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Sat, March 28

Overdose Fatality Review Board a tool to saving lives

In the search for ways to combat opioid overdose deaths across Yavapai County, MatForce leaders three years ago opted to find a way to do in-depth examinations of at least a sampling of those deaths.

The thought was to forge a collaborative, multi-agency effort to glean more about what preceded these deaths so as to better prepare how to fight back and save lives. They wanted to look into common themes behind the deaths, as well as track the type of drugs leading to the overdoses.

Most importantly, MatForce leaders wanted to talk with the families, or close relations, to those who died. They wanted to be certain not to let these statistics just be numbers; each person was someone’s child, someone’s mother, someone’s spouse, or someone’s brother or sister.

That vision birthed what in August 2016 became the Yavapai County Overdose Fatality Review Board, a 25-agency group representing leaders from law enforcement, criminal justice, social services, community and mental health services, as well as the state Medical Examiner’s Office, local pharmacists and early childhood advocates. This was the first of its kind in Arizona.

MatForce Executive Director Merilee Fowler said she and others researched a similar effort launched in the state of Maryland. They also considered similar models in Arizona established to review deaths of children and victims of domestic violence.

To fine tune the focus, a decision was reached to have the board limit its in-depth reviews to those cases deemed accidental overdoses, with volunteer family interviews counted as integral to the process, she said.

To Fowler, this process would be an exercise in futility if there was no action, no recognition of the people behind the statistics.

“Let’s not just look at the data. We need to take action,” she said.

Statistics

Between January and June 2017, the board reviewed nine overdose deaths from the prior year. The demographics on those cases included three from Prescott, two in Prescott Valley and one in Mayer. Two of the nine cases were heroin intoxication; two were lethal combinations of multiple drugs that included fentanyl; two methamphetamine intoxication; two mixes of methamphetamines and heroin and one case of mixed heroin and oxycodone intoxication. The average age of the victims was 32.

Further review of those cases showed that eight of the nine suffered with some type of mental health issue, four of them diagnosed with a severe mental illness. Five of the nine had spent time in jail and were on probation or parole at the time of death. Seven of the nine were prescribed opioids by a doctor at some time. Six of the nine used alcohol or marijuana at a young age.

Seven of the nine received outpatient treatment, five of them inpatient; two received medication-assisted treatment and one came to Yavapai County for treatment. Five of the nine had family members with a history of drug abuse or addiction, and three of the nine lost a loved one to drug abuse or addiction. Eight of the nine were unemployed; seven of them were homeless at the time of their death.

In 2017, the board examined an additional 22 accidental deaths, 12 of them undergoing a thorough review with family interviews. Eleven of the deaths occurred in either Prescott or Prescott Valley, with several of the deaths related to a mix of heroin and methamphetamines; one of those deaths was connected to fentanyl.

Across the first two years, Fowler said, the board delved into 21 deaths and came up with some 33 recommendations about ways to intervene so that those numbers don’t continue to climb, Fowler and others said. Fowler noted that the board reviews helped identify the arrival of fentanyl in Yavapai County.

To Fowler, this process would be an exercise in futility if there was no action, no recognition of the people behind the statistics.

“Let’s not just look at the data. We need to take action,” she said.

Recommendations

One of the interventions now in full force is the Yavapai County Sheriff’s Office “Reach Out” effort that requires all people who show up at the jail to have an assessment of needs. Upon their release, the individuals are directed to services that can help them avoid becoming repeat offenders, including options for mental health care and treatment for addiction.

MatForce founder and County Attorney Sheila Polk said this board has proved a catalyst for the state to encourage all counties to create such panels, and to inform and inspire the community to take a stand.

“In typical MatForce style, we don’t just react. We try and get ahead of the trends,” Polk said. “If everybody from every angle comes together, and if we do some digging, and involve surviving families perhaps we can learn how to do things better in the future and prevent more deaths.”

Yavapai County Community Health Services Director Leslie Horton said she sees this board’s work, most of it volunteer, as a frontline tool to saving lives.

By reaching out to families, and delving into these individuals’ past lives and struggles, Horton said she believes drug abuse becomes less of a mystery or stigma.

Out of this work have come intervention proposals and legislative efforts to limit prescription opioids and push people to think twice about the wisdom of recreational marijuana, board members said. Law enforcement leaders are targeting dealers of illicit drugs, and joining forces with educators to inform young people about the dangers of drug experimentation.

From the board’s analysis, Horton said there is more talk within the community about the need to fund more mental health services for children and teens. Doctors are rethinking how to treat pain, she said.

The tenacity of multiple agencies willing to tackle the frightening, and frustrating, complexities of drug abuse and addiction give her hope that these efforts will produce long-lasting results, Horton said.

“There’s not one silver bullet that’s going to solve drug abuse,” Polk concluded. “We’re not going to just try one thing and give up.”

#StopFentanylNow

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