Overdose surveillance system helps fight opiod deaths, experts say.

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Capital News Service 

LANSING — A 2-year-old tracking system for opioid overdoses has greatly improved the ability of health agencies to monitor where opioids are a deadly problem and where to focus their efforts, experts say. 

The System for Opioid Overdose Surveillance, also known as SOS, is run by the University of Michigan Injury Prevention Center.

The university created the system in partnership with Michigan HIDTA — High Intensity Drug Trafficking Area — a federal program that tracks data from emergency medical service agencies and medical examiners across the state. 

The state has seen an increase in the number of opioid overdoses over the past few years, according to Debra Pinals, the medical director for behavioral health and forensic programs at the Department of Health and Human Services.

Pinals said there was a “significant jump” in opioid overdose deaths from 2015 to 2019. 

In Michigan, 1,980 people died from drug overdoses in 2015, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics. In 2019, that number increased to 2,385. 

“In 2015, 35% of opioid deaths were caused by synthetic opioids,” she said. That grew to 82% in 2019. 

Synthetic opioids are opioids that are synthesized in a laboratory and intended for medical use. They include fentanyl and methadone.

Natural opioids, or opiates, include substances such as morphine and codeine.

Pinals said the surveillance system has improved the state’s efforts to intervene in areas where overdose deaths are prevalent.

Naloxone is a drug that can treat a narcotic overdose in an emergency situation. 

Calhoun County reported the highest rates of emergency naloxone use between Jan. 1 and Sept. 11, 2020, with 207 cases for every 100,000 people. 

Wayne County had 175 cases of emergency naloxone administration for every 100,000 people over the same period. 

Multiple counties had fatal overdose rates above 25 deaths for every 100,000 people during that time, including Wayne (39), Ingham (35), Genesee (30) and Muskegon (26).

The most common opioid found in toxicology reports was fentanyl, which appeared in 86% of cases.

Pinals said, “We’re carefully reviewing the medical examiner’s reports, over time, (to) allow us to see trends across the state and compare and contrast where we need particular interventions.,” 

The system presents first responders and health authorities with such up-to-date data as instances of the naloxone being used by medical professionals so they can better target their opioid prevention and response efforts. 

There are two primary sources for the data, one about fatal overdoses and the other about nonfatal overdoses, said Jason Goldstick, an associate professor of emergency medicine at U-M’s Injury Prevention Center who helped create the system. 

Nonfatal overdoses are incidents where an emergency medical technician administers naloxone.

Other experts agreed that the system has greatly helped mitigate the opioid crisis. 

“The SOS system really adds a lot of value, for people and organizations that are working on the local level, because they can log in and see what overdose activity looks like on any given day,” said Sarah Rockhill, an epidemiologist with the state.

“It’s meant to be a snapshot of current overdose activity. They can also see where those overdoses are being clustered within their communities,” she said. 

A doctor who focuses on substance abuse said the surveillance system has greatly assisted his organization’s response efforts.

“Before SOS, it was extremely difficult to get data,” said Kanzoni Asabigi, the vice president of the Detroit Recovery Project, a nonprofit that helps people with substance abuse problems. 

“I’ve been in this field for a number of years, and what usually happened was you got the data and it’s two years old and that didn’t really have any immediate impact on what we did,” he said. The system “gives us almost real-time data.”

It allows organizations like his to better understand how many overdoses are reported in a ZIP code and where to provide products such as fentanyl test strips, condoms and clean needles to prevent sexually transmitted diseases. 

The Detroit Recovery Project also uses the information to target areas with high rates of overdoses and train people there on how to use naloxone, Asabigi said. 

Overdoses in Detroit tend to affect people, ages 55 and older, while overdoses reported in some other parts of Wayne County tend to occur in individuals in their 20s or early 30s, Asabigi said. 

The overdose surveillance system can provide medical agencies with demographic information on areas with high rates of reported overdoses, including age groups, gender and race information. 

“We need different strategies,” Asabigi said. “The strategies have to be different for an older population, versus a younger population and the different demographics that come into play.” 

This would include older users with other health problems such as diabetes and high blood pressure.

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