facilities and licensed detoxification and rehabilitation facilities for the treatment of people in need of inpatient hospitalization or detoxification.

This registry would contain information about facilities and licensed providers; information regarding the number of beds available at a facility; and provide a search function to identify available beds that are appropriated for the treatment of a substance abuse emergency.

Heffley also introduced a bill, Warm Hand-off legislation, an act providing for transferring overdose survivors to addiction treatment, for a comprehensive warm handoff initiative; establishing the Warm Hand-Off Initiative Grant Program; providing for consents and for immunity; establishing the Overdose Recovery Task Force; and, providing for overdose stabilization and warm handoff centers, for rules and regulations and for an annual report.

He said hearings are scheduled next month in Harrisburg for the Warm Hand-off legislation, a bill that has been modeled after the Blue Guardian program that’s been successful in Lehigh County.

“There’s been a lot of talk lately about Narcan that’s been administered hundreds of times throughout the county and state, saving thousands of lives,” Heffley said. “(The question becomes), how do we get people into treatment.”

Heffley said Pennsylvania lost about 2,300 people to overdoses last year, noting that it’s the No. 1 leading cause of accidental deaths in the state.

“It really is an epidemic,” he said. “There’s nothing more heartbreaking then sitting with a family who lost a 19- or 20-year-old daughter or son to opioids addiction.”

Heffley said the opioids epidemic is something that affects every level.

“It really is something that we need to address,” he said. “We need to do more to keep our community safe.”

Heffley praised the federal, state and local government for stepping up.

“We all have to work together in this,” he said. “I commend administration, and the funding they have provided is a good thing.”

While the breadth of the epidemic is daunting, the state administration’s continuing developing communication and coordination between agencies is helping officials get a better grasp of what they are facing and how to help victims. Deputy Secretary for Health Preparedness and Community Protection Ray Barishansky said via a recent phone interview a 17-state Prescription Drug Monitoring Program, new treatment options and accessibility and growing use of Narcan are early and successful steps in the fight. But he warns, “This is a crisis that’s developed over several decades. We’re not going to be able to reverse it in a year or two.”

He said while authorities are using the PDMP to reduce and more clearly monitor opioid prescriptions, reducing them by as much as 20 percent, they are seeing an increase in cocaine, methamphetamine and fentanyl use. “This is not an easy fight. I don’t think there’s a silver bullet on this one,” he said, but explained many initiatives are active from the federal to local level, and all are working together to mature and evolve best practices. “No one initiative is going to make the difference. It’s all of them coming together.”

Heffley said he plans to continue to work with the state Department of Health to “encourage them to make sure these solutions don’t get bogged down in bureaucracy.”

“We’re losing more people to this opioid epidemic than we ever did to AIDS,” he said. “Addiction left untreated is always fatal. We want to try to help get these people treatment.”

Barishansky says the life-saving medication is at least a key to that while officials nationwide seek other options. “You have to be alive to get into treatment. Naloxone can be the bridge – helping them stay alive and getting them into treatment. [Survivors] are the best advocates.”