Until recently, only 41 of Texas’ 254 counties were mapping their drug overdose data to help health and law enforcement agencies track trends and coordinate responses.
But a new state lawthat went into effect Sept. 1 requires all emergency medical responders to report drug overdose information to local health authorities, who then feed the data into a software program that maps it.
Dallas officials say analyzing that data is key to helping battle the rising rates of fentanyl-related deaths.
That’s why the city began collecting the information three months ago and sending it to the county, where it is input into a national database, the Overdose Detection Mapping Application Program.
While the county refused to provide The Dallas Morning News with the information — citing privacy reasons — officials say the data is already helping them in the fight to save lives.
They plan to use the data to identify overdose hotspots: Hospitals will be better prepared for overdose patients, police will know when to arm themselves with Narcan — the medication that can stop an overdose — and where to hone in on areas with high supplies of the deadly pills. Education and support services can be beefed up to prevent more deaths.
“Information is power,” Dallas County Judge Clay Lewis Jenkins said. “The more information we have about this, the better we’re going to be able to protect our community.”
There were 70 cases that contained the word “fentanyl” as a cause of death in the Dallas County Medical Examiner data from January 2023 to April 2023 — a dramatic increase from five years prior, when there were four deaths with “fentanyl” listed as a cause.
These numbers are likely to be an undercount, as fentanyl-related deaths may be referred to in different ways in the data.
The uptick in cases tracks with national overdose data.
Dallas Fire-Rescue may also be responding to more fentanyl overdoses. Although their records don’t specify which drug may be involved in an overdose, emergency crews are responding to more calls listed as overdoses.
In 2007, Dallas Fire-Rescue responded to 583 emergency calls classified as overdoses, according to data obtained by The News. In the latest available data from 2022, the department responded to 3,056 overdose-related calls. By Sept. 7 of this year, that number had already reached more than 2,500 calls.
NATIONAL DATABASE
City first responders send data on overdose responses to the Dallas County Health and Human Services, where staff input the data into the ODMAP national database. The information alerts officials about sudden spikes and where they occur, helping officials chart trends and plan accordingly with hospitals and paramedics.
“We’re very happy to now have it in place,” Dallas County Health and Human Services Director Philip Huang said of the program. “It’s taken some work to get there, and we’re really trying to expand it and increase the information we have about this.”
Identifying clusters of overdoses could help officials ensure that first responders in these areas carry naloxone — otherwise known as Narcan, Huang said.
Currently, Dallas police sergeants and officers in certain units such as narcotics and the SWAT team carry Narcan, public information officer Kristin Lowman said. There are plans to equip all patrol officers with the opioid-reversing drug, but there is no deadline in place to do so.
Dallas Fire-Rescue Battalion Chief Scott Clumpner, who has been spearheading efforts to track and combat climbing overdose rates, said that in 2020, his crews administered 942 doses of Narcan. Last year, crews administered about 2,130 doses — a 126% increase.
“This is going to get worse before it gets better,” he said.
The web-based ODMAP tool that city and county officials are using was first tested in the Washington, D.C., and Baltimore areas in 2017. It was funded by a federal program to combat drug trafficking, ODMAP Program Manager Ali Burrell said.
More than 4,600 agencies across the country — including Philadelphia, Cape Cod, Bay County in Florida and Aiken County in South Carolina — have signed up.
With the overdose data, “You’re not just seeing your community, you’re seeing your neighboring communities, you’re seeing what’s going on in your state. You’re seeing what’s going on nationally,” Burrell said. “We encourage connections with other agencies — but our ability to provide that data nationally just allows people to understand trends, how they change distribution pathways, spikes and things of that nature.”
An agency partnering with ODMAP inputs overdose data, including the date and time of the overdose, approximate location, whether it was fatal, the victim’s age and sex, drugs involved, hospital transport information and whether Narcan was administered.
When communities notice a spike, Burrell said the mapping program can help law enforcement, health officials, and other agencies determine whether there was a “bad batch” or new fentanyl pills coming in.
Dallas City Council member Paula Blackmon helped spearhead the effort to share city data with Dallas County Health and Human Services. She said the information will help first responders “crack down on the criminal elements” and keep families safe.
“If you need to lose weight, you step on the scale and be really honest with yourself and say, ‘Where are we?’” Blackmon said. “We were stepping on the scale and saying where are we as a community regarding fentanyl with overdoses — those that have taken it and survived and those that haven’t. Then, what are we going to do to reverse that trend?”
No staff has been added for the program, Huang said, so it is unclear how much the data processing is costing the county.
Developing plans rely in part on an $11 million federal grant the Dallas County Health and Human Services was awarded at the end of August. Huang said Dallas was the only health department in Texas to receive the Centers for Disease Control and Prevention grant to limit opioid overdoses.
The agency plans to use the funds over the next five years to create a 24/7 overdose prevention hotline, expand Dallas Fire-Rescue’s overdose response team, add support services at Parkland Hospital and open an opioid testing and surveillance program targeting wastewater for traces of fentanyl, Huang said.
New grant-funded support services at Parkland will add case coordinators and expanded outpatient services to make the hospital system the “air traffic controller,” Clumpner said.
“If somebody comes out of Parkland, they’re going to have case managers, they’re going to have access to my team, which can go out and do a follow-up check,” he said. “Hopefully, from the time they hit the ER to the time they are clean, somebody has carried them along the way.”
Clumpner will also be able to bolster staffing on Dallas Fire-Rescue’s overdose response team, which follows up with those who have overdosed to perform a medical assessment and work with a peer support specialist to educate, share resources like rehabilitation and social programs and provide Narcan to those who live with them.
The team has one full-time employee dedicated to that work. The grant will help Clumpner expand that team to four.
THE FUTURE
Clumpner is also looking forward to the impact of the new state law that requires emergency medical services to collect and share data on overdoses by controlled substances with other agencies.
The data will help officials understand the movement of lethal drugs. He said he has worried about a lack of communication between first responders from different North Texas agencies. He said, for example, he became aware of the recent overdoses in Carrollton only through media reports.
“They would have no idea that just across (Interstate) 635, there’s a significant problem — which we know is going to bleed into that part of the City of Dallas, or vice versa,” he said. “If we have a significant problem on the outskirts of us, the suburbs don’t even realize it.”
Huang wants to expand Dallas County Health and Human Services’ data collection into neighboring cities. He’d also like for data entry to be more automated.
The city plans to discuss next steps and improvements to the program in October, Blackmon said.
“What we’ve done is what we set out to do, and it’s working,” she said. “It doesn’t mean it’s perfect.”
©2023 The Dallas Morning News, Distributed by Tribune Content Agency, LLC.
