Death Numbers A Flash Point In Broome Opioid Crisis

Sep 2, 2016

Overdose victims' families marked Overdose Awareness Day in downtown Binghamton on August 31.
Credit Bret Jaspers / WSKG News
 

Brenda Vanderpool's son is addicted to heroin. She said the drug nearly killed him, twice. Vanderpool said she also lost a friend this week to synthetic marijuana. 

Leaving a rally for Overdose Awareness Day on Wednesday, Vanderpool, a Binghamton resident, was clear about why she wants to know how many people have died from drug overdoses. "So we know how bad it really is out here," she said. "This is not a joke. This is awareness. This is what is happening to our community."

Number Crunching

In July and August, leaders and residents of Broome County clashed over an important number: how many Broome residents have died this year from drug overdoses. There’s also disagreement over when that count should be released.

Broome County District Attorney Steve Cornwell did his own research into overdose deaths. Last week, he said 53 people had died from overdoses so far this year. This week he added to that total: 58 drug overdoses in Broome County from January through August, 2016. The vast majority of those are opioid-related, he said.

"The county needs to know where we stand. The public needs to know where we stand," Cornwell said at his announcement last week. "You can't solve a problem if you don't understand the problem. You have to develop a solution, and it's based on the numbers." Cornwell said he relied on county coroners for information.

But the Broome County Health Department has a much different tally, citing 11 opioid-related deaths from January 1 to July 21, 2016. 

Broome Medical Director, Dr. Christopher Ryan, uses death certificates from localities to arrive at that count. Ryan excluded pending cases and cases that have a vague cause of death like "cardiopulmonary arrest." Those are cases that could very well involve opioids, but without more information, they play it safe, in accordance with practices established by the Council of State and Territorial Epidemiologists.

Ryan told WSKG in July there's always a trade-off between accuracy and timeliness in disease reporting.

New York State is the final arbiter, because its numbers have gone through the most thorough analysis. "That process takes a long time. They're very careful, they're very thorough about it," Ryan said. "And we will get those data files back from Albany 18 to 24 months after the year in question."

Too Soon, or Too Late?

18 to 24 months is certainly different from Cornwell's up-to-the-minute announcements. Weekly numbers like Cornwell’s don't allow time for toxicology tests in what might be a complicated death. Cornwell defended his process last week. "You don't need a toxicology report to confirm an overdose death when all of the circumstances surrounding the death indicate to an overdose death."

At the same time, Broome Public Health Director Sean Britton stands by the County's method. "We go by the body of public health practice and knowledge and we look to the body of scientific literature for what we should be doing," Britton said in July. "And sometimes that goes contrary to popular sentiment."

Britton and Ryan expressed privacy concerns for the families of overdose victims. Ryan also said an apparent spike might instead just be random and that public health research shows no clear benefit to having immediate numbers.

On the other hand, advocates want the quick numbers to alert people to a potentially dangerous drug batch. They say it would warn addicts to not use alone, or to start with smaller “test hits.”

But these alerts come with a risk, according to the New York State Department of Health: some users could be attracted to a superstrong batch, because it would indicate a stronger high. In addition, the state doesn't want to suggest some strains of heroin are safe by cautioning against one strain in particular.

Guohua Li is an epidemiologist at Columbia University who's written about injuries caused by drugs and alcohol. He said the solution is somewhere in the middle. "You don't want to experience too much delay, [but] you do need some quality control measures in place," he said. "So how to come up with a compromise I think is the challenge."

What's Next?

A compromise may be coming. NYSDOH said in an email that due to a new law, it expects to give counties a quarterly report this year, aligned with definitions laid down by the Centers for Disease Control and Prevention (CDC). The report will have opioid overdose numbers "each for deaths, emergency department visits and hospitalizations." That data will specify total opioid overdoses, heroin overdoses and non-heroin opioid overdoses.

Many call the opioid epidemic a true emergency, and say getting data can't wait. All sides agree that one death is too many. 

Brenda Vanderpool's son has so far escaped that fate, but she's clearly worried. Overdose Awareness Day seemed to leave her at least a little optimistic. "I think the community's coming together. And we're gonna try to solve this epidemic and help our kids." Kids like her son, who she wants to keep from being counted as an opioid-related death.