ALBANY, N.Y. (AP) — Drug overdose patients rushed to some emergency rooms in New York’s Hudson Valley are asked a series of questions: Do you have stable housing? Do you have food? Times and location of overdoses are noted, too.

The information is entered into a new overdose-tracking system that provides near real-time glimpses into the ravages of the opioid-fueled drug crisis. The Hudson Valley Interlink Analytic System is among a number of surveillance systems being adopted around the country by police, government agencies and community groups. While the number of drug overdose deaths appears to have fallen nationally in 2018 for the first time in nearly three decades, the overdose death rate remains about seven times higher than a generation ago.

If there’s a spike in overdoses, the system will sent text
alerts to health administrators and community workers. And system users
can see what drugs are being abused for faster and focused responses to
the ever-evolving problem.

“We can’t get ahead of a situation
that’s already passed. This kind of information has to be given almost
instantaneously or else the narcotics that we’re trying to track have
already been sold, and they’re already on to the next batch,” said Sgt.
Julio Fernandez of the New York National Guard’s Counterdrug Task Force,
which helped usher in the system.

The Hudson Valley system was
adopted earlier this year by two hospitals north of New York City
serving areas hard-hit by drug abuse: St. Luke’s Cornwall Hospital in
Newburgh and Ellenville Regional Hospital. Administrators say nearby
Catskill Regional Medical Center is ready to enter information and that
Orange Regional Medical Center in Middletown will begin data entry next
month. Administrators are talking to other hospitals in the region about
signing up.

When a patient comes in, a nurse or another worker
enters data about the overdose and the drug. Patients retain their
legally required anonymity, but system users can still glean general
information about the age, gender and housing status of people in
trouble.

The idea is to “get that information out there as
efficiently and as quickly as we can,” said Daniel Maughan, a senior
vice president at St. Luke’s.

The data has helped track the rise
of fentanyl being laced into cocaine, Fernandez said. Dawn Wilkin,
director of prevention services at Catholic Charities of Orange,
Sullivan, & Ulster, said the system has guided workers on where to
conduct needle cleanup within days, instead of waiting a week or more.

Wilkin
said there have been no text alerts to warn of a spike in overdoses
sent out yet, likely due in part to a drop in overdoses locally.

Participation
by patients is voluntary. If someone is unresponsive or unwilling to
answer questions, workers enter the data that’s available. Kathy
Sheehan, director of emergency and trauma services at St. Luke’s, said
many patients cooperate, though there are just as many others who are
not willing to speak.

“They’re private,” she said, “they’re maybe afraid of the repercussions.”

Around
the country, workers on the front lines of the opioid crisis are
looking to speedier data access as part of their prevention strategy.

In
northeastern Minnesota, a pilot system involving six hospitals uses
information from case reports submitted by emergency room staff to
quickly provide health officials with warnings about overdose clusters
or unusual symptoms. The Minnesota Drug Overdose and Substance Use
Surveillance Activity system also analyzes blood or urine samples from a
subset of patients to be able to detect patient exposure to fentanyl or
other substances.

In Michigan, the System for Opioid Overdose
Surveillance processes data from medical examiners and from EMS
encounters in which overdose-reversing naloxone was administered. The
system maintained by the University of Michigan Injury Prevention Center
sends out reports to county health departments and other users.

The
most ubiquitous surveillance system is the Overdose Detection Mapping
Application Program, or ODMAP. The system allows first responders and
others to enter data on suspected overdoses, including locations, times,
naloxone dosages, victim ages and suspected drugs. The system designed
by the High Intensity Drug Trafficking Area program in the
Washington/Baltimore area sends out spike alerts to police and other
agencies. Launched as a pilot in January 2017, it is now in 48 states.

Officials
in Oneida County using ODMAP in upstate New York last month were able
to marshal forces after receiving a spike alert notification for 21
overdose reports and four fatalities suspected to be associated with
heroin within 15 days.

The Hudson Valley system gathers much of
the same data as ODMAP, though Wilkin said it also collects information
on patients’ housing and transportation status to give system users
additional insights into the social conditions of people fighting
addictions.

The Hudson Valley groups had been logging local
overdose data on to a shared Google Document before health-care IT
consultant Marisa Barbieri volunteered to create the current system. She
designed a dashboard to give users an at-a-glance look overdose trends.
She hopes to add a feature to warn where deadly batches of drugs are
headed next, similar to how meteorologists track of deadly storms.

“We need to be able to predict when a cluster is forming,” she said. “I don’t want to see on the news that 12 people died. I want a system to be watching.”

By Michael Hill

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