NC agencies go high-tech against opioid crisis
Using ODMAP, law enforcement and public health can input, monitor and track overdose data using times, dates and locations
By Elizabeth Pattman
Times-News, Burlington, N.C.
BURLINGTON, N.C. — Three Alamance County agencies are taking a new approach to fighting the nationwide opioid crisis with new software that tracks overdoses, naloxone administration, trends and more. Representatives from each of the agencies explained when they started mapping and how the data are helping them protect the community.
The Sheriff's Office, Burlington police and county Health Department all recently began using the Overdose Detection Mapping Application Program.
ODMAP allows agencies in both law enforcement and public health to input, monitor and track overdose data using times, dates and locations, as well as record information about fatalities and drug administration.
Meredith DiMattina, a crime analysis supervisor with Burlington police, explained that data are entered into the system from police or EMS reports. Personal data are redacted from the reports, but the information is made visible to all regional users. With higher access levels, national data can also be viewed, according to the ODMAP website.
In Alamance County, users include hospitals, health departments and emergency responders, she said. Government agencies serving public safety and health interests are the only organizations eligible to use this tool. The program is free, DiMattina said.
Stacie Saunders, director of the Health Department, called the software "a really interesting data tool." According to her, the health department was eager to take on mapping overdoses after a taskforce was formed in 2018 to combat the opioid crisis.
"All that data is there to help us figure out what we're doing well, where there are gaps, and what we can do to fill those gaps," Saunders said. "There is something in the data that helps us figure out if there's a need for intervention."
Mapping since December
How often the map is updated or referenced varies among agencies.
At the Sheriff's Office, a team of three deputies — Sgt. Chris Crain, Sgt. Josh Hayes and Deputy Jake Harris — are responsible for updating the database as new overdose reports come in. The Sheriff's Office has been mapping overdoses since early February, but also added previous overdoses, both fatal and nonfatal, to the database.
Burlington police used to have a specific employee tasked with maintaining the map, but DiMattina said that employee recently left to work on the federal level and the department has not yet appointed a new officer to maintain the ODMAP. The department has been mapping overdoses since December 2018.
Saunders said the Health Department has not gotten into a steady routine of updating the system yet, but plans to work out those kinks as they continue using the software. The department has been mapping for just a few months beginning in mid-2019.
How ODMAP helps
In 2017, there were 1,952 opioid overdose deaths in North Carolina alone, according to the National Institute on Drug Abuse. That places North Carolina at 19.8 per 100,000 people. The national overdose death rate average is 14.6 deaths per 100,000. Fentanyl and other synthetic opioids are the most lethal opioids in the United States, according to the Drug Enforcement Agency's 2019 drug threat assessment.
While tracking fatal overdoses has been commonplace for years, the creators of ODMAP said "there is an absent methodology nationally to track nonfatal overdoses." ODMAP seeks to change that by offering "the ability to collect both suspected fatal and nonfatal overdoses, in real time, across jurisdictions, to mobilize a cohesive and collaborative response."
When data are entered into the ODMAP database, color-coded pins are dropped on a map showing where the overdose occurred. The color coding indicates whether the overdose was fatal or not, whether naloxone was used, and if so, how many doses were used. Other information entered includes the suspected drug and whether a motor vehicle was involved.
The pins can help agencies identify areas where overdoses are happening more frequently to step up law enforcement patrols, identify drug trafficking areas, or identify where more public health prevention education or recovery resources are needed.
"It helps all the agencies to understand and appreciate just how widespread this problem is and how there needs to be more resources in the form of rehabilitation," Crain said. "I think it will help everybody understand that there needs to be more resources in general for this kind of problem."
Crain said the Sheriff's Office looks for clusters of overdoses when referencing the map.
"These hot spots tend to cluster in areas because there may be a batch of what we call hot dope or fentanyl laced heroin," he said. "We use it again for targeted enforcement in certain areas.
"If we can use that to get to the dealers, then we will definitely pursue that."
Crain said the Sheriff's Office will reference the ODMAP during vice/narcotics investigations as needed, but it has been used sparingly thus far.
"It can help us with those clusters where [overdoses] have been occurring at a higher rate," he said. "It could indicate the location of some dealer that we are trying to make a case against.
"We will actively seek an investigation against any person who sells narcotics that causes an overdose, whether fatal or not," Crain added. "We have done it several times already this year."
DiMattina, however, said Burlington has not used the map during investigations. In Burlington, the system is used to identify high-risk areas and try to predict future overdose activity by tracking surrounding metro areas.
On the public health side, Saunders said the information can be used "to better inform [the taskforce] and better inform our work."
"Let's think of what prevention education we need to do, and think about, are there any recovery centers in the area? It helps us fill those gaps," she explained of the thought process after seeing overdose clusters.
Chloe Donohoe, a special projects manager for the Health Department, also noted that the map provides a visual of naloxone administration that is useful for public health leaders.
So far this month, Alamance County has seen three reported overdoes, with one being fatal. In the past calendar year, the county has had 73 reported overdoses, nine of which were fatal and 30 of which involved naloxone administration. For the past 10 years, or the amount of time Alamance County officials have kept track of overdose numbers, there have been 423 reported overdoses, 35 of which were fatal and 149 of which involved naloxone administration.
Crain emphasized that these numbers reflect only reported overdoses and the numbers could be exponentially higher.
Officials also noted that parts of the county, including Graham, Mebane, Elon, Gibsonville and Haw River, are not using the ODMAP, so overdose numbers within their jurisdictions are not included in those figures.
"The ODMAP may be incomplete," Saunders said simply.
The Health Department has received only one or two monthly reports from the system thus far and is unable to identify major trends at this point, she said.
"I think it's too early to think about trends," she said. "Ask us again in a year."
However, both Burlington police and the Sheriff's Office said they have seen a common trend.
According to Assistant Chief Brian Long and Crain, overdoses throughout Alamance County tend to be cyclical. Crain said the number of overdoses in a given timeframe depends on what drugs are circulating and what is in the batch.
"It comes and goes in waves where you have certain times when overdoes are higher, then it drops down again," he said.
While looking over the ODMAP on Thursday, Crain remarked, "It's all over," referring to where overdoses are most common. "It's north, south, east and west."
Crain went on to explain that high traffic areas along the interstate as well as within the Burlington city limits are "hot spots" for overdoses. While Crain could not comment on specific areas of Burlington, he noted that the Sheriff's Office often gets involved with overdoses at the hotels along the highway, particularly those near Maple Avenue.
Crain also said Thursday that the southern end of the county sees frequent overdoses, but that trend has been slowing down in recent years.
"People say drugs are a victimless crime, but I don't actually think that's true," he said. "These drugs are destroying families."
©2019 Times-News (Burlington, N.C.)