Burstein shares opioid overdose progress

An innovative collaborative effort among those affected by the opioid epidemic has drastically reduced the number of Erie County opioid deaths since a record high in 2016, Gale R. Burstein, Erie County health commissioner and clinical professor of pediatrics, told an interdisciplinary group assembled recently at the School of Nursing.

“We’re light years ahead,” Burstein replied when asked by nursing Dean Marsha Lewis how Erie County compared to other regions in the country fighting the opioid epidemic.

Burstein said a documentary production company hired by MSNBC has been reporting on what Erie County has done to combat what health officials have described as a nationwide epidemic of opioid overdoses. There will be four episodes from different parts of the country showing how each region dealt with the problem.

“They told us we’re going to be the last one as the place that figured it out,” Burstein said.

Opioid deaths in Erie County spiked at 301 in 2016. At that point, the county established what Burstein called a pivotal task force to address the problem, and in 2019 the number of deaths dropped to 120, down from 191 in 2018.

“That’s still a lot,” she said, “but it’s a lot less than where it was last year.

“It’s been the community coming together and embracing the problem and working together,” Burstein said in the talk on Feb. 7 in Wende Hall, South Campus, sponsored by UB’s Opioid Workforce Expansion Program. “Law enforcement, health officials, substance-use providers, family members, people involved in education, crime reduction units: It’s involved people of all disciplines to collaborate and develop strategies using their expertise.”

Her presentation detailed the local and national opioid epidemic and the coordinated approach Erie County has taken to significantly lower the number of opioid-related deaths.

In 2015, 92 million people in the U.S. used prescription opioids, according to Burstein. More than 11 million people misused these prescription drugs and 2 million reported opioid disorders.

From 1999 to 2017, 700,000 people died in the nation from drug overdoses, two-thirds of them from opioid overdoses, she said, noting that an average of 130 American still die each day. And in Erie County, the number of opioid deaths doubled from 127 in 2014 to 256 in 2015.

“We had a crisis,” Burstein said. “So I went to the county executive and said, ‘Houston, we have a problem.’ I can’t fix this by myself.”

Bringing together county and community leaders from different backgrounds to create the Erie County Opiate Epidemic Task Force became the turning point, she said.

 “We put together this community task force, it’s a community problem” she said. “We had to embrace we had a problem, talk about it, and then we had to get everyone together to figure out how to solve it. It’s not something the health department can figure out, and it’s not something the mental health department can figure out. It really takes a village.”

After the number of overdose deaths in the county reached 301 in 2016, “we started bending the curve,” she said. “All our good programs started to become effective, and we’re continuing to bend the curve.” The most recent county 2019 data showed 120 overdose deaths, she said.

The task force responded to the heroin epidemic in three ways: preventing people from starting heroin, reducing heroin addiction and reversing heroin overdose by expanding the use of naloxone, which reverses the effects of an overdose if administered in time.

Burstein said the task force is comprised of seven different working groups, each with its own expertise to develop programs.

Among the seven groups are law enforcement, families who have lost loved ones through overdoses, community education groups that design anti-stigma education, health care providers who have changed prescription practices to provide alternatives to opioids, and first responders who are trained to recognize overdoses, providing them with NARCAN to resuscitate overdose victims until EMTs arrive on the scene.

Burstein was especially proud of the county’s media campaign, which includes billboards that feature people in the community who are struggling with opioid disorders.

“Their cases are on the billboard to show, ‘Hey, I look like you. We’re here in the community,’” she said. “ ‘Drop the stigma.’

“We just want people to come out and seek care and not end up in our medical examiner’s office,” she said. UB’s interdisciplinary Opioid Workforce Expansion Program, which sponsored Burstein’s presentation, aims to train students to treat opioid and substance abuse disorders, and to increase this particular workforce in Western New York. It is supported by a grant from the Health Resources and Services Administration of the U.S. Department of Health and Human Services.

“At UB School of Nursing, we really strive to improve the health and wellness of the Western New York community and beyond,” said Yu-Ping Chang, associate dean for research and scholarship and primary investigator on the HRSA-funded opioid workforce grant.

“Inviting speakers like Dr. Burstein and engaging in an honest dialogue about the very serious opioid and other substance use issues affecting our community is an important step in the process,” Chang said. “The more we know and are engaged in the problem, the more we can affect positive change as educators, researchers and community members.”

The program included NARCAN training after Burstein’s presentation to demonstrate the nasal spray that is used to reverse an opioid overdose.

Burstein's presentation was supported by HRSA as part of an award totaling $1,350,000 with 0% financed with nongovernmental sources. The contents were those of the author and did not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. government.