City Overdose Epidemic Costs Millions

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   The overdose epidemic comes at a massive cost. In Middletown, it’s millions.
Ed Richter   Staff Writer
Updated 6:32 a.m. Saturday, Jan. 27, 2018   Local News

The overdose epidemic that became one of the biggest stories of 2017 around the country has strained families and the community.
It also struck Middletown’s budget and resources.
City officials said the battle to fight the heroin and opioid epidemic cost taxpayers more than $2.3 million in 2017. That cost shifted time and resources away from other duties, such as efforts to prevent other crime or the ability to respond to a medical emergency elsewhere in the city.
FROM 2017: Middletown council member: Can we stop responding to overdoses?
The city estimated the cost at $1.5 million in 2015. No estimate was calculated for 2016.
To put the 2017 costs into perspective, $2.3 million is about what the city of Middletown has appropriated for paving in 2018.
“That number is large but most of it is not really ‘extra’ money, just loss of capacity for the existing budget,” said City Manager Doug Adkins. “We now have seven officers in narcotics. It used to be three or four. Those extra officers could be on the street doing crime prevention if we had less opiates. Same thing with fire. We staff for several crews each day. Not running those opiate calls free those crews up for more calls, faster response times, etc. for our residents.”
The number of overdoses was also striking. There were 966 overdoses reported in Middletown for 2017, which was up from the 532 reported in 2016. Deaths from overdoses increased from 74 in 2016 to 77 in 2017, according to the Middletown Division of Fire.
MORE: Middletown leaders voice progress in overdose fight
MORE: Those on front line of heroin epidemic share frustrations, concerns
City leaders and stakeholders will gather for the 12th Heroin Summit on Monday at Atrium Medical Center as Middletown and cities around the country are looking to take action.
Middletown has implemented best practices learned from experience and other communities. They include: More enforcement with additional K-9s and four more detectives, going after nuisance addresses, deploying a Heroin Response Team to get people who overdose into some type of treatment program, education programs, needle exchanges and partnering with drug enforcement units from Butler and Warren county sheriff’s offices.
“Everything we’re doing is working, but the problem is bigger than the resources available,” said City Manager Doug Adkins. “It would be worse if we weren’t already working on the problem.”
What is the cost?
The city of Middletown provided a breakdown by several departments on how much the opioid epidemic is costing taxpayers. Adkins noted that the cost of Narcan, indigent burials the Heroin Response Team and others go beyond regular staffing.
Police costs alone were more than $1.92 million and included everything that could be tied to opioid-related cases and also the costs of the narcotics division, drug dogs, patrol officers and detectives. That included salaries and benefits, overtime, court time and Heroin Response team costs related to opioids.
Adkins confirmed this amount would be the equivalent of placing more than 20 full-time fully-equipped police officers with cruisers on the streets.
MORE: Middletown on pace to double drug overdoses from last year
Middletown Municipal Court has no direct costs associated with heroin specifically, Adkins said.
“The same staff resources are used regardless of the underlying issue or drug of choice,” he said. “With that said, our previous estimate of $110,530 would still be valid using a cost per case formula. The only increase cost we have seen are for an increase use of oral drug screens in the courtroom, but these are paid for by user fees.”
The Middletown Health Department spent about $76,217 for its efforts in fighting the heroin/opioid epidemic, including syringe exchange, indigent burials and personnel costs.
The Middletown EMS and Heroin Response Team’s total costs have been calculated at $199,300 for the 966 incidents that were responded to an opiate abuse in 2017.
Adkins said most times they responded with three to five fire personnel depending on which unit was dispatched and the staffing that day. Of the total fire cost, the largest portion, $122,800, was for fire personnel to respond to these runs.
Of the total fire costs, drugs and supplies for responding to these runs cost the city $39,500. Adkins said the supplies for these runs were calculated based on who got Narcan.
In 2017, 798 individuals received Narcan. Adkins said the cost of Narcan was closely monitored and was based on $23 a syringe, which includes a $6 rebate cost from the Ohio Attorney General’s Office. The cost for medical supplies to administer Narcan and giving medical care was estimated at $6 in treating these individuals. According to the Division of Fire, Middletown EMS units used 1,501 syringes to administer 2,970.5 milligrams of Narcan in 2017. One dose of Narcan is 2 milligrams.
MORE: Middletown councilman drops controversial ‘3-strike’ narcan proposal
The Heroin Response Team costs were listed at $37,000 for the fire and police personnel putting in about 430 hours preparing for and working in the field which referred more than 250 people into treatment. Adkins said these are hours spent pulling reports and working in the field talking to individuals. In addition, Adkins said he’s spent several hours each week working in many different areas involving opiates.
He said the cost of the care coordinators used in the outreach was in-kind work received from One City Against Heroin and Butler County Mental Health and Addictions Recovery Services Board. Adkins said one coordinator worked for the entire year and a second started around October for full-time work. Their full time hours have been spent largely in Middletown and has not been a cost to the city, he said.
By the Numbers
Costs of heroin epidemic for Middletown taxpayers in 2017
$2.3 million: The overall cost to Middletown taxpayers in 2017. It is the approximate amount Middletown plans for paving in 2018.
$1.92 million: The overall cost for police services that were opioid-related.
$1.5 million: The overall cost to Middletown taxpayers in 2015. No calculation was made in 2016.
$199,300: The overall cost to taxpayers for Middletown EMS responses, Heroin Response Team, Narcan and other drugs and medical supplies.
$110,000: Approximate costs for Middletown Municipal Court services in opioid-related cases.
$62,000: For police overtime costs for patrol officers, narcotics officers, detectives and canines.
$57,000: Costs for syringe exchanges and Narcan syringes used in 2017.
$45,000: For court time paid to police officers in drug cases.
$14,725: Costs to the city for indigent burials.
2,970.5: Number of milligrams of Narcan administered by Middletown EMS in 2017.
1,501: Number of syringes used by Middletown EMS in 2017.
966: Number of opioid-related overdoses in Middletown in 2017, up from 532 in 2016.
798: Number of individuals who received Narcan from Middletown EMS medics.
430: Number of hours used by fire and police personnel on the Heroin Response Team preparing for and working in the field.
250: Number of people referred into opioid treatment by the HRT.
77: Number of opioid-related fatal overdoses in 2017, up from 74 in 2016.
$23: The discounted cost for one dose of Narcan.
$6: The cost of medical care and supplies to administer Narcan.
2: The number of milligrams in one dose of Narcan.
Source: The city of Middletown

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Analytical Members Profile Send Private Message Find Members Posts Add to Buddy List MUSA Citizen Joined: Nov 19 2015 Location: United States Status: Offline Points: 562	Post Options Post Reply Quote Analytical Report Post Thanks(0) Quote Reply Topic: City Overdose Epidemic Costs Millions Posted: Jan 27 2018 at 8:29am
	The overdose epidemic comes at a massive cost. In Middletown, it’s millions. Ed Richter Staff Writer Updated 6:32 a.m. Saturday, Jan. 27, 2018 Local News The overdose epidemic that became one of the biggest stories of 2017 around the country has strained families and the community. It also struck Middletown’s budget and resources. City officials said the battle to fight the heroin and opioid epidemic cost taxpayers more than $2.3 million in 2017. That cost shifted time and resources away from other duties, such as efforts to prevent other crime or the ability to respond to a medical emergency elsewhere in the city. FROM 2017: Middletown council member: Can we stop responding to overdoses? The city estimated the cost at $1.5 million in 2015. No estimate was calculated for 2016. To put the 2017 costs into perspective, $2.3 million is about what the city of Middletown has appropriated for paving in 2018. “That number is large but most of it is not really ‘extra’ money, just loss of capacity for the existing budget,” said City Manager Doug Adkins. “We now have seven officers in narcotics. It used to be three or four. Those extra officers could be on the street doing crime prevention if we had less opiates. Same thing with fire. We staff for several crews each day. Not running those opiate calls free those crews up for more calls, faster response times, etc. for our residents.” The number of overdoses was also striking. There were 966 overdoses reported in Middletown for 2017, which was up from the 532 reported in 2016. Deaths from overdoses increased from 74 in 2016 to 77 in 2017, according to the Middletown Division of Fire. MORE: Middletown leaders voice progress in overdose fight MORE: Those on front line of heroin epidemic share frustrations, concerns City leaders and stakeholders will gather for the 12th Heroin Summit on Monday at Atrium Medical Center as Middletown and cities around the country are looking to take action. Middletown has implemented best practices learned from experience and other communities. They include: More enforcement with additional K-9s and four more detectives, going after nuisance addresses, deploying a Heroin Response Team to get people who overdose into some type of treatment program, education programs, needle exchanges and partnering with drug enforcement units from Butler and Warren county sheriff’s offices. “Everything we’re doing is working, but the problem is bigger than the resources available,” said City Manager Doug Adkins. “It would be worse if we weren’t already working on the problem.” What is the cost? The city of Middletown provided a breakdown by several departments on how much the opioid epidemic is costing taxpayers. Adkins noted that the cost of Narcan, indigent burials the Heroin Response Team and others go beyond regular staffing. Police costs alone were more than $1.92 million and included everything that could be tied to opioid-related cases and also the costs of the narcotics division, drug dogs, patrol officers and detectives. That included salaries and benefits, overtime, court time and Heroin Response team costs related to opioids. Adkins confirmed this amount would be the equivalent of placing more than 20 full-time fully-equipped police officers with cruisers on the streets. MORE: Middletown on pace to double drug overdoses from last year Middletown Municipal Court has no direct costs associated with heroin specifically, Adkins said. “The same staff resources are used regardless of the underlying issue or drug of choice,” he said. “With that said, our previous estimate of $110,530 would still be valid using a cost per case formula. The only increase cost we have seen are for an increase use of oral drug screens in the courtroom, but these are paid for by user fees.” The Middletown Health Department spent about $76,217 for its efforts in fighting the heroin/opioid epidemic, including syringe exchange, indigent burials and personnel costs. The Middletown EMS and Heroin Response Team’s total costs have been calculated at $199,300 for the 966 incidents that were responded to an opiate abuse in 2017. Adkins said most times they responded with three to five fire personnel depending on which unit was dispatched and the staffing that day. Of the total fire cost, the largest portion, $122,800, was for fire personnel to respond to these runs. Of the total fire costs, drugs and supplies for responding to these runs cost the city $39,500. Adkins said the supplies for these runs were calculated based on who got Narcan. In 2017, 798 individuals received Narcan. Adkins said the cost of Narcan was closely monitored and was based on $23 a syringe, which includes a $6 rebate cost from the Ohio Attorney General’s Office. The cost for medical supplies to administer Narcan and giving medical care was estimated at $6 in treating these individuals. According to the Division of Fire, Middletown EMS units used 1,501 syringes to administer 2,970.5 milligrams of Narcan in 2017. One dose of Narcan is 2 milligrams. MORE: Middletown councilman drops controversial ‘3-strike’ narcan proposal The Heroin Response Team costs were listed at $37,000 for the fire and police personnel putting in about 430 hours preparing for and working in the field which referred more than 250 people into treatment. Adkins said these are hours spent pulling reports and working in the field talking to individuals. In addition, Adkins said he’s spent several hours each week working in many different areas involving opiates. He said the cost of the care coordinators used in the outreach was in-kind work received from One City Against Heroin and Butler County Mental Health and Addictions Recovery Services Board. Adkins said one coordinator worked for the entire year and a second started around October for full-time work. Their full time hours have been spent largely in Middletown and has not been a cost to the city, he said. By the Numbers Costs of heroin epidemic for Middletown taxpayers in 2017 $2.3 million: The overall cost to Middletown taxpayers in 2017. It is the approximate amount Middletown plans for paving in 2018. $1.92 million: The overall cost for police services that were opioid-related. $1.5 million: The overall cost to Middletown taxpayers in 2015. No calculation was made in 2016. $199,300: The overall cost to taxpayers for Middletown EMS responses, Heroin Response Team, Narcan and other drugs and medical supplies. $110,000: Approximate costs for Middletown Municipal Court services in opioid-related cases. $62,000: For police overtime costs for patrol officers, narcotics officers, detectives and canines. $57,000: Costs for syringe exchanges and Narcan syringes used in 2017. $45,000: For court time paid to police officers in drug cases. $14,725: Costs to the city for indigent burials. 2,970.5: Number of milligrams of Narcan administered by Middletown EMS in 2017. 1,501: Number of syringes used by Middletown EMS in 2017. 966: Number of opioid-related overdoses in Middletown in 2017, up from 532 in 2016. 798: Number of individuals who received Narcan from Middletown EMS medics. 430: Number of hours used by fire and police personnel on the Heroin Response Team preparing for and working in the field. 250: Number of people referred into opioid treatment by the HRT. 77: Number of opioid-related fatal overdoses in 2017, up from 74 in 2016. $23: The discounted cost for one dose of Narcan. $6: The cost of medical care and supplies to administer Narcan. 2: The number of milligrams in one dose of Narcan. Source: The city of Middletown

VietVet Members Profile Send Private Message Find Members Posts Add to Buddy List MUSA Council Joined: May 15 2008 Status: Offline Points: 7008	Post Options Post Reply Quote VietVet Report Post Thanks(1) Quote Reply Posted: Jan 27 2018 at 1:45pm
	All of this is wasted taxpayer money IMO. I happen to agree with Picard's reasoning and again ask, is this a city obligation to take care of these people? It makes it extremely difficult to care about drug using people who could care less about themselves. Even harder for me to justify this costs to help them live another day. They created the mess they are in. Let them be responsible for getting out of the mess. I do not want to hear that they are incapable of doing so by the bleeding heart liberals out there. Social programs only go so far before you are taken for a ride and proven to be a fool for some of these so called "helpless" people. Not buying the (to coin a phrase from the movie Modern Problems...."help me help me, I'm a wounded duck" (Dabney Coleman line) Insensitive? Perhaps. A fool for the drug users and supporting all the social programs the Dems want to hand out..... Nope
	I'm so proud of my hometown and what it has become. Recall 'em all. Let's start over.

buddhalite Members Profile Send Private Message Find Members Posts Add to Buddy List MUSA Citizen Joined: May 11 2017 Location: Middletown Status: Offline Points: 499	Post Options Post Reply Quote buddhalite Report Post Thanks(0) Quote Reply Posted: Jan 27 2018 at 5:21pm
	As a Christian - it's hard for me to NOT care for others, regardless of my opinion of them, their actions or their works. On the other hand - Viet, at some point you're right. We can't continue to carry multi-million dollar costs every year for these folks either. It is a mixed bag - hopefully Trumps pledge of federal funds will alleviate a bit of the issue, but I'm sure once it filters down it will be nowhere near enough either. It may be time for tough love - I wish Picard hadn't dropped it. At least the conversation was happening - now nothing is happening but us paying the bill.
	"Every government intervention [in the marketplace] creates unintended consequences, which lead to calls for further government interventions." -Ludwig van Mises

VietVet Members Profile Send Private Message Find Members Posts Add to Buddy List MUSA Council Joined: May 15 2008 Status: Offline Points: 7008	Post Options Post Reply Quote VietVet Report Post Thanks(1) Quote Reply Posted: Jan 28 2018 at 8:55pm
	buddhalite: "It is a mixed bag - hopefully Trumps pledge of federal funds will alleviate a bit of the issue, but I'm sure once it filters down it will be nowhere near enough either." IMO, no amount of money nor meetings thrown at the problem (Atrium meetings) will have any effect. Drug arrests/administering of Narcan do nothing to solve the issue either. Cities can have all the "gatherings to address the drug crisis" they want, I will predict it will make no difference in the outcome. Throwing money at the problem by buying Narcan to bail the user out time and time again only saves their lives at that particular moment. It certainly doesn't solve the reuse issue nor does it make the problem go away. Forget about "community messages about drug usage" seen on TV and on billboards as well. Wasted time, money and effort by the communications community. No, IMO, the only thing to do is to let them make the choice- use or don't use. If they choose to use, THEY are responsible for whatever happens to them. THEY are required to prepare themselves for the overdose. It is a lifestyle choice just as excessive drinking, smoking and any other CHOICES in life one makes. You can do anything you wish in life, including murder, IF you are willing to accept the consequences. That is a hardline fact about life's choices. This is a social issue that has to play itself out in the form of survival due to changes made by the user to stop using. How bad does your life have to be and how many bad events in one's life have to happen before the desire occurs to change for the better? It was their choice in the beginning. It will be their choice to stop in the end........or die in the user's refusal to make the right decision. Bottom line. It is up to the person (and family support) who started down the destructive path in the first place to make a life saving change.....or die. It is not society's responsibility to play Mother Theresa with a "save them from themselves" mentality. Those in government are trying to play "savior" in their actions and spending budget busting funds to do so. Apply the money to where it will do the most good.....the wants and needs of the majority who need decent streets, police, fire protection and infrastructure....you know, the basics. JMO If we keep helping them out on each overdose, what is the incentive for them to stop and change? There must be a deterrent somewhere in this. That deterrent would be for them to know there is no more help coming on the next overdose.
	I'm so proud of my hometown and what it has become. Recall 'em all. Let's start over.