CLARK COUNTY – Clark County’s overdose-related deaths in 2018 totaled 50, down 15 percent from 2017 – the lowest since 2013.
Even more, emergency room visits for opiate-related issues at Clark Memorial Health last year were down 40 percent from 172 to 103 in 2017.
Then there was a diagnosis of only one person with HIV and 16 new cases of Hepatitis C.
And, most importantly, more than 220 current or former syringe exchange patients are in active recovery.
“What a wild ride it’s been the last year,” says Dr. Eric Yazel as he reflected back on 2018.
The Clark County Health Department health officer and local emergency medicine physician credits collaboration with Clark County CARES as the key to his department’s progress in the war against drug abuse.
A COMMUNITY OF CHAMPIONS
Clark County CARES is a grassroots organization that brings together different community members and leaders, from law enforcement and first responders to health department officials to family members affected by the drug abuse crisis, and together they plan ways to educate the public and do advocacy work.
“I think this is the one area where Clark County CARES has been the most effective. So many [local] community organizations are chipping in and involved that you are almost conspicuous by your absence if your organization isn't involved,” Yazel said.
He cited events like their planning retreats, monthly meetings and, especially, their drug awareness week each January as just a few of the reasons why there are so many community leaders involved in the non-partisan effort.
“I can't tell you how important that is in regards to developing working relationships and understanding the unique challenges each organization faces,” he said.
“Then, each person goes back to their entity and essentially acts as a champion for the cause to increase education in their respective areas. It has been the single most effective thing in developing our recovery community here, in my opinion.”
While Yazel can point to several game-changing 2018 initiatives, he highlighted the rollout of PulsePoint as a significant community success story.
A free app that alerts CPR-trained individuals of a nearby cardiac arrest and the location of the nearest Automated External Defibrillators (AEDs), PulsePoint went live in Clark County in early November.
As previously reported in the News and Tribune, PulsePoint users are immediately notified by Clark County's 911 system when their help is needed, and the app directs them to the scene.
Yazel says this initiative didn’t just end there. The basic use of PulsePoint is now strengthened locally because many of the civilian responders are cross-trained to carry naloxone, a lifesaving overdose-reversal medication that is commonly called by its brand name – Narcan.
“Using this, we are one of the first and only counties in the country that is delivering Narcan directly to overdose patients, instead of simply hoping they come across a good Samaritan,” Yazel said.
“And, above all, we are keeping our substance abuse disorder patients alive.”
MORE WORK TO BE DONE
While Yazel is proud of the collaborative work accomplished in Clark County in 2018, he isn’t naive. The doctor recognizes there are still urgent issues that need to be tackled because the death rate is not at zero.
“It’s still 50 too many young lives lost,” he said, referencing 2018’s statistic. “We still are seeing a whole generation of children being raised by grandparents.”
Yazel said these issues, and others, are the very reason why the health department – along with the people and organizations that comprise Clark County CARES – can’t rest on their laurels.
“We must assess what interventions are working and put even more resources into them, evaluate the ones which are not, and decide how to move forward in a different direction.”
However, Yazel feels the momentum building, and he is excited about the progress to come in helping the addicted and those who love them.
Recent accolades by Indiana drug czar Jim McClelland proves Clark County is moving in the right direction.
“Mr. McClelland has spread the word all over the state at different events about the hard work we have put in down here,” Yazel said of the executive director for Drug Prevention, Treatment and Enforcement for Indiana.
McClelland confirmed at a Clark County CARES event in January – where he and Yazel both spoke – that he is impressed by the work being accomplished on all fronts in Clark County.
“I frequently refer to Clark County CARES as a great example of a community coalition that’s making a real difference,” the drug czar said.
“I don’t know of a county in the state where so many people from so many walks of life are working together – pretty much all on the same page – and figuring out how to use their respected skills and resources to cause some good things to happen that simply would not be happening.”
Yazel said that mutual respect and partnership with McClelland has “opened numerous doors for us by recommending us for conferences; helped us foster relationships with state leadership and provided invaluable support in many other areas as well."
Despite the 2018 successes, those fighting in the trenches with Yazel and his team cannot let the momentum drop.
"I feel like maintaining focus and always making forward progress is key,” he said. “Evaluating what is working and double down on those projects, and adjusting what isn't, is the next step.”
He stresses that the county can’t be solely focused on opioid usage.
“We are seeing a huge surge in co-abuse with methamphetamine, which while it doesn’t cause the high rate of overdose deaths, it is just as addictive and carries the same public health risks associated with IV [intravenous] drug abuse,” he said.
Yazel brings a wealth of strengths and bench depth to the health officer role, thanks to his work as a highly-skilled physician working in the emergency department at University of Louisville Hospital, the region’s only Level I trauma center. He also works in Clark Memorial Health’s emergency department.
However, the doctor is quick to say he doesn’t have all the answers. That’s why he is still working to adjust Clark County’s game plan against the drug epidemic.
"I do think one of my faults as health officer comes from my Emergency Medicine background. I focus so much on the front-end process – reaching overdoses quicker, increased Narcan availability in the community, things like that,” Yazel said.
“The future focus needs to be on developing our options downstream. Increased treatment options, job training and other areas that assist integration back into the community.”
More so, the doctor said that everyone involved in this Herculean effort to save lives and rehabilitate the addicted needs to maintain awareness of future trends.
“So, as we make headway against heroin, fentanyl, etc., where will the future go? It’s naive to think there won't be shifting patterns of abuse. We are already seeing that with methamphetamine,” he said.
"We have got to make sure our programs are versatile to address emerging trends. I feel like we were late to the game with IV opiates, and so many lives were lost as a consequence. We can't let that happen again.”