阿片类药物的使用和资源

 IN CRISIS?  Crisis Lifeline dial 9-8-8. If there is imminent danger to anyone, dial 9-1-1.
Never Use Alone hotline dial 877-696-1996. An operator will stay with you while you use, and call emergency services if needed.

 
Introduction

Data are a critical tool for understanding how opioid use is impacting our local community. Tompkins Whole Health tracks and publishes indicators related to opioid use within Tompkins County from a number of sources in an effort to provide the public as well as policy makers with information that is relevant and of interest. The data presented show the scale and scope of the crisis in Tompkins County.


 
Substance Use Data


如因用药过量而出现紧急情况,请致电 911

所有拨入汤普金斯县 9-1-1 中心的电话都会根据紧急情况类型进行编码。通过该代码(称为自然代码),调度员可得知是否要将紧急情况分配给警察、消防或紧急医疗服务 (EMS)。  

在接到医疗求助电话后,9-1-1 调度员会根据部门紧急医疗调度计划中的规程,向来电者询问某些关键问题,以确定病症是否由药物引起。有时来电者知晓原因,而有时调度员需根据其对问题的回答、其他情况以及多年的经验确定编码。 

Total number of 9-1-1 calls per month that are C.A.D. coded as "Overdose/Poisoning," 2019-present. Computer Aided Dispatch (CAD) calls, Nature Code for “Overdoses/Poisoning.” Source: Tompkins County Department of Emergency Response (DoER).


数据来源:汤普金斯县应急响应局 (DoER)。


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Unintentional fatal overdoses: demographic profile.

Like many communities, Tompkins County has experienced an increase in unintentional overdose deaths. When reviewing these datasets it is important to always remember that they represent individuals who are sons and daughters, families and friends whose lives have been interrupted or tragically ended, in some cases without warning.

The graphs below provide demographic information about the 100 people who died in Tompkins County from accidental drug overdose from 2019-2023. The larger sample size provided by totaling across five years increases the confidentiality of the individuals, and the confidence in how the data is interpreted.

“Unintentional Fatal Overdoses” includes those for which the “Manner of Death” is classified as an accident and substances identified in a toxicology screening are ruled as the immediate cause of death.

The US Census data (American Community Survey 2022 5-year estimates) compare the demographics of the deceased with the county population as a whole.

 
药物相关死亡

The deaths in this dataset may include overdose deaths due to pharmaceutically and illicitly produced, naturally occurring, semi-synthetic, and synthetic drugs. These deaths may not be attributed to an overdose.

 

“Drug Related Deaths” includes all deaths in which drugs are involved. In these cases, the immediate cause of death is not or not solely drugs, and drugs are often listed under “Other significant contributions.” These also include those in which the manner of death is not ruled as an accident.


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NYS Opioid Quarterly Report

In accordance with the recommendations of the New York State Heroin and Opioid Task Force and 2016 legislation, the NYSDOH provides quarterly reports with opioid overdose information (deaths, emergency department (ED) visits, and hospitalizations) by county. Please note that the data presented in these are considered preliminary by the NYSDOH and should be used and interpreted with caution. Subsequent quarterly reports may contain figures which differ from a previous report due to additional confirmations, updates, and timing of data received. The reported cases are based on county of residence.

QUARTERLY RATE CALCULATION (person-years):  [# events / (population X 0.25 years)] X 100,000.

 
Summary of Tompkins County data published October 2024
(Provisional data as of July 2024)

 
Overdose deaths

This dataset represents deaths from all opioids, including heroin, synthetics, and pharmaceuticals.

 
Emergency Department Visits and Hospitalizations

Emergency department visits and hospitalization rates help to show the extent of the opioid crisis in Tompkins County.  

 
EMS Suspected Opioid Overdose Incidents

 

 
Full report on the NYSDOH website


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Naloxone (Narcan)

Naloxone is a lifesaving medication that can be administered to reverse an opioid overdose. Narcan is the most well-known brand of Naloxone and is used widely by emergency responders and members of the public, alike.

When naloxone is used at a scene by Emergency Medical Services (EMS), law enforcement, or registered overdose prevention programs, the incident is reported to New York State. The state compiles these incidents into quarterly reports, which are then available to the public.

 
Narcan Use

The trend of naloxone use is considered an indicator of the level of opioid use. The graph below is a visualization of these quarterly reports for Tompkins County (lower is better). You can see that overall naloxone use dipped in the first half of 2022, then did not fall again until Spring 2023. Numbers for Q2 2024 should be available October 2024


 
Narcan Training and Distribution

Many individuals carry Narcan with them so they are ready to act if they see someone who appears to be overcome by a drug overdose. Tompkins County Whole Health and its partners are working to distribute Narcan to more residents and train them in how to use it.

     [How to give Narcan]

Across the state, the NYS Department of Health is setting up Opioid Overdose Prevention Program (OOPP) sites to distribute Narcan and train the public in its use. TCWH is a Registered OOPP, and members of the public may request Narcan at both our Brown Road and Green Street offices. A list of OOPP locations is below.

As part of its distribution program, TCWH is tracking the number of people trained and Narcan kits distributed by local OOPPs and reporting this information to the public. In the following graphs you can see how training dipped during the COVID-19 pandemic and has risen in the last three quarters of 2023.

The distribution of Narcan spray kits varies more from quarter to quarter since 2019, then increases at the end of 2023. Together, the graphs illustrate the increasing effort in Tompkins County to build a safety net across the community focused on reducing the number of deaths we experience due to drug overdoses.


 
纽约州阿片类药物数据仪表板:

  • County (use the Select County dropdown menu to display the Tompkins dataset) 
    screenshot of the "Select County" dropdown

More information & resources:  NYSDOH Opioid Data & Reports


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Opioid Resources

 
How to lower the risk of opioid overdose

  • Never use alone. Use with others and take turns.
  • Before using drugs, ask someone you trust to check on you regularly.
  • If you are alone call the Never Use Alone hotline. Dial 1-877-696-1996. An operator will stay with you while you use, and call emergency services if needed.
  • Test your drugs. Use test strips to test your drugs for Xylazine and Fentanyl. Drugs with one of these cut in can kill you.
  • Always carry naloxone (Narcan®) with you.
  • Go slow by taking small amounts, especially if you haven’t used for a while.
  • Wait before taking more. Wait long enough to feel the effects of the drugs you took before taking more.
  • Avoid mixing with alcohol or other drugs, especially drugs that make you sleepy.
  • There is no safe dose of opioids.

芬太尼

芬太尼是一种高度成瘾的合成物质,被添加到非法街头毒品中以增加消费量。此外,芬太尼还与用药过量死亡风险密切相关。汤普金斯县卫生部已发布健康警报,警告居民当地街头毒品中含有芬太尼的风险极高。

有害副作用包括 

  • Sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.

用药过量的迹象包括 

  • Stupor, changes in pupillary size (pinpoint size pupils), cold and clammy skin, cyanosis (blue discoloration of the skin), coma and respiratory failure leading to death. 

用药过量预防策略 


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Xylazine

Xylazine (also called “tranq” or “tranq dope”) is a powerful non-opioid sedative or tranquilizer that is increasingly being found in the US illegal drug supply and linked to overdose deaths. Due to its impact on the opioid crisis, fentanyl mixed (adulterated) with xylazine has been declared an emerging threat by the White House’s Office of National Drug Control Policy. In one study, xylazine was found in almost 80% of drug samples that contained opioids (Maryland, 2021-2022). In another, xylazine was found in 31% of heroin and/or fentanyl overdose deaths (Philadelphia, 2019). [Source: CDC]

Symptoms and health risks of xylazine

  • Sedation, difficulty breathing, dangerously low blood pressure, slowed heart rate, wounds that can become infected, severe withdrawal symptoms, death.

Reduce the overdose and the harms of overdose 

  • Never use alone.
  • Provide rescue breaths, especially for people who have used xylazine since xylazine causes breathing to slow down. Harm reduction experts also suggest rolling individuals on their side, into the recovery position.
  • Carry naloxone and learn how to use it. Because xylazine is often mixed with opioids like fentanyl, naloxone should be given in response to a suspected overdose to reverse any possible opioid effects. Importantly, naloxone will not reverse effects of xylazine. In the event of an overdose, call 911 for additional medical treatment.
  • Reduce injection-related risks by using sterile injection equipment, rotating injection sites, allowing skin veins time to heal before another use, and taking drugs in other ways besides injection.
  • Test drugs before using. There are commercially available test strips to test for the presence of xylazine in a sample of drugs. Test strips are available free of cost at a variety of local programs (see "Local services and support" section below).

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Test Strips for fentanyl and xylazine

  • Fentanyl and Xylazine Test Strips can tell you if your drugs contain the synthetic opioid Fentanyl or the non-opioid sedative Xylazine. Both are frequently found in street drugs. Xylazine is always cut in with fentanyl, so drugs that test positive for xylazine will also contain fentanyl.
  • If used correctly, these test strips can help to prevent overdose deaths and, with other risk reduction practices, save your life.
  • Fentanyl Test Strips are blue and marked with the letters “FYL”.
  • Xylazine Test Strips are red and marked with the letters “XYL”.

Image with steps typed out for how to test with test strips. Right click to open the image to full size or click the link below for a PDF version

Image with steps typed out for how to test with test strips. Right click to open the image to full size or click the link below for a PDF version

 
PDF version for how to use xylazine and fentanyl test strips. 


 
NYS Drug Checking: Data on New York’s Unregulated Supply

New York's Drug Checking Service offers people who use drugs timely and detailed information on the contents of their drugs, helping them to make more informed decisions.

This service also shares information on New York's unregulated drug supply with harm reduction workers and clinicians to help them tailor the care they provide to people who use drugs, while informing advocacy, research, and policy.

The data page includes: Total samples, Monthly samples, Expected drugs, Expected vs. actual drug, Monthly trends, Noteworthy drug trends. The page also links to FAQs on drug checking, Drug Dictionary, Alerts, Resources.

 
Opioid Overdose Prevention Program (NYS OOP)


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Naloxone (Narcan®)

Naloxone (Narcan®) is a medication that can reverse the effects of an overdose from opioids, including fentanyl, heroin, and opioid-based pain killers. It is a tool that community members can use in emergency situations where opioid overdose occurs, providing a chance for individuals to receive further medical care and treatment.

 

Using Narcan

Used correctly, naloxone can reverse an opioid overdose. When Narcan is administered, it attaches to receptors in the brain and blocks opioids from having their usual effects. This helps to rapidly reverse an overdose by restoring normal breathing and providing an opportunity for medical assistance. There is no safety risk associated with naloxone.

 
How to Give Narcan:

  1. Call 9-1-1
  2. Carefully remove Narcan from packaging
  3. Hold the nasal spray with your thumb on the plunger
  4. Tilt the individuals’ head back
  5. Place the tip of the nasal spray in either nostril of the person experiencing an overdose, firmly press the plunger and release the entire dose of medication.
  6. Wait 2-3 minutes while checking for responsiveness
  7. If there is no response, give additional dose, switching nostrils, until help arrives.
First dial 9-1-1  Peel open the Narcan spray pack  Position the Narcan spray in your hand  Tilt back the head, put the Narcan spray nozzle in the nostril, push the plunger in all the way  Put the individual in the recovery position  Check to be sure the individual is breathing

Click here to open a 5-step guide for giving naloxone nasal spray.
Remember to always DIAL 9-1-1 FIRST. (Click here for a PDF.)

 
Watch this 30-second video for a quick "Naloxone/Narcan How-To" (30 seconds).

 
The video below shows you the signs of an overdose and how to respond and take the steps to prevent opioid overdose.

 
For additional information on how to use Naloxone (Narcan®), dial 2-1-1 for information about where you can get trained on how to use Naloxone (Narcan®) in our community.

 
Carry a Narcan kit with you

Opioid Overdose Prevention Programs (OOPPs) are organizations that provide individuals with training and a FREE Narcan kit to carry and dispense this potentially life-saving medication. OOPPs are registered by NYS Department of Health.

FREE Narcan kits are available at one of the local registered OOPP community agencies listed below.

For additional options Dial 2-1-1 (1-877-211-8667) 24/7. Or text your Zip code to TXT211 (898211). Available M-F 9 AM to 4 PM

 

Pharmacy Standing Order:

A statewide pharmacy standing order allows anyone* to get naloxone (Narcan®) nasal spray at a pharmacy without a prescription in NYS. Ask for it at the pharmacy counter. Insurance covers up to $40 copay. If you don’t have insurance, you can buy naloxone at the pharmacy.

*Dispensing to adolescents under age 18 is at the discretion of the pharmacist.


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Local and regional services and support


紧急情况

  • 如果您或您认识的人遭遇紧急医疗情况,请立即致电 911
  • 自杀预防和危机干预服务,危机干预热线 9-8-8,一周 7 天全天 24 小时提供免费保密性危机咨询。

 
预防

  • Southern Tier 艾滋病项目中心 (STAP):在纽约南部提供全面的 HIV/AIDS 服务。该中心提供阿片类药物服用过量预防计划,可为居民提供培训、纳洛酮试剂盒和处方,以便其携带和分发这种可能挽救生命的药物。
  • 汤普金斯县心理健康协会(主页)成立于 1954 年,旨在解决伊萨卡社区的心理健康需求。
    • Jenkins 希望与康复中心无需预约,面向那些接受或曾接受过心理健康服务的居民开放。Jenkins 中心提供安全环境,心理健康顾客可在此放松身心、与同龄人一起玩乐,以及互相分享信息和提供支持。
  • 纽约州成瘾服务和支持办公室主办了“COPE 项目”,该网站有助于在纽约州预防用药过量和减少伤害教育。该计划旨在让居民学习如何防止用药过量并挽救社区居民的生命。
  • 预防服务的其他资源:纽约州艾滋病研究所提供者名录

 
Using

  • 汤普金斯县锐器收集和处理场地
  • Never Use Alone hotline. Dial 1-877-696-1996. An operator will stay with you while you use, and call emergency services if needed.
  • Test strips for Fentanyl and test strips for xylazine are available for free at the Southern Tier AIDS Program, REACH Medical, Cayuga Addiction Recovery Services, and Tompkins County Whole Health's office at 201 E. Green St.
  • Narcan, fentanyl testing strips and xylazine testing strips can be ordered free of cost and delivered to your home via NYS OASAS. Complete the order form online at: oasas.ny.gov/harm-reduction.
  • MATTERS facilitates rapid referrals to outpatient treatment for opioid and substance use disorders. Referrals are submitted online 24/7, 365 days a year by participating referral sites throughout NYS. Individuals may request test strips through the MATTERS website. Find them at mattersnetwork.org. Get the MATTERS Network mobile app on the App Store or Google Play.
  • 您可以参加基于社区的帮扶小组,帮助自己顺利康复,也可以向遭受亲人药物滥用影响的亲友提供帮助。

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治疗

  • Cayuga Addiction Recovery Services (CARS) offers intensive residential and out-patient treatment services, including Medication Assisted Treatment (MAT). CARS offers Open Access Monday thru Thursday from 8:30 a.m.–4:00 p.m. Clients need only to bring an insurance card, if they have one. 607-273-5500.
  • REACH Medical provides medical and behavioral services, including MAT. The REACH Project is a non-profit operating as a low threshold, harm reduction medical practice in Ithaca. Reach Medical offers a wide range of services including: opioid replacement therapy, medical cannabis certification, Hep C treatment, primary care and behavioral services, in a stigma-free, inclusive setting. 607-273-7000. REACH Project Facebook page.
  • 纽约州成瘾服务与支持办公室 (OASAS):治疗查找器
  • About Medication Assisted Treatment (MAT)


康复

  • Ithaca Community Recovery, is a non-profit organization that provides a meeting and activity space for Ithaca’s recovering community. They host a variety of meetings, including Alcoholics Anonymous, Al-Anon Meetings, Narcotics Anonymous, and more. Go to their website for meeting schedules.
  • Mental Health Association in Tompkins County was established in 1954 to address mental health needs in the Ithaca community.
    • Jenkins 希望与康复中心无需预约,面向那些接受或曾接受过心理健康服务的居民开放。Jenkins 中心提供安全环境,心理健康顾客可在此放松身心、与同龄人一起玩乐,以及互相分享信息和提供支持。


预防自杀

  • 自杀预防和危机干预服务提供免费的保密性危机咨询。危机干预热线 9-8-8 可一周 7 天全天 24 小时拨打。
  • Tompkins County Suicide Prevention Coalition.
  • Sophie Fund, Inc. 是一家成立于 2017 非营利性慈善公司,旨在为大伊萨卡和汤普金斯县的年轻人提供心理健康计划支持。该公司支持开展计划和项目;提高相关意识,消除围绕精神疾病和治疗的耻辱感;在社区中倡导“零自杀”精神;为患有精神疾病的年轻人充当社区倡导者。 


全国范围

  • SAMHSA 全国援助热线 FindTreatment.SAMHSA.gov/,1-800-662-4357(援助)。援助热线为面临药物滥用和心理健康问题的个人和家庭成员提供免费的保密性信息(英语和西班牙语)。每周 7 天全天 24 小时提供服务。该网站还设有位置查找器,可根据输入的邮政编码查找最近的治疗服务。
  • SAMHSA 为应对心理问题和药物滥用障碍的家庭提供资源

 Need help finding help?   Dial 2-1-1 (877-211-8667) for supportive referrals.

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