Heroin Epidemic

Presentation Update:
Title Here
Additional Line ifMay 22, 2017
Needed

Maryse Amin, PhD, MS

Jennifer Mooney, PhD,
Date Here
MS
 Drug overdose epidemic
nationally

CDC/NCHS; 2016
 Drug overdose epidemic in Ohio

From 2000 to 2015, Ohios death rate due to

unintentional drug poisonings increased 642%
Increase in deaths driven by opioid-related overdoses

In Ohio, there were 411 fatal unintentional drug

overdoses in 2000, growing to 3,050 deaths in 2015

Approximately, 8 people die each day in Ohio due

to unintentional drug overdose

Ohio Department of Health, Bureau of Vital Statistics

Review of heroin-related overdose
data for Cincinnati
Data sources:
CincyInsights City of Cincinnati EMS transport (based
on site of the incident)

Epicenter Hospital response (based on patients home

address)

Greater Cincinnati Fusion Center (GCFC) Cincinnati and

Hamilton County police incident response

Hamilton County Coroner person could be from

anywhere, but died in our county
 EMS transports by month in
Cincinnati: May 2016-May 2017

CincyInsights Emergency Medical Services (EMS) incident response

 Top 5 neighborhoods impacted by
heroin epidemic in Cincinnati

Neighborhood Number of incident responses: 5.1.16-5.10.17

West Price Hill 208
Westwood 166
Downtown 145
East Price Hill 143
Over-The-Rhine 133

CincyInsights Emergency Medical Services (EMS) incident response

 Focusing on West Price Hill EpiCenter
hospital response in 2016
Figure 1. Number of overdoses sent to local hospitals by month in Price Hill
Jan-Dec 2016
40

35 34

30
30

25
Count

20

15 15
15 13
12
10
10 9
8 8
7
6
5

0
Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec
Month

Ohio EpiCenter Hospital accidental overdose cases

 Focusing on West Price Hill EpiCenter
hospital response in 2016
Figure 2. Number of overdoses sent to local hospitals by gender in Price Hill
Jan-Dec 2016
25

20

15
Count

10

0
Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec
M 4 3 6 6 6 7 8 16 22 11 6 8
F 4 4 0 4 9 2 4 14 12 4 2 5

M F

Ohio EpiCenter Hospital accidental overdose cases

 Focusing on West Price Hill EpiCenter
hospital response in 2016
Table 1. Number of overdoses in Price Hill by facility of service Jan-Dec 2016

Mercy
Anderson Bethesda N Christ CCHMC Good Sam Jewish UH West
Jan 0 0 1 0 1 5 1
Feb 0 0 1 0 4 0 0 2
Mar 0 0 0 0 3 0 1 2
Apr 0 0 0 0 0 0 4 6
May 0 0 0 0 2 1 7 5
Jun 0 1 1 0 2 2 2 1
Jul 0 0 1 0 1 1 3 6
Aug 0 0 0 0 4 0 13 13
Sept 0 0 0 1 4 0 13 16
Oct 0 0 0 0 1 0 7 7
Nov 0 0 1 0 0 0 4 3
Dec 0 1 1 0 0 1 7 3

Total 0 1 5 1 22 4 59 62

Ohio EpiCenter Hospital accidental overdose cases

 2016 heroin-related overdoses by
month
2016 Overdose totals by reported police incidents in Cincinnati and Hamilton County
450

400

350
Number of Overdoses

300

250

200 367

150
235
100 168
111 111
50 98 76 98 94
69 72 70

0 11 9 6 6 15 7 2 10 19 9 7 6
Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec

Fatal Non-Fatal

Greater Cincinnati Fusion Center police incident report

 2017 heroin-related overdoses by
month
2017 Overdose totals by reported police incidents in Cincinnati and Hamilton
County
350

300

250
Number of Overdoses

200

285
150

210 232
100
142

50
50
9 16 17 11 7
0
Jan Feb Mar Apr May

Fatal Non-Fatal

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: August 2016

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: September 2016

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: October 2016

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: November 2016

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: December 2016

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: January 2017

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: February 2017

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: March 2017

Greater Cincinnati Fusion Center police incident report

 Monthly heroin incident heat
map: April 2017

Greater Cincinnati Fusion Center police incident report

 Death to OD Ratio
Figure 1 & Table 1. Death to OD ratio;
Hamilton County residents, 2014 first half 2016*.

Risk Ratio (compare to

ED Visits Death to prev year) Confidence
Year (HamCo Residents) OD Deaths OD Ratio Interval
2014 907 247 0.27 -
2015 1,167 335 0.29 (0.89 , 1.24)
2016 (1st half) 809 141 0.17 (0.50 , 0.74)
Intervention response

Quick Response Team:

Pilot in Price Hill
QRT comprised of 1 fire lieutenant, 1 police
officer, 1 Talbert House representative (72 work
hours total)
Six weeks of implementation
Tuesdays, 10am-2pm
2 individuals in treatment through C.A.T. House
3 individuals in intensive outpatient therapy
 What is the data telling us?
The City of Cincinnati is greatly impacted

The City of Cincinnati police and EMS continue to

have a greater burden of response

Certain neighborhoods with greater needs, i.e.

West Price Hill

Naloxone is working to save lives

Data Limitations
Limitations with data compatibility (comparing
apples to apples)

No access to treatment data (e.g., beds available,

types of services offered)

Unable to determine unique cases

Confirmed death data is delayed by 90 days (e.g.,

fentanyl spike difficult to determine)
Recommendations

Opiate Community Resource Guide

Develop a centralized dashboard of treatment centers

to be updated in real time

Currently unable to determine to what extent those on

Medication Assisted Treatment (MAT) are represented
in overdose and overdose death data

Analyze QRT data to understand ROI and full

implementation
Questions?