Council Report: Opioids and Fort Worth



Fort Worth has less of an opioid problem than other places, but there is still room for improvement.

That was the message to the Fort Worth City Council at Tuesday’s work session in a joint presentation from the Fort Worth Fire Department, Fort Worth Police Department, and MedStar Mobile Healthcare.

The presentation was introduced with several key points:

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*Addiction is a re-lapsing brain disease.

*It impacts an entire community.

*Fort Worth does not appear to be as impacted as the Midwest.

*The goal is to proactively address and mitigate issues before they become

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an issue here.

*Recovery Resource Council hosted a Recent Addiction Recovery Luncheon that focused on the impact of addiction and opioids in Fort Worth.

*Focus on opportunities to work in collaboration now to prevent the impact felt throughout the Midwest.

*There are two generations impacted by this issue.

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Fort Worth MedStar is responding to about three opioid overdoses per day, said Matt Zavadsky, Chief Strategic Integration Officer for MedStar locally. And while that is three too many, he said it pales in comparison to places, such as the state of Ohio, where statistics show 5,000 annual deaths from opiates since 2014. The city of Columbus averages 8-12 overdoses a day and two to three fatalities a week.

“We are blessed to not have that,” he said. “We saw a spike in 2016, but ever since the trend has been going down.”

Fort Worth Fire Chief Jim Davis came here 10 months ago after serving four years in Columbus.

“There’s probably nobody in this room who has not been impacted by some form of addiction in their family, their friends, and their workplace,” Davis said.

Zavadsky said he believes that not only are people becoming more educated about the dangers of opioids, but so is the health care system.

“A number of communities, including Fort Worth, stood up and said we need to address this,” he said. “We cannot arrest our way out of this.”

Fort Worth Police Chief said the combined approach to targeting opioids includes:

*FWPD partnering with the DEA and created a Tactical Diversion Squad.

*Office of Diversion Control’s mission is to prevent, detect, and investigate the diversion of controlled substances from legitimate sources.

*Target doctors who prescribe opioids outside legitimate medical purposes, along with pharmacies operating outside normal practices, pill mill operations, pharmacy burglary rings, prescription forgery groups, clandestine lab operations, and illegal importation of controlled substances form overseas sources.

Narcan, which is an opioid antagonist used for the complete or partial reversal of opioid overdose, including respiratory depression, has been issued to SWAT, Gang Units, Narcotics, Vice, and Special Reaction Teams. It has also been issued in the property room, jail (on a volunteer basis), along with Property Crime Units and Bike Unit (on a volunteer basis).

Classes in administering are now being offered to patrol officers on a volunteer basis.

All FWPD tactical medics have Narcan medication. In 2017 they administered two doses, and in 2018 they administered one. So far in 2019 they have administered one. Each officer carries two doses and is required to attend a two-hour training class.

FWPD diversion results include:

*Identified and executed search warrants on six doctors’ offices/residences.

*Investigated approximately 29 pharmacies for regulatory violations.

*Approximately 30 undercover operations have been conducted related to opioids.

*Investigated one overdose death related to over-prescribing by doctor (pending judicial).

*Multiple arrests and prosecutions (or pending prosecution), including four doctors (Arlington, Garland, Brownfield), one doctor’s office employee (Granbury), five individuals in distribution ring (Burleson), one EMT (Fort Worth), four individuals for prescription forgery (Fort Worth).

*Two pharmacists and eight doctors surrendered their DEA registrations and can no longer issue controlled substances.

*A combined $460,000 in fines have been paid by doctors and pharmacies.

*$3.6 million in U.S. currency has been seized in Fiscal Year 2019.

*56 kilos of pharmaceutical drugs have been seized.

*676 dosage units of (liquid) pharmaceutical drugs have been seized.

*Tactical Diversion Squad and Diversion support the National Drug Prescription

Drug Take Back program

*118,761 pounds of medications were turned in and destroyed from the division


Profile stats for the MedStar EMS from July 2018 to June 2019 include:

*663 responses, 22 dead on scene with resuscitation attempted.

*619 transported to the emergency department (93%).

*Average age 49, youngest 6, oldest 99.

*59% male, 41% female.

*Average dose of Narcan administration per patient, 1.16 milligrams.

Community partnership has also included Tarrant County MHMR and a grant from the Substance Abuse and Mental Health Service Administration. This also includes helping first responders, along with patients, family members and care givers learn the correct use Narcan and counseling/education.

Through MedStar sharing data regarding overdose victims, MHMR can do follow-ups with the victims.

Outcomes include:

*602 referrals.

*35 committed to enroll.

*12 actually participated and remained in treatment.

*24 individuals have been referred to the TORRI project (Tarrant Opiate Reduction and Recovery Initiative) multiple times.

“Every day MedStar sends to MHMR a list of everyone we gave Narcan to, and they follow up,” Zavadsky said.

And while Fort Worth is ahead of other places when it comes to an opoid problem, Zavadsky believes even better days are ahead for here and elsewhere.

“I think we’ll get that number down even more because the country is going to address it,” he said.