Katlyn Bradford

[katlynrbradford]

Due to the geographical isolation, financial hardships, and the stigma associated with opioid addiction found in Harnett County, it is very difficult for those addicted to find the treatment they need. The lack of treatment availability found in Harnett County could be a contributing factor to the rate of opioid overdoses seen in the area. To help decrease the potential opioid overdoses, research was conducted on what was being done in other rural areas to help addicts receive the treatment they need.

One of the most interesting programs found is being conducted by the Michigan State Police and is called the Angel Project. This program is a voluntary, non-arrest program, and allows the police to offer referrals to detoxification and rehabilitation treatment programs. Additionally, the police departments ensure that those who want treatment will have immediate transportation to a treatment center. To aid in transportation to the treatment centers, volunteers throughout the community are available to provide transportation to an appropriate treatment center. The volunteers are also available to meet with the addict and discuss the treatment options that are best for them. The Angel Project has been effective for Michigan rural counties and has served 87 participants through 100-125 volunteers in November of 2018. This program could also be quite effective in Harnett County, however, there is still the concern for the treatment to be affordable to addicts once they arrive at the treatment center and the cost of transportation for the Angel volunteers and police officers.

To implement such a program, the Harnett County Sheriff’s Office can seek aid through a nonprofit organization known as the Police Assisted Addiction and Recovery Initiative (PAARI). PAARI seeks to help spread the Angel Project (and other programs like it) throughout the United States. The non-profit organization helps Sheriff’s Offices and police departments fund programs like the Angel Project through the money obtained in drug busts, and by helping the police force partner with treatment facilities in the area. By partnering with PAARI, the Harnett County Sheriff’s Office could resolve the financial issue seen if they were to implement the Angel Project alone.

In addition to partnering with PAARI to implement the Angel Project, other recommendations have been offered to the Sheriff’s Office to help with fighting the opioid crisis in the community. To gain a better understanding of the dispersion of opioid overdoses in Harnett County, the Sheriff’s Office (along with the other police departments in the county) should upload their overdose incidences to a national system that tracks overdoses in real-time. By doing so, the deputies can have a better understanding of where the “hot spots” are, and where intervention may be the most helpful. As mentioned with the Angel Project and PAARI, the Sheriff’s Office should consider partnering with many other organizations in the community. Partnering with EMS, the fire department, churches, schools, and hospitals can help with providing transportation for those seeking treatment and with the possibility of implementing an opioid addiction awareness program for the community. The Sheriff’s Office should also consider partnering with those in recovery and with those who were addicted to opioids in the past. Doing so can provide those seeking treatment with a peer to discuss treatment with, as well as a person who understands what they are going through.

By getting the Sheriff’s Office to partner with other organizations and people in the community, the Angel Project and the other recommendations can be implemented. By doing so, those currently addicted be able to get the treatment they need and future opioid overdoses will be prevented.

[katlynrbradford]

As mentioned before, our project is heavily weighted on data input and analysis. After taking approximately 4 weeks to input data into a shared excel spreadsheet, the data was compiled and uploaded into SPSS to better assess the trends seen in the incident reports. To begin the analysis, overdoses, in general, were analyzed, after which the overdoses that resulted in death were examined. Of overdoses in general, the sex (male vs female), race, and age were analyzed of the victims in the incident reports. Most of the victims of overdoses were identified as male (56.9%), white (82.16%), and between ages 26-31 years old (23.57%). These demographic trends are as expected because the majority of Harnett County’s population are white males, and the officers at the Sheriff’s Office have noticed a trend in drug users being mid-twenties to early thirties. Also analyzed were the zip codes where the overdoses occurred. The top four zip codes were: 28390 (Spring Lake), 27546 (Lillington), 28326 (Cameron), and 27332 (Sanford), respectively. The zip codes encompassing Spring Lake, Cameron, and Sanford are all located in the southeastern part of the county. The clustering of these three counties may indicate that this area of the county is a target population, and may be more at risk for overdoses than the rest of the areas in Harnett County. However, the clustering may also be due to the lack of local police found in other areas of the county (Dunn, Erwin, Angier, etc.). Because of the lack of local police stations, the three areas listed are relying solely on the Sheriff’s Office to respond as law enforcement to overdoses.

When analyzing deaths, similar demographic patterns are seen. Of the males in the reports, 22.4% died, while only 8.5% of the females in the reports died. After splitting races into white and non-white for simpler analysis, it was seen that 17.3% of whites in incident reports died, and 13.9% of non-whites died. However, the zip codes housing the most overdose deaths were quite different than the ones home to the most overdoses in general, except for the #1 spot. The top zip code was 28390 (Spring Lake), while the second-highest spot was tied with four zip codes: 27546 (Lillington), 27501 (Angier), 27526 (Fuquay-Varina), and 28334 (Dunn). The four zip codes tied for second are clustered in the northern part of the county, the opposite side where the most overdoses, in general, seem to occur. This result may be due to an underlying issue with lack of treatment facilities and/or access to providers, however, it is also possible that the Sheriff’s Office was called in when an overdose case was seen to be particularly dangerous. The more dangerous opioid overdoses are also more likely to result in death, meaning the incident reports ending in deaths would be concentrated in those areas. As mentioned previously, the top zip code for the most overdose deaths (Spring Lake) is also the top zip code for the most overdoses in general, providing serious evidence that this area may be the most at-risk geographical area for opioid overdoses.

The top drugs involved in overdoses were also of interest and were split into two groups: those involved in overdoses in general, and those involved in overdoses that resulted in death. The top five drugs involved in overdoses were heroin, fentanyl, cocaine, and a tie between Xanax and alcohol. Heroin held the top spot by far, as it was listed in 91 of the incident reports where drugs were listed. Regarding the reports that resulted in death, heroin also held the top spot by being listed in 15 of the incident reports. The other drugs were fentanyl, cocaine, and alcohol, respectively. However, it must be noted that the second most mentioned response for drugs being involved in the overdose death reports was “unknown” (listed in 13 of the reports). This observation means that the Sheriff’s Office is unsure of what caused or was taken prior to the overdose that resulted in the death of the victim.

The data analyzed in the incident reports can be key factors when planning future intervention strategies in Harnett County. Through the analysis conducted, an intervention strategy can be tailored to the demographics and geographical location resulting in the most overdoses and deaths due to overdosing. Through analysis of the drugs, officers can be more informed on what is causing the overdoses in Harnett County, and can, therefore, be better equipped to respond to them. To continue bettering the opioid epidemic present in Harnett County, however, it would be beneficial for the Sheriff’s Office to continue working towards gaining access to the overdose incident reports located at the larger cities in the county that have their own police.

[katlynrbradford]

Playing with the drone before taking it out to get shots of it the community!

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Data analysis is underway! Can’t wait to see the final presentation!

[katlynrbradford]

As PH students go into the preceptor fair today, I’m excited to see how I can incorporate what I’ve learned about opioid addiction into my potential practicums next semester!

[katlynrbradford]

Had so much fun at Coats’ Farmers Day! We raised a lot of awareness by passing out pamphlets and bracelets to all of the community members!

[katlynrbradford]

Preparing for the Farmer Days festival this Saturday! Can’t wait to spread awareness about opioid overdoses in Harnett County!

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As we prepare for Farmer Days in a couple of weeks, we can’t help but get excited when our wristbands come in!

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After many strenuous interviews Team Overdose has officially chosen our mascot, Bo! As part of his first meeting with the team we ordered wristbands to help raise awareness of the Harnett County opioid crisis at Coats’ Farmer Days this October!

[katlynrbradford]

Team overdose incorporating our practicum into class by making a Causal Loop Diagram!

[katlynrbradford]

Team Overdose has been inputting data from incident reports concerning opioid overdoses dating from 2016-2019 into spreadsheets. Before doing so research was conducted to identify access to care barriers that affect rural communities, specifically Harnett County. Through research, it has been noted that there are minimal care facilities, including hospitals, treatment centers, and rehabilitation centers. These observations are especially true in the southern part of the county, where there are no established towns such as Lillington, Dunn, Coats, and Erwin. The main treatment facility appears to be the Morse Clinic in Dunn, with treatment costing $80-$120 per week. The higher costs of treatment may factor into why some individuals do not seek treatment. Also, because of the clinic’s location, it may not be easily accessible to those living in the southern part of the county.

Another barrier to care within the county is the limited places to get Naloxone which is a medication used to reverse the effects of an overdose. While it is offered by many pharmacies, especially retail pharmacies such as Walgreen's and CVS, there are a fewer number of pharmacies in this community compared to an urban community. As seen with the treatment centers, this is especially true with the southern region of the county. The major pharmacies around the southern region of the county appear to be concentrated around Spring Lake, which is located in Cumberland County. The absence of pharmacies within the county, especially the southern region, most likely contribute to the high rate of opioid overdoses.

The lack of resources within the southern part of the county appear to have an impact on the overdose rates in that area, as confirmed by discussions with our preceptor and the incident reports. Many of the reports have addresses located within the southern region of Harnett County, or directly outside that area of the county. However, this trend may be exaggerated because the towns located within the northern part of the county have local police, who have not yet fully disclosed their incident reports with the Sheriff’s Department. Until the Sheriff’s Department and local police can work more cohesively, it may be difficult to observe accurate geographical trends related to opioid overdoses in the county.

Another access to care barrier is the stigma that is felt toward drug addictions, especially in a rural community. Coupled with the stigma is the closeness of the community and the fact that community members play multiple roles, leading to confidentiality concern. These many factors can cause serious apprehension to those who need treatment. The fear of being outed for having an addiction and experiencing stigmatization from the entire community can prevent people in need from seeking out the few treatment options available within the county.

While there are very few options for treatment, it appears there are even fewer options for prevention within Harnett County. Besides the Sheriff’s Department visiting local schools and community events, the only main source of prevention that can be found is what is known as Project Lazarus. The project originated in Wilkes County, NC, and is focused on community education and resources for rescue medication (such as Naloxone). The project also provides medication disposal bins, one of which can be found in Harnett County Sheriff’s Department. Providing a safe place for medication disposal can help prevent community members from accessing opioids. However, the southern part of the county is again at a disadvantage because there are no police stations present in that part of the county. To safely dispose of medications, community members in southern Harnett County will have to drive to a pharmacy providing that service or to a police station in the northern part of the county.

The isolation and lack of resources felt throughout the rural county have the Sheriff’s Department quite concerned for the well-being of the community members. Like many other rural communities, Harnett County experiences issues with poverty and transportation. Because of these issues, community members may forego treatment for opioid addiction. The lack of prevention models also contributes to the high rates of opioid overdoses. As discussed earlier, these observations are especially true in southern Harnett County where people may have to travel further or to a different county to get treatment and prevention opportunities. As our team’s research continues, the trends we will find may be helpful for the Sheriff’s Department to target the most at-risk populations in the county and focus on providing them more prevention and treatment options. In doing so, those battling opioid addiction will receive the care they need and the overall health of the community will improve.

[katlynrbradford]

Now that data entry is done, I can’t wait to see the trends we’ll discover!

[katlynrbradford]

This past Wednesday was Overdose Awareness Day, so of course we had to show our support! Thanks Lt. Christensen for getting in on the action!

[katlynrbradford]

Week #2 of practicum is off to a great start! Can’t wait to see how much we’ll accomplish this semester!

[katlynrbradford]

So excited to see what this semester’s practicum has in store!🤗