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New Orleans and the opioid epidemic 

A year of rising overdose deaths and policy changes

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In his trademark grim delivery, New Orleans Coroner Jeffrey Rouse announced to the New Orleans City Council last summer that for the first time perhaps ever, more people in New Orleans died from opioid-related overdoses than homicides in the first few months of 2016. Within the first five months of the year, Rouse classified 65 deaths as opiate overdoses — compared to 63 opiate overdoses in all of 2015. By Aug. 1, Rouse says 90 people died from opiate-related overdose deaths, including the synthetic opioid fentanyl as well as heroin and prescription opioids. Rouse classified 93 deaths as murders during the same time frame.

  New Orleans was among dozens of cities across the U.S. seeing a spike in opioid use. According to the Centers for Disease Control and Prevention, opioids killed more than 33,000 people in 2015, more than quadruple the number of opiod deaths a decade ago. More than three-quarters of heroin users had used prescription opioids before using heroin. New Orleans Emergency Medical Services (EMS) began to see a rise in opioid overdoses in 2014 and 2015, but within the first weeks of 2016, EMS was responding to double the number of calls per day as it had in the last days of 2015. At January's end, EMS crews responded to as many as five overdoses a day (and, on one day, 10). The city's health department issued a public health advisory in the wake of a spike in overdose deaths over Christmas 2015 through January 2016.

  The city made naloxone — which can reverse the effects of a heroin or opiate overdose — available without a prescription (but for a price) at University Medical Center and several drug stores. Before she became Baton Rouge mayor this year, then-Louisiana Sen. Sharon Weston Broome authored a "Good Samaritan" mea- sure in 2014, providing immunity to people who call 911 for help, despite opiate possession or use. That same year, state Rep. Helena Moreno, D-New Orleans, supported a measure allowing first responders to carry the potentially life-saving naloxone. But a 2016 Gambit cover story found that no law enforcement agency in the state carries it. A recent report from the U.S. Department of Health and Human Services found that Louisiana was among only a handful of states to see a decline in opioid-related hospital stays from 2009-2014 — partially because there are fewer places to go. Budget cuts forced Interim LSU Public Hospital to close its 20-bed detox wing in 2012. Meanwhile, there are no plans to decriminalize opioids, and the New Orleans area continues to see a decline in services for treating or providing inpatient or long-term care to users.

  In August, the Drug Enforcement Agency announced opioids, particularly fentanyl, posed the biggest drug-related threat to the region. Rouse attributed 28 overdose deaths to fentanyl by mid-2016, more than double the number of fentanyl-related deaths in all of 2015. Jefferson Parish Coroner Gerry Cvitanovich classified 15 fentanyl-related deaths by mid-2016, compared to 14 in all of 2015. By July, toxicological tests put Rouse's office nearly $20,000 over its budget. ("At any moment I am a broken X-ray machine away from stopping operations," Rouse told the Council Criminal Justice Committee.)

  Rouse anticipates announcing opioids' overall impact in 2016 by late February.



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