Hartford Business Journal Special Editions

34 Hartford Business Journal • December 9, 2019 • www.HartfordBusiness.com 34 Hartford Business Journal • December 9, 2019 • www.HartfordBusiness.com HEALTH CARE HEROES 2019 Early warning system aims to prevent opioid overdoses By Karen Sackowitz Special to the Hartford Business Journal A paramedic for over 25 years, Peter Canning began to see a troubling pattern five years ago. "Opioid overdoses were starting to climb; every month was more than the previous month," he said. "I start- ed keeping a spreadsheet, marking down the patient's gender, age, what drug they used, how they had taken it. Then I started paying attention to the heroin bags, which are often branded by the dealers. I was looking around on the ground to see what brands were involved in overdoses." By educating himself on the crisis and contemplating how EMS work- ers could use their front line posi- tion to be part of prevention efforts, Canning says the concept of an early warning system began to take shape. "I was already tracking overdose data; what if other paramedics were too, and what if we could put it all together to share with local harm reduction groups and public health departments?" he says. Canning brought his idea to Dr. Rich Cayman, medical director at UConn and the EMS medical direc- tor for the state of Connecticut. They were conceptualizing ele- ments of a pilot project when they met Dr. Charles McKay, then acting director of the Connecticut Poi- son Control Center. After hearing Canning give a talk about a pos- sible early warning system, McKay offered to host the system, given that poison control had operators available 24 hours a day. "There was a need to monitor and surveil overdoses in a more systematic way, both regionally and statewide, and to identify emerging threats as they occur," says Dr. Su- zanne Doyon, current medical direc- tor of the Connecticut Poison Control Center. "We also needed information that was actionable — information we could use to generate a response proportional to the threat." UConn Health's Connecticut EMS Statewide Opioid Reporting Directive pilot program officially launched in May 2018. On June 1, 2019, the program began running statewide. Incredibly, its impact was felt on day one. "On June 1st, a pattern began to emerge; users were overdosing on what seemed to be an opioid, yet when they responded to naloxone and woke up, they told their care providers they never sought to do heroin or fentanyl. They were strictly crack users," Doyon explains. Through the newly launched pro- gram, information gathered by Poison Control was used to determine that the crack in that area had been con- taminated with fentanyl, a substance 50 times stronger than heroin. "Poison Control immediately notified the state health depart- ment," says Canning. "By the end of the day, we had notified the Hartford local health department, the Hartford police, and all harm- reduction agencies, which were able to get out on the street and warn crack users that there could be fentanyl in their supply. Over a period of four days, there were 27 overdoses and five or six fatalities; but it could have been a lot more if we hadn't gotten the warning out." Overdose information fed from EMS workers is also used to popu- late a heat map to quickly identify critical areas. "It's a dynamic overdose map," Doyon says of the tool, originally created as part of a national High Intensity Drug Trafficking Area (HIDTA) program. "As we enter overdose information, the state and local health departments can look at it to visualize and determine what customized response they want to have to a particular event." Canning says the overdose map also helps in advocating for more community services to combat the opioid epidemic. "Our harm-reduction coalition set up a walk-in center on Albany Avenue, where a user can walk in, get clean supplies if they need them or have somebody to talk to if they just want help," he says. "They've been talking about opening another one on Park Street, and Hartford is using our data to get support for that. They can show the map as powerful evidence that Park Street in Hartford is ground zero for the heroin epidemic in the state." Going forward, Canning says goals for the program include im- proving data reporting around the more detailed findings, and continu- ing to get EMS engaged so that all information gets into the system. Part of that is adding education on addiction and mental health into EMS training in an effort to reduce the stigma around drug users. "So many are ordinary people who got sick or injured, got hooked on powerful medication, then got cut off," he says. "It's our job to keep them safe and help them. Hopefully this project will help with that." Category: Advancements in Healthcare — Prevention UConn Health's Connecticut EMS Statewide Opioid Reporting Directive Emergency Medicine's Dr. Richard Kamin, Peter Canning the EMS Coordinator, and Dr. Suzanne Doyon outside UConn John Dempsey Hospital's Emergency Department at UConn Health in Farmington. All three care providers have played role in developing or using UConn Health's EMS Statewide Opioid Reporting system, which helps prevent drug overdoses.

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