CommStat 3/29/18
SubStat What is it? SubStat is a mechanism to identify individuals involved with Opioid addicted behavior (i.e. overdoses) with the goal of the access to treatment offering. Information from SubStat is brought back to the involved police departments to inform officers.
Who is involved: • States, Attorney Burlington Police Department (1/17) • DOC – Field Colchester Police Department (1/17) • DCF – Local South Burlington Police Department • Field Director (1/17) • Street Outreach Winooski Police Department (1/17) • Vermont Information Center Essex Police Department (7/17) • Chittenden County Opiate Alliance Milton Police Department (7/17) Shelburne Police Department (10/17) New as of 3/18/18: Richmond Police Department Vermont State Police Hinesburg Police Department Williston Police Department
Overdose Data 7/1/17 through 3/22/18 Gender Fatal/Non-Fatal Male Fatal Female Non-Fatal 21/75 Female - 54/75 Male 62/75 Non-Fatal – 13/75 Fatal
Since July 1 st , 2017, the SubStat group has discussed 194 separate police interactions. Breakdown of Involvements Overdoses (Non-Fatal and Discussed Fatal) Drug Possessions Untimely Deaths Assists Theft Other
Overdoses Per Town 7/1/17-3/22/18 (Fatal and Non-Fatal) 45 40 35 30 25 20 15 10 5 0 Burlington - 39 Winooski - 11 Colchester - 11 South Burlington Milton - 4
Fatal and Non-Fatal Overdoses by Town, per 10,000 Residents 18 16 14 Incidence Rate per 10,000 12 10 8 6 4 2 0 Winooski - 15 Burlington - 9 Cholchester - 6 South Burlington Colchester - Milton - 4 - 5
Fatal and Non-Fatal Overdoses by Age Category and Sex per 10,000 Residents 25 20 Incidence Rate per 10,000 15 Male 10 Female 5 0 12-19 20-29 30-39 40-49 50+ Age Category (years)
Lessons Learned Thus Far 1. The need for the “law enforcement” community to meet 2. The need to look at the significant role of “law enforcement” within this epidemic 3. The need to pay attention to Opioid data to tell us the stories of our successes and failures 4. The need to further connect to social services and ensure point of service treatment when needed
Data Discussion Kayla Donohue, MPH kayla@unitedwaynwvt.org kdonohue@bpdvt.org
How can we use data? Data for Action Data for Impact • To respond to today’s needs Establish that our • Manage our teams interventions lead to better lasting change • Improve efficiency • How much did we • Inform policy spend? • How much did we do? • Is anybody better off? https://ssir.org/articles/entry/using_data_for_action_and_for_impact
What do we need? • Access to accurate data • Measurable research questions o Ex. How do burglary rates correlate with opioid use in Chittenden County from 2013-2017? • Priorities • Prevention • Enforcement • Treatment • Recovery • Desired outcomes or targets • Ex. Reduce burglaries by 20% by 2020.
What do we have? • Hub & Spoke Data • Median days to treatment, monthly and overall • Number of new service requests and new admissions • Average days to treatment, monthly and overall • Number of individuals on the waitlist • Number of admissions by TNQ Score category • Number of individuals discharged or transferred • Total number of clients • Number of waivered service providers • SIREN Data for Emergency Medical Services • Police Data • Vermont Department of Health • University of Vermont Medical Center
Individuals Receiving MAT in Chittenden County Hub & Spokes, by Provider 1800 1600 1400 1200 1000 800 600 400 200 0 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb 2017 2018 Total Spoke Hub CHCB Community Lund Maple Leaf Total UVM MC Howard Spoke COGS ATP Data Source: Vermont Department of Health and Opioid Care Alliance of Chittenden County
Individuals Receiving MAT at Chittenden County Hub and Reporting Spokes 1800 1600 1400 1200 1000 800 600 400 200 0 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb 2017 2018 Spokes 607 595 651 641 629 663 605 658 545 507 706 531 539 Hub 971 976 994 994 1009 984 964 970 985 1004 1007 1016 1014 Data Source: Vermont Department of Health and Opioid Care Alliance of Chittenden County
Percent of Individuals Receiving MAT at Reporting Spokes Community COGS 3% 12-month average 3% Lund (Feb. 2017-Feb. 2018) 5% ATP of individuals treated 5% at spokes = 606 Howard Spoke 14% CHCB 51% Total UVM MC 19% Data Source: Vermont Department of Health and Opioid Care Alliance of Chittenden County
Chittenden County Hub-Level Active Waitlist Volume & Average Wait Time 160 138 140 130 120 93 100 87 84 80 80 71 62 59 58 53 75 58 60 67 67 41 23 40 47 44 23 17 24 16 15 20 11 10 7 0 0 0 0 0 0 0 # Individuals Waiting Average Days to Treatment per Month Median Days Waiting Data Source: Howard Center Triage Report
Chittenden County Hub-Level Admission Volume & Average Wait Time 60 53 50 46 44 43 42 39 40 46 40 39 37 38 40 38 37 35 34 30 29 30 25 24 28 20 23 16 15 17 10 14 11 7 0 # Individuals Admitted Average Days to Treatment Data Source: Howard Center Triage Report
What do we have? • Hub & Spoke Data • SIREN Data for Emergency Medical Services – OD Surveillance • “Overdose/Abuse of Opiate” • Incident date, time, district • Medications given (Naloxone/Narcan) • Medication administration route • Police Data • Vermont Department of Health • University of Vermont Medical Center
VT EMS Responses to Overdose Incidents Monthly EMS Incidents with Primary Monthly EMS Incidents with Provider Impression of “Overdose / …” Primary Provider Impression of in VT, 2017 “Overdose / …” in District 03 (Chittenden Cty), 2017 175 175 150 150 Overdose / Opiate 125 125 Overdose / Any 109 100 100 75 75 50 50 45 25 25 27 11 0 0 May Jun Jul Aug Sep Oct Nov Dec May Jun Jul Aug Sep Oct Nov Dec Data Source: SIREN EMS Incident Reports
Jan. 2018 SIREN Data w/ Time of Incident Preliminary EMS Incidents with Preliminary VT EMS Incidents with Primary Provider Impression of Primary Provider Impression of “Overdose / …” “Overdose / …” By Hour of Day, Jan By Region, Jan 2018 2018 8 90 78 7 80 70 6 60 5 50 4 40 3 30 23 19 20 2 10 3 1 0 0 Chittenden Cty. Vermont 0 2 4 6 8 10 12 14 16 18 20 22 (D3) Overdose / Any Overdose / Opiate Overdose / Opiate Overdose / Any Data Source: SIREN EMS Incident Reports
What do we have? • Hub & Spoke Data • SIREN Data for Emergency Medical Services • Police Data • SubStat Incidents – Chittenden County • Crime Rates (burglary, theft, fraud, trafficking, etc.) • Opioid-related events • Calls for service • Vermont Department of Health • University of Vermont Medical Center
SubStat Opioid-Related Overdose Incidents Opioid-Related Overdose Calls Responded to by BPD, CPD, SBPD, MPD, EPD, SPD & 16 WPD per SubStat Period Non-Fatal Opioid-Related 5 Overdose Incidents Among SubStat Partners Since Jan. 4 th 4 3 2 1 1 Fatal Opioid-Related Overdose Incidents Among SubStat Partners 0 Since Jan. 4 th 1.2-1.16 1.16-1.30 1.30-2.13 2.13-2.27 2.27-3.13 Data Source: Valcour Incident Report
What do we have? • Hub & Spoke Data • SIREN Data for Emergency Medical Services • Police Data • Vermont Department of Health • Fatal overdoses • Prescription drug monitoring reports • BRFSS & YRBS data briefs • University of Vermont Medical Center
Number of Accidental and Undetermined Opioid- Related Fatalities Among Vermont Residents 120 101 96 100 80 74 70 63 67 58 60 49 51 44 45 43 39 40 33 34 39 33 37 35 35 31 21 28 26 20 10 9 17 4 12 6 1 5 0 2010 2011 2012 2013 2014 2015 2016 2017 All Opioids Rx Opioid (No Fentanyl) Heroin Fentanyl
Accidental or Undetermined Opioid-Related Fatalities Among Chittenden County Resident 30 28 25 21 20 20 17 17 16 16 15 13 13 13 12 11 10 12 10 9 8 10 10 8 8 5 4 5 3 5 5 4 1 3 3 0 0 1 0 2010 2011 2012 2013 2014 2015 2016 2017 All Opioids Rx Opioid (No Fentanyl) Heroin Fentanyl
Accidental and Undetermined Opioid-Related Fatalities in Chittenden County and Among Chittenden County Residents 40 35 35 28 30 24 25 21 20 19 18 20 17 17 17 16 13 15 10 5 0 2012 2013 2014 2015 2016 2017 Occurred in Chittenden County Chittenden County Residents
What do we have? • Hub & Spoke Data • SIREN Data for Emergency Medical Services • Police Data • Vermont Department of Health • University of Vermont Medical Center • Opioid-related Emergency Department encounters • Discharge Disposition • Zip code of residence
Monthly UVM Medical Center ED Encounters Coded as “Opioid OD” & “Opioid Poisoning” 30 25 20 15 10 5 0 Jan MarMay Jul Sep Nov Jan MarMay Jul Sep Nov Jan MarMay Jul Sep Nov Jan 2015 2016 2017 2018 Data Source: University of Vermont Medical Center
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