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County unveils opioid strategy

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Opioids are taking a lot of lives, and communities everywhere are struggling to contain the still unfurling epidemic.

Monroe County officials today released an Opioid Action Plan, which is meant to combat what County Executive Cheryl Dinolfo called "one of the most challenging public health crises our nation faces."  The Monroe County Medical Examiners office identified 206 opioid overdose deaths in 2016, up from 85 the previous year; the figures account for the 10-county Greater Rochester area, though 169 of the 2016 deaths occurred in Monroe.

The plan, which Dinolfo laid out during an afternoon press conference,  includes a lawsuit against prescription opioid manufacturers and marketers as well as doctors that helped market the drugs; county Department of Health commissions to evaluate medical system and treatment access issues; efforts to improve overdose data collection; expansion of school and community outreach programs; more public training sessions for the overdose reversal drug naloxone; and additional toxicology staff for the county Medical Examiner's Office.

The county is also working with the Rochester Drug Treatment Court — the first drug treatment court in New York State — to pursue a $1.8 million grant to expand its case management services and streamline its treatment and detox referral services.

The plan is quite an undertaking and all of its parts are important; the county's press release offers some useful detail. But the work of the commissions, which have been put together by Monroe County Health Department Commissioner Dr. Michael Mendoza, will be of interest to many in the medical, public health, and social work fields, as well as to members of the general public. Among the issues they plan to examine: the role of emergency departments in getting overdose patients into addiction treatment after discharge, and issues of access to treatment in general.

Monroe County Sheriff Todd Baxter emphasized the need for better, timely data on overdoses during his election campaign last year. He argued that such data could inform local law enforcement's response to opioids. Baxter stood with Dinolfo today as she unveiled the plan and explained that local law enforcement, emergency medicine, and public safety providers have already begun talking about what data they have and how it could be better shared.

Dinolfo also said that the number of overdose deaths may not best illustrate the extent of Monroe's opioid problem and that other measures, such as the number of times police and emergency responders use naloxone, may provide a clearer picture.

CITY talked to Dr. Jeremy Cushman, Monroe County's EMS medical director, for a story about public naloxone trainings this past summer. He said that Monroe County fire, ambulance, and police staff administered naloxone 657 times from the start of the year through July 1, and that the numbers were on track to exceed the 748 administrations in 2016.

He also said that responders are also up against increasingly stronger drugs, especially as heroin is displaced fentanyl, which is much more potent. Responders used an average of 1.3 doses per patient in 2015, but the number had risen about 1.5 to 1.6 doses.

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