PHD: Opioid epidemic top priority

SANDPOINT — The opioid epidemic is one of the top issues impacting North Idaho, according to Panhandle Health District officials.

“It’s not just one age group that is affected by this — we are seeing it in all age groups,” said Nick Swope, a program manager with PHD who presented the topic during the Rotary Club of Sandpoint’s weekly meeting on Wednesday.

The data presented by Swope showed that even young children, who likely ingested it on accident, have been affected by opioids, though the highest number of emergency department visits are by those over 18.

“That’s why many of us in this room have some sort of connection to the opioid epidemic personally,” Swope said.

Drug overdose deaths by county in North Idaho, per population by 100,000, between 2014 and 2018 show Shoshone County with the highest rate at 25.5 percent, followed by Benewah at 19.8 percent and Kootenai at 12.9 percent. Bonner County fell in at 10.8 percent, with Boundary seeing the smallest percentage of deaths by population at 8.7.

The counties with smaller populations had a higher percentage rate, though Kootenai County actually saw the largest amount of overdose deaths with 99 over those five years. Bonner County had the next highest total deaths at 23. Shoshone had 16 overdose deaths reported, Benewah had nine and Boundary had five.

One of the most “encouraging” trends, Swope said, is that the number of opioid prescriptions is starting to go down over the past couple of years. In response to a question by a Rotarian, Swope said the data is limited on being able to recognize who is abusing prescription opioids and who is using them properly. One of the main indicators is tracking visits to the emergency department, as well as information from EMS providers on the number of times they use Naloxone, an opiate inhibitor that can “essentially” bring someone back to life when used on an overdose patient, Swope said. National trends show about 20 percent of opioid users abuse the prescriptions, Swope said, adding that he does not have that specific data for North Idaho.

With the opioid epidemic a top priority for Panhandle Health District, Swope said they held a symposium last year from which came a goal of establishing a strategic plan. They split up into four working groups to each address one of four specific areas — prevention, harm reduction, access and awareness of treatment, and community resources.

Each group then came up with a number of goals. The prevention workgroup, for example, is to limit and potentially stop or reduce the total amount of use of prescriptions in North Idaho, and to do it responsibly, Swope said. Some of the goals for the group include a regional standard of care, to increase awareness and education of opioids and opioid use in individuals age 27 and older, as well as use and misuse in individuals 26 and younger.

The primary goal for the harm reduction workgroup is to have pharmacies in the region begin adhering labels to the seal of all Narcan (Naloxone) prescriptions warning patients to dial 911 for medical care when the seal is broken and it is used. The group is also working on public education on safe storage and disposal of prescriptions, and increasing the number of permanent box locations for disposal.

The access and awareness of treatment group is focused primarily on improving access and awareness to addiction treatment by increasing opioid use disorder treatment teams to provide services in all five northern counties, as well as improving emergency room treatment and treatment center integration.

The fourth group, community resources, is contacting and encouraging agencies to upload services to Idaho resource directories including 211 and Live Better. Other goals of the group are to conduct a detox feasibility study; develop a process for evaluation, appropriate referrals and continuum of care for individuals or families experiencing the effects of opioid use disorder; and to expand resources for individuals to maintain long-term recovery through a healthy and active lifestyle.

Swope said opioids were historically pitched as a non-addictive way of pain management, and initially worked “great” for that. While it has become an epidemic, they are, in fact, only addictive for some people, he said.

“They are not addictive unless you are somebody who becomes addicted to them,” Swope said. “There could be 20 of us, everybody could take exactly the same prescription and not everybody is going to become addicted, but you don’t know … One of the most encouraging things that we see in all of our workgroups is in our language we are saying ‘opioid use disorder’ and we are focusing on those treatments, but everything we are doing in community resources works for every type of substance.”

Information on opioids and opioid prevention can be found on the district’s website at panhandlehealthdistrict.org.

Mary Malone can be reached by email at mmalone@bonnercountydailybee.com and follow her on Twitter @MaryDailyBee.