Ocean County authorities are asking hospitals to collect and provide more information about overdose victims, but patient privacy laws and data collection methods may prevent that from happening.
The county had New Jersey’s highest number of overdoses in general and the most fatal overdoses during 2012, prompting officials to seek more info about the victims, particularly survivors, to stem the flood of cases. Specific overdose data can also help the county secure more funding to continue education and enforcement.
In 2012 alone, there were 3,683 substance abuse admissions for heroin and opiates in Ocean County, according to data from the state Department of Human Services’ Division of Mental Health and Addiction Services. That data, while grim, could be useful to authorities, if they knew more specifics about the cases.
“I want to see how many overdoses go through the emergency room. Then I want to get a ratio of how many ODs we’re dealing with in the county and how many are resulting in death,” Ocean County Prosecutor Joseph Coronato said.
Hospitals employ different methods in compiling the information, Coronato said. Also hindering the flow of information is the Health Insurance Portability and Accountability Act, or HIPAA, which protects the privacy of patients’ health records, he said.
“But we don’t want names. We don’t want patient-specific information. We just need the numbers,” he said. “Are the statistics showing one in four overdose victims die, (or) one in five? We have no idea. Being able to cull out this data will help me identify the magnitude of the problem.”
Little Egg Harbor Township Police Chief Richard Buzby said when a resident of West Creek in Eagleswood Township, Tuckerton or Little Egg Harbor overdoses on drugs, that person is either taken to Southern Ocean Medical Center or to AtlantiCare Regional Medical Center, Mainland Campus, in Galloway Township, which can make it difficult to track overdose statistics.
“I’m asking hospitals for the total overdoses by ZIP code and by drug classification, and I know they have it. We’re trying to save lives,” Buzby said.
“It’s not as simple as, can you tell me how many heart attacks there were in the month of April? I could tell you that,” said Dr. Thomas Brabson, chairman of emergency services at AtlantiCare Regional Medical Center. Brabson said he does not compile statistics for drug overdoses, and he doesn’t know of anyone in the hospital who does.
By obtaining accurate data, Ocean County will not only be able to account for all overdoses but also move forward with education and enforcement, Buzby said.
“There is funding and grants that we’re missing out on that we could use in this war on heroin, because we don’t have the accurate statistics,” he said.
The latest data from the state Health Department’s New Jersey Hospital Discharge Data System at the Center for Health Statistics details nonfatal heroin and prescription overdose hospitalizations and emergency department visits for 2010-12 but is based on county of treatment, not county of residence.
There are other problems, such as identifying the drug that killed a victim.
As an example, Brabson said, if a patient who arrived showing signs of opiate overdose was given the anti-overdose drug naloxone, also known by the brand name Narcan, and woke up, the doctor’s presumption would be that the patient had ingested an opiate. But that opiate could be heroin, oxycodone, oxycontin or another substance, he said.
If someone died in an emergency room, the case would be reported to the medical examiner’s office. While doctors might have their suspicions about an overdose, they can’t know for sure until toxicology tests are returned.
“If we don’t test for the drug, it’s very difficult for me as a clinician to say the overdose was a result of a specific substance,” he said.
Even when a victim is found in the bathroom with a needle in his or her arm, authorities cannot assume heroin was taken.
And even if hospitals tested for opiates in someone’s body, not all of them show up in a standard drug test, Brabson added.
“So, for example, if someone used heroin that was laced with Fentanyl, heroin would show in a drug test up, but the Fentanyl would not,” he said.
The impasse is an unusual and frustrating one for law-enforcement officials: Even if they subpoenaed records from the hospitals, they would be limited to getting information only about a specific case, one that police would have to be investigating in connection with a suspected crime, Buzby said.
“The stats right now are flawed. We’re asking for the total of all overdoses, not just fatal. Just because someone’s life was saved on this occasion doesn’t mean they won’t become a fatality statistic next time,” Buzby said.
“We understand the frustration of not having one central source for gathering and dissemination of aggregate data. AtlantiCare is not required to report drug overdose data, therefore, does not routinely track it,” AtlantiCare spokeswoman Jennifer Tornetta said.
Tornetta went on to say the hospital does comply with the law in providing information.
“We regularly provide information to law enforcement following HIPAA guidelines as mandated by law. HIPAA is meant to protect patient privacy, not hinder law enforcement,” she said.
Donna Sellmann, spokeswoman for Southern Ocean Medical and Ocean Medical Centers, said Meridian Health preferred not to comment on the issue of releasing drug overdose data to authorities.
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