A new report attempts to provide a snapshot of Ulster County’s raging heroin epidemic. But law enforcement officials conceded this week that collecting data remains a work in progress and the report likely undercounts the true toll of opioid abuse in the region.
“We all need to get on the same page to make [the data] better,” said Sheriff Paul VanBlarcum who, along with District Attorney Holley Carnright, oversees the data collection effort. “We know that there are places we’re not getting information from right now.”
County health departments have long been required to report overdose deaths and hospital admissions to the state. In response to the opioid crisis, that effort has expanded to include admissions of opioid users to treatment programs and the administration of the overdose-reversing drug Narcan by first responders and trained civilians. Ulster County police agencies began collecting their own information last year after the county was designated a “High Intensity Drug Trafficking Area under” a federal program that directs resources to drug-plagued jurisdictions. The program paid for an intelligence analyst who assesses data, looks for trends and provides input to police and public health officials developing strategies to combat drug and other crimes.
Since January 2016, police agencies countywide have been asked to fill out a form every time an officer encounters an overdose in the field. The forms go the sheriff’s office where they are included in the analyst’s data set.
Last week, the Ulster Regional Gang Enforcement Narcotics Team, which spearheads the Sheriff’s anti-drug effort, released data illustrating the results of the first year of the data collection effort. Personnel from the sheriff’s office, 12 local police agencies and the state police logged a total of 134 overdoses in all of 2016, including 26 which resulted in death. Among the hardest-hit communities were Esopus with 20 overdoses, Lloyd with 15, and Ellenville with 13. Kingston, New Paltz and Saugerties each reported eight overdoses in 2016 while Woodstock reported five. The numbers provided by URGENT also show a spike in ODs during the summer months peaking in August 2016 with 23. Demographics of overdose victims skew young and male with the largest single group, 37, comprising men between the ages of 20 and 29.
The URGENT statistics also quantified what drugs were found at overdose scenes based on testing at police labs. The numbers show a significant difference between the cause of fatal and non-fatal ODs. In fatal overdose incidents, heroin was suspected in 62 percent. Four percent involved a combination of heroin and the synthetic opiate fentanyl while 13 percent were attributed to other opiates, including prescription medications. Twenty-one percent of the fatal overdoses were ascribed to “other drugs.”
Among non-fatal OD’s, heroin, heroin-fentanyl amalgams and other opioids accounted for 57 percent of the total while “other drugs” made up 43 percent. District Attorney Holley Carnright said that he expected the share of deaths ascribed to “other opiates” and the total number of overdoses to increase with the introduction of new synthetic opiates many times more powerful than heroin into the local supply of narcotics.
“The synthetic heroin we’re seeing coming down the pike now is more dangerous than anything we’ve seen so far,” said Carnright. “If you’re a new user and you don’t have a tolerance, you don’t have a chance.”
More coordination needed
While Carnright and VanBlarcum said that the data would provide a valuable baseline for tracking Ulster County’s opioid crisis, both men conceded that the data was incomplete and called for closer cooperation with civilian authorities to form a more complete picture. For example, while the county health department statistics and the police agencies’ numbers for overdoses during the first half of 2016 are quite close — 59 on the health officials’ list and 52 on the police list — it is by no means clear that the two groups are counting the same victims.
“We got some records from [Ulster County Health Commissioner Dr. Carol Smith] and they were totally different from what we had,” said Carnright. “I don’t think there were three [overdose cases] that were on both lists.”
There are a number of reasons why police might miss ODs that turn up in health department records and vice versa. Carnright said Smith’s numbers relied on data from HealthAlliance of the Hudson Valley, which operates hospitals in Kingston and Margaretville but not Ellenville Regional Hospital. Meanwhile, many overdose victims in the southern portion of the county may be transported to hospitals in Poughkeepsie or Newburgh for treatment and not get logged in county medical records. Police officers, meanwhile, may never learn of overdoses that are called into 911 as “unresponsive subject” and handled by ambulance companies or fire departments, or cases where victims are taken directly to the hospital by friends or family members. In fatal overdoses, absent obvious signs of overdose, the cause of death may not be determined until an autopsy is conducted. Both police and health officials likely miss dozens of overdoses where Narcan is administered by civilians and victims do not seek further medical attention. VanBlarcum and Carnright said efforts were underway to coordinate data-sharing between police, the health department, emergency services and other agencies to provide more complete data. A call to County Executive Mike Hein regarding the data collection effort was not returned to a reporter. VanBlarcum, meanwhile, said obstacles remained to efforts to coordinate civilian and law enforcement efforts.
“A lot of it is confidentiality issues with medical information on their end,” said VanBlarcum.
Despite the incomplete nature of the URGENT data, Carnright said the number clearly showed an alarming trend. Carnright added the data would help support lobbying efforts for state and county resources while raising awareness about the extent of the opioid crisis in Ulster County.
“Moms and dads should know, school districts should know, the general public should know,” said Carnright. “This data helps us shine a light on the problem in a much more focused way than we are now.”
Join the family! 
