After a record-setting 2017, drug overdose deaths were down last year in Northwest Indiana, and local officials are cautiously optimistic that the opioid epidemic is slowing down.
"I would like to hope — I think that would probably be the best word — that we have reached the peak," said former Porter County Coroner Chuck Harris, who in 2019 became that county's recorder. "It's been a long, hard-fought battle."
In 2018, Lake County had 152 overdose deaths, Porter County had 46 and LaPorte had 17, compared to 196, 50 and 26 the year before, according to their county coroners. Northwest Indiana had its most drug deaths in 2017 — 268 vs. 215 last year.
Experts attribute the decline to the widespread use of the overdose-reversal drug naloxone, an increase in treatment availability and more awareness about the crisis, among other reasons.
Nationally, drug overdose deaths appear to be declining, falling 1.3 percent in July 2018 from July 2017, the Centers for Disease Control and Prevention reported. The CDC also estimated that Indiana's drug overdose deaths had fallen 5.7 percent in that period, though that data is incomplete.
Even so, the United States set a record for drug overdose deaths in 2017, with more than 70,000 fatalities, the agency found. More than two-thirds of them were caused by opioids, with much of the increase in deaths due to fentanyl and other synthetic opioids.
Fentanyl also drove the spike in Northwest Indiana drug deaths in recent years. And 2018 saw the first death in the Region — in Porter County — from carfentanil, a synthetic opioid 5,000 times more powerful than heroin. Just a speck of the drug, which is used as an elephant tranquilizer, can be lethal.
"It will be fatal to almost everyone that uses it, and all first responders will need to be extremely careful since it can easily be absorbed through skin contact with the drug," Harris said.
Cocaine, meth use up
Deaths involving heroin in the Region were down in 2018, but local experts say cocaine and methamphetamine use are both on the rise.
"We have an opioid epidemic going on, but truly overall we have a drug and alcohol epidemic," said Megan Fisher, director of medication-assisted treatment for Porter-Starke Services.
"The good thing is some of those other substances are less likely to lead to a fatal overdose."
She said the state's decision to allow Medicaid to cover methadone also has helped.
"I'm really hopeful that we've sort of peaked and are on the downslope," she said. "That's not saying we don't have a lot of work to do."
Chuck Porucznik, executive director of the Indiana High Intensity Drug Trafficking Area, said there has been an increase in seizures of methamphetamine, yet a decline in the number of meth labs. He said the price for meth imported across the southwest border of the United States has dropped.
"People don't have to cook it anymore, because it is more readily available," he said. The number of meth lab busts in Indiana dropped to 371 in 2017, from 1,452 in 2015, according to the Indiana State Police.
He also noted that fentanyl is hard to intercept, because a lot of it comes in small amounts like ounces, from China, through the parcel services.
Naloxone making a difference
Lake County Coroner Merrilee Frey said she believes people are using drugs at the same rate as before but that more of them are being resuscitated with naloxone, which reverses opioid overdoses.
Nearly all first responders carry naloxone, which also goes by the brand-name Narcan, as do many people with opioid addiction and their friends and families. The drug can be bought over the counter. The use of naloxone by emergency medical services jumped by more than 75 percent between 2012 and 2016, the CDC reported.
"It's saving a lot of lives," Frey said.
She noted that many families of people who died from drugs say their loved ones had overdosed — and then been revived — several times before. She said emergency rooms are still busy saving overdose victims.
Franciscan Health hospital in Crown Point, for one, sees more more overdose cases than it did three to five years ago, but in February had the lowest number of overdoses in a month since the start of 2018, according to Robert Blaszkiewicz, a hospital spokesman.
He also noted that the hospital is one of many agencies that speak about the opioid crisis at local schools.
A few weeks ago, a woman overdosed, was resuscitated at the ER and sent home, and died the next day of an overdose, Frey said. The coroner said she believes ERs need to staff recovery specialists to get patients into treatment.
Frey cautioned that during the first 50 days of 2019, 35 people have died of drug overdoses in Lake County. "My feeling is our numbers are going to be up" this year, she said.
On the plus side, she noted, treatment is increasingly available, thanks to a growing number of inpatient beds and more insurers willing to pay for it.
Experts also note that some local jails now offer Vivitrol, a long-acting shot that reduces opioid cravings, to departing inmates. They are susceptible to overdoses because their tolerances have waned while they were behind bars. Frey, for one, said she is seeing less overdose deaths of people who were just released from jail or wearing ankle monitoring devices.
Prosecutors also have been more willing to send drug offenders to treatment instead of jail through local drug courts, experts say.
Allen Grecula, director of clinical services for Frontline Foundations, an outpatient treatment center in Chesterton and LaPorte, said this "holistic, all-hands-on-deck" approach is what is making the difference.
He pointed to partnerships his agency has with the LaPorte County Health Department to train residents in naloxone, with NorthShore Health Centers to prescribe patients buprenorphine and other opioid replacement drugs, and with LaPorte first responders to try to get overdose victims into treatment.
Grecula also noted the state and federal government have been putting more resources into fighting the epidemic. Indiana, for instance, now offers free Lyft rides to treatment and pays for rehab for felony drug offenders through the Recovery Works program.
He said that any drop in overdose deaths means the world. In 2018, there were 13 fewer deaths in the counties his agency serves, Porter and LaPorte.
"Those are 13 families that don't have to bury their sons or daughters or parents," Grecula said.