Overdose Deaths Drop in Putnam, But Fentanyl Remains Acute Crisis

by Michael Gold—

Training of first responders in the use of NARCAN, an increase in harm-reduction programs and emphasis on public education may be contributing toward a reduction in overdose deaths in Putnam County this year.

So far in 2023, there have been four confirmed fatal overdoses, compared to 20 all of last year, 14 in 2021 and 13 in 2020, according to the county coroner’s office.

NARCAN, a medicine that quickly reverses the effects of an opioid overdose, and training for police and ambulance corps personnel may be a key reason, said Michael Piazza, commissioner of the Putnam County Department of Social Services and Mental Health.

Another may be the county’s public messaging about the threat of substance abuse to health and life, he said. The county has deployed an array of services to help those with substance use disorders, such as detoxification, treatment and rehabilitation.

Piazza is grateful to The Prevention Council of Putnam, a nonprofit organization, and agencies such as Arms Acres, Cove Care and St. Christopher’s Inn for their work in harm reduction, education and treatment.

“We have been pushing harm-reduction programs and pushing NARCAN,” Piazza said.

The good news is tempered by the risks still out there for those using fentanyl, heroin and even xylazine, an animal tranquilizer.

Piazza characterized fentanyl as “such a potent drug, because it causes the brain to slow down breathing and your heart stops.” People need to be warned “how potent, how dangerous it is,” he said.

Some substance abusers are using xylazine, an animal sedative, with other drugs, possibly unknowingly.

“Xylazine is a dangerous drug for the same reason as fentanyl,” Piazza said. “It’s easy to overdose on.”

Drug dealers often mix heroin with fentanyl and xylazine, Piazza explained, to make their product cheaper and improve profit margins. The result: It overwhelms the central nervous system.

“Xylazine is being used to enhance the effect of the drug you’re taking, like heroin, like fentanyl,” Piazza said. “(Even a) low dose can kill you.”

Dealers may mix a wide assortment of drugs such as heroin, fentanyl, valium, oxycontin and methadone, he said.

Citing the county coroner’s report, Piazza said of the 20 fatal overdoes last year, 17 had a mixture of drugs in their bodies. One overdose was attributed to fentanyl alone.

People are also combining fentanyl with prescription medication.

Putnam County Executive Kevin Byrne sees fentanyl as having had disastrous effects.

“The pervasiveness of fentanyl in our community has been devastating,” Byrne wrote in an e-mail. “The opioid epidemic remains the public health crisis of our lifetime and we’re working every day with our local partners to find ways to save lives. While enforcement is critical, we need help from the federal government to cut off the supply of illicit drugs coming into our country. At the local level we must be focused on prevention, harm reduction, treatment and recovery efforts.”

Piazza talked about the impact of opioids on every community.

“Very few people haven’t been touched” by opioids, he said. “It’s difficult to eradicate.”

Despite the pervasiveness of various substances, Piazza believes alcohol use remains the primary substance of abuse in Putnam. Alcohol use is often associated with public intoxication, car accidents, domestic violence, and assaultive behavior, he said.

Vape shops are also a concern.

“We’re not happy with vaping,” Piazza said. “It’s a very efficient method of delivering a drug. It’s a way to increase the potency of drugs. It goes right into your lungs.”

The problem is compounded if vape shops would be able to distribute cannabis, said Piazza, who is uncomfortable with marijuana legalization.

According to the Marijuana Regulation & Taxation Act, passed in 2021, adults over 21 can possess up to three ounces of cannabis in public and five ounces in their homes. They can possess 24 grams of concentrated cannabis such as vaporization oil or an edible. That means someone can put cannabis in a vape pen and smoke it.

Also, the potency of pot is greater than in the past.

“Vape shops have brought young people in. The concern is that pot would be a class of drugs targeted to young people,” Piazza said.

“The other real concern we have is the proliferation of marijuana delivered as edibles, so very often the packaging mimics candies or baked goods,” he continued. “As a result, we are aware of children in the area who have inadvertently eaten these edibles and ended up in the emergency room.”

Piazza’s advice for parents is to talk to their children about the negative impacts before they start drinking or using other drugs. For instance, alcohol can have long-term effects on certain organs, including the liver, kidneys, heart and the brain.

Parents should also reach out to The Prevention Council of Putnam for help, Piazza said. The council provides education and promotes awareness of substance use disorders and problem gambling for the county. In addition, it offers information on prevention, treatment and recovery services.

In the county, multiple organizations provide resources to residents suffering from substance use disorder. Among the services that can be obtained are community and school-based prevention education; detox; treatment; rehabilitation and recovery; veteran substance abuse care; adult and young adult care; mental health counseling; and psychiatric services.

The county is now emphasizing treatment for co-occurring disorders, Piazza said. “Depression and anxiety often accompany substance disorder problems, as well as other psychiatric issues that need to be addressed,” he said.

Treatment providers will be trained on how to counsel those with substance abuse issues in combination with any mental health problems from which they may be suffering.

Counselors with county-affiliated agencies will require training to work with a substance abuser’s spectrum of substance and mental health issues as a regular part of their treatment.

Additionally, the county is helping to fund a professional crisis stabilization center for mental health and substance abuse issues in Brewster, tentatively scheduled to open next year.

The Prevention Council of Putnam’s Community Engagement Facilitator Lauren Johnson stated that while the organization cannot comment directly on the reduction of overdose deaths this year, it is encouraged by the numbers. Large-scale accessibility and use of Narcan often coincides with fewer deaths, Johnson said.

This year, the council has distributed 1,923 naloxone kits, 193 fentanyl and xylazine test kits and 230 medication deactivation bags. In April, in collaboration with Putnam Hospital Center, the sheriff’s office and Kent police, it collected 127 pounds of sharps.

“These comprehensive environmental prevention and harm reductions strategies all work together, and we can only hope that these evidence-based and promising practice strategies lend to the reduction in both overdose deaths and other negative outcomes,” Johnson stated in an e-mail.

For those who need assistance, contact Cove Care Center in Carmel at 845-225-2700; Arms Acres in Carmel at 845-225-5202; or St. Christopher’s Inn in Garrison at 845-335-1000.