On paper, they’re numbers: twice as many people in Cortland County dead of opioid overdose this year compared with last year. Overdose calls are up, too.
To a cop, those are people. And if Cortland police Lt. Michael Strangeway has seen peaks and valleys in drug use in Cortland during his three-decade career, he’s seen nothing like this.
“It’s alarming for us locally to be dealing with numbers like this,” Strangeway said.
But the trend isn’t just countywide, it’s being seen across the nation.
“More than 40 states have reported increases in opioid-related mortality as well as ongoing concerns for those with a mental illness or substance use disorder in counties and other areas within the state,” states a news release from the American Medical Association updated Sept. 8. To top it off, a number of branded packages of heroin are being sold across the county and a deadly synthetic opioid new to the Cortland area was behind at least one overdose death.
A Siena College Research Institute poll also found 59% of New Yorkers report knowing someone who has abused opioids. That is up 5 percentage points from two years ago. And 78% of respondents still believe opioid abuse is an issue in their area, although that number is down from 82% in 2018.
The increase in calls in the city has led police officials to urge people to seek recovery options, while they investigate where the drugs are coming from.
It’s a process that the Drug Enforcement Administration task force based in Syracuse helped the city with before the city pulled out of the program last year.
But new efforts are under way to counteract the trend.
Overdoses, deaths rise
City police have seen a rise in overdose calls, the department has reported twice in the past two weeks. Strangeway said Monday that two people had died from overdoses in the last 10 days, following another death reported Sept. 18.
“In the last 45 days, city police have responded to 15 calls for service involving individuals who have overdosed on drugs (opiates and bath salts, or ‘Molly’),” Stangeway said Sept. 18 in a news release. “That number is up from five cases in the preceding month. Those are just the cases where police were notified. Many others are treated personally through the use of Narcan, which many users now carry on their person for use upon themselves in the event they accidentally overdose. Others still, are transported to the hospital without law enforcement’s knowledge.”
On Monday, Cortland police reported officers had responded to five more overdoses in the past 11 days where naloxone was required to stop an opioid overdose. Still, two people died.
Cortland County Coroner Whitney Meeker said 20 of the 34 autopsies performed this year were overdoses.
“We did not have nearly that many last year,” Meeker said Monday.
In 2018, the county had four overdose deaths, according to the state Department of Health. From January 2019 to June 2019, there were three deaths, but the state has yet to update its reports to include the rest of 2019.
Meeker said she believed there had been 10 deaths in 2019, but didn’t have firm data.
In fact, overdoses have become so common that toxicology tests are routine, Meeker said. But the cause of the increase isn’t so clear.
“We have heard anecdotal reports of increases in substance use related to COVID19,” said Evan Frost, the assistant director of communications and public information for the state Office of Addiction Services and Supports, in an email Wednesday.
However, without hard data, it’s difficult to conclude how much of a role COVID had on overdose numbers, said Sara Watrous, the project director of the HEALing Communities Study, which is researching opioid use in Cortland County.
“We won’t have definitive data to confirm overdose deaths for likely another 6 months,” she said in an email Wednesday.
The county Health Department reported 87 overdoses between March 1 and Sept. 29, compared to 74 between March and September of 2019.
More data are also needed to determine the effect of bail reforms on overdose numbers, she said.
Meeker said bail reform laws haven’t helped because people in jail can get help they may not get if they’re not held.
“There were a lot of programs offered through the jail,” she said.
A new drug
Of the overdose deaths this year, only one has been related to a new drug appearing in Cortland County: brorphine, a cheap synthetic opiate used to cut heroin. But more may come.
“We’re waiting on more toxicology reports,” Strangeway said. That can take two months.
The police department originally announced Sept. 18 the drug had been found in the county.
“It was reported by the pathologist in that case, this was the first instance of overdose by brorphine that he was aware of in the area,” Strangeway had said.
Brorphine is similar to fentanyl, according to The Center for Forensic Science Research & Education.
Strangeway said brorphine is largely untested and it’s unclear whether it can be passed through the skin like fentanyl.
Meeker said the drug may appear in white powder form, making it difficult for users to distinguish from other substances. Meeker had said it’s unclear if naloxone will stop the effects of brorphine, as it does heroin.
“I hope so, but I don’t know,” she said.
Stamped bags leave mark
City police are seeking the drug’s source. Strangeway said several stamped waxed bags have been collected as evidence from some overdose calls.
“The presence of stamped bags in this community is a disturbing sign,” Strangeway said. “Bags of this sort typically originate in large metropolitan areas (such as NYC/ NJ area, Philadelphia and Chicago) where vast quantities of heroin is bagged for individual use and stamped to identify the drug that is being marketed by an organization.”
Brand popularity leads dealers to seek more profit by mixing it with other synthetic substances like fentanyl or brorphine.
“Heroin itself is a strong opiate and results in overdose deaths around the country every day,” Strangeway said.
No drug task force
The city used to be part of a Syracuse based DEA task force that traced the origin of drugs, but withdrew a year ago.
Cortland Police Chief F. Michael Catalano said he’s not sure remaining part of the task force could have made a difference.“It’s hard to speculate if it would’ve resulted in less deaths,” he said.
The city Common Council voted in two separate meetings on Sept. 17 and Oct. 1 to have the city police department drop out of the task force. Strangeway had been a member for two years, but city leaders were concerned about the cost of mileage and should an officer be injured outside the city.
Both he and Catalano had said they were shocked by the decision.
Catalano said staying on the task force could’ve made a difference in at least one aspect though.
“I was under the belief it could help stem the drugs coming in,” he said.
Sheriff Mark Helms said that the county wouldn’t join the DEA task force, but declined to explain why.
Now the community faces the task of finding the drugs’ origins alone. And Syracuse police Sgt. Matthew Malinowski said Syracuse hasn’t seen the brorphine, yet.
The community can still act. The greater Cortland area offers services, including naloxone training, inpatient and outpatient services and a program through the city police department called the Angel Program.
The program lets drug users turn themselves, and their drugs, into Cortland police. If they have no outstanding warrants, they can be taken to Helio Health in Syracuse by a member of Cortland Family Counseling Services Center for Treatment Innovation
Five people have participated in the Angel Program since its inception, said City Lt. David Guerrera, three in 2019 and two so far this year.
Frost said OASAS has expedited approvals for providers who are using tele-medicine practices during COVID.
“OASAS has also worked with the Opioid Treatment Program providers to ensure all individuals on medication-assisted treatment have uninterrupted access to their medications by expanding take home dosing of methadone and working with local partners to facilitate home deliveries to those isolated due to quarantine or inability to travel to their provider,” he said.
But there are a few things communities can do to help too.
“Each community has different challenges and needs, but the most important thing is to ensure that services are available,” he said, and to reduce the stigma of treatment.
Study seeks answers
The county, along with 15 others in New York, is part of an $86 million, four-state study by Columbia University to determine how to reduce opioid deaths 40%, according to a resolution the county adopted in 2019 to join the study.
“This project is just getting off the ground so we won’t have any final results for a few years, but it is using a data-driven approach so as we implement strategies, such as increasing access to naloxone, we will be measuring the impact,” Watrous said.
The study will take four years. Cortland County was chosen to participate in wave one of the study, meaning the county won’t see additional funding to implement programs for two years.
“We are currently conducting a comprehensive needs assessment to better understand the issue of opioid use and overdose in Cortland County so that we can focus on the strategies that will be most effective for our community,” Watrous said.
She said groups have started coming together to distribute naloxone. There is also a group exploring the possible use of software that would track fatal and non-fatal overdoses quickly to help communities to identify hot spots.
“The more data we have,” Watrous said, “the better we are able to address this issue in a targeted, strategic way.”