Commentary: Chester County joins fight against OD epidemic

By Michelle Kichline

Chester County is one of the wealthiest, one of the best educated, and yes, even one of the healthiest counties in the nation. But we are not immune to the heroin and opiate epidemic. We face the same crisis that is creating significant issues - and causing deaths - across Pennsylvania and America.

Recently, Philadelphia City Councilman David Oh asked me to testify at one of his community meetings on the crisis - to confirm that prescription medications and heroin are as much a problem in places like Chester County as they are in Center City. With the blessing of my fellow commissioners, I accepted the invitation because we want to share how Chester County is working smart and hard to control the issue, treat it, teach everyone about it, and try to stop it.

Chester County, like the rest of the nation, has been overprescribing, undereducating, and falling behind in the prevention and treatment of opioid drug abuse. Americans are the number-one consumers of opioids. Not only are we the top consumers, but our level of consumption is skyrocketing. According to the National Institute on Drug Abuse, prescriptions for opioids have dramatically increased - going from 76 million in 1991 to 207 million in 2013.

Opioids are being abused by young, old, wealthy, and poor. And abuse of these prescription drugs has opened the door to heroin use, especially among young people, because heroin is cheaper and easier to obtain.

According to the Centers for Disease Control and Prevention's National Center for Health Statistics, there were nearly 44,000 deaths from drug poisoning in 2013, 81 percent of which were accidental overdoses. Heroin and other opiates were the most commonly used drugs. In Chester County, our overdose death rate has doubled since 1999. We had 72 accidental overdose deaths in 2015, occurring in 36 of our 73 municipalities - not just in the larger urban centers but across the county. The number of deaths would have been higher had it not been for the use of Narcan, a medication used to block the effects of opioids, especially during an overdose. Currently, 46 of our 47 police departments carry Narcan, and 46 "saves" have been performed.

What is Chester County doing to address the problem?

We have established an Overdose Prevention Task Force, led by the commissioners, District Attorney Tom Hogan, the Health Department, and the Department of Drug and Alcohol Services.

The district attorney is taking a strong stance in the arrest and prosecution of individuals who deal drugs, and he even notes that "dealers now charge a premium to come to Chester County." His office has installed 19 medication collection boxes, covering every corner of the county, and his team has made key contributions in the drafting of legislation to encourage the use of Narcan and reporting of overodoses without the risk of criminal penalties - so-called Good Samaritan laws.

Officials with Drug and Alcohol Services are going to great lengths to ensure that access to appropriate drug treatment is available. The department provides education to treatment providers and the public on insurance laws and benefits to ensure access to the right care.

The Health Department is tackling the epidemic from a public health perspective, setting up an overdose death review team to track data, identify trends, and make recommendations for policy creation. Importantly, it's focusing the education of doctors and other health-care providers on opiate prescribing practices.

Collectively, task force members are increasing public awareness in schools - meeting with more than 30,000 students in 2015 using the Narcotics Overdose Prevention and Education program. Chester County was the first in the region to establish a treatment court.

Most notable are three events that are bringing all parties together to great effect. An Overdose Prevention Symposium, held in October, was attended by more than 90 community members, students, and professionals representing physicians, treatment providers, first responders, school nurses, and law enforcement.

Last month, a second symposium was attended by the Pennsylvania physician general, targeting doctors, and other health-care providers. The event was significant because it recognized that despite the many strategies introduced, the heroin and opiate epidemic will continue to exist until we control prescription opioids. Why prescribe 30 when three will do? Or maybe none at all?

Our third event, scheduled for August, will focus further on opiates and overdose prevention.

The collaborative work that is being done to address the drug abuse and overdose problem will continue in Chester County for as long as the problem exists. But as with any major public health issue, our efforts must also include collaboration with neighboring counties and states. We cannot do this alone.

Michelle Kichline is a Chester County commissioner. mkichline@chesco.org