1. Snapshot of Lancaster County
Jessica Klinkner, MPH CHES
Lancaster General Health/Penn Medicine

2. Protective Factors for Substance Misuse and Abuse
Community
Peer/Individual
Rewards for Prosocial Involvement
Interaction with Prosocial Peers
Prosocial Involvement
Family
Family Attachment
Belief in the Moral Order
Opportunities for Prosocial Involvement
Religiosity
School
58%
Have 3 or more Protective Factors
Prevention is a science. The risk and protective model of prevention is a proven way of reducing substance abuse and its related consequences.
Protective factors, also known as “assets,” are conditions that buffer youth from risk by reducing the impact of the risks or changing the way they respond to risks.
Protective factors exert a positive influence and buffer against the negative influence of risk, thus reducing the likelihood that adolescents will engage in problem behaviors. Protective factors identified through research include strong bonding to community, family, school, and peers, and healthy beliefs and clear standards for behavior. Protective bonding depends on three conditions:
• Opportunities for young people to actively contribute
• Skills to be able to successfully contribute
• Consistent recognition or reinforcement for their efforts and accomplishments
Good news: 58% of students have 3+ of these protective factors
Source: 2015 Pennsylvania Youth Survey

3. Risk Factors for Substance Misuse and Abuse
Low Neighborhood Attachment
Low Commitment Toward School
Perceived Availability of Drugs
Rebelliousness
Laws & Norms Favorable Toward Drug Use
Gang Involvement
Perceived Risk of Drug Use
Family History of Antisocial Behavior
Attitudes Favorable Toward Drug Use
Poor Family Management
Attitudes Favorable Toward Antisocial Behavior
Parental Attitudes Favorable Toward Drug Use
Sensation Seeking
Parental Attitudes Favorable Toward Antisocial Behavior
Rewards for Antisocial Behavior
Friend's Use of Drugs
Family Conflict
Interaction With Antisocial Peers
Academic Failure
Depressive Symptoms
“known to predict increased likelihood of drug use, delinquency, school dropout, and violent behaviors among youth, risk factors are characteristics of community, family, and school environments, and of students and their peer groups. For example, children who live in families with high levels of conflict are more likely to become involved in delinquency and drug use than children who live in families characterized by lower levels of conflict.”
36% of Lancaster County youth are at risk—6th % 8th grade (5+ risks) 10th & 12th grade (7+ risks)
36%Total Risk
Source: 2015 Pennsylvania Youth Survey

4. Lancaster County Youth
Heroin Use: 0.4%
Narcotic Prescription Drug Use: 5.7%
42.4% took them from a family member living in their home
46.8% received them from a friend or family member
21.7% bought them from someone
Narcotic use—10% of 12th graders
Source: 2015 Pennsylvania Youth Survey

5. Lancaster County Youth
26% of youth state that it is “Sort of Easy” or “Very Easy” to access prescription pain drugs
Overdose deaths in 2016—2 under 18
16 y/o male
17 y/o male
Source: 2015 Pennsylvania Youth Survey

6. An estimated 32,866 people aged 12+ may be in need of substance abuse treatment at any given time.
The prevalence estimate is reached by taking the population count for each age group from the US Census and calculating a percentage based on the National Survey on Drug Use and Health (NSDUH). This yields an estimate of the number of persons in that age group who may be in need of substance abuse treatment at any given time. Age group Population Estimated rate of prevalence for this age group Prevalence , % 36,822
Source: Lancaster County Drug and Alcohol Commission 2016 Treatment Needs Assessment Summary

7. 9-1-1 EMS Overdose/Poisoning Related Calls
Annualized for the remainder of 2017
Overdose/poisoning related Emergency Medical Service calls have increased 37% since 2010.
-Lancaster County-Wide Communications Center
8910 calls since 2010
737 through end of June
Annualized it will be 1474, about 30 calls more than 2015
Source: Lancaster County-Wide Communications

8. Emergency Overdose Reports 2014-2016
January 2014-November 2016
Represents about 4600 calls
Source: Lancaster County-Wide Communications

9. Successful Naloxone Reversals by Police Officers in Opioid Overdose Events
2 state police,
182 Municipal/regional police
Similar to Chester County, lower than counties on our northern border. York second highest in the state at 476.
Does not paint a complete picture—does not include EMS.
Currently no unified data reporting process for EMS—something that this Coalition would like to see happen to have a more realistic picture of what is happening within the County.
Source: Pennsylvania Department of Drug and Alcohol Programs, Rev. 7/12/17

10. Hospitalization Rate for Opioid Overdose, 2016
Number per 100,000 residents
29.6 hospitalizations per 100,000 residents
127 total in 2016, 61 for admitted for heroin and 66 for prescription drug
Higher than Berks, Chester, and York
Source: Pennsylvania Health Care Cost Containment Council, Research Brief

11. Drug Related Overdose Deaths 2016
The rate of drug-related overdose deaths in Pennsylvania increased from 26.7 per 100,000 in 2015 to 36.5 per 100,000 in 2016, far exceeding the national average (16.3 per
100,000).
Source: Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.

12. Drug Related Overdose Deaths 2016
With a death rate of 22.3, Lancaster County ranks 43rd out of 67 counties, but 11th in the number of deaths (117).
Source: Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.

13. Change In Overdose Deaths 2015-16
For this report, only drug-related overdose deaths ruled accidental or undetermined (if provided and toxicology was present) were analyzed. Suicides were excluded
due to previous studies demonstrating the toxicology, demographic information, genetic predisposition, and other factors of suicide decedents are dissimilar to those of accidental overdose.
Between 2015 and 2016, there was a 37 percent increase in the number of drug-related overdose deaths in Pennsylvania. The change in deaths (percent) from 2015 to 2016 varied across the counties and ranged from a 37.5 percent decrease to a 300 percent increase. Figure 3 depicts the counties in the highest 25 percent, upper percent, lower percent, and lowest 25 percent of percent change from 2015 to 2016.
Source: Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.

14. Change In Overdose Deaths 2015-16
there was a 33% increase
Overall, the state had a 37% increase
Source: Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.

15. Most Frequent Drug Category in Overdose Deaths, 2015-2016
Fentanyl/FRS/NPSOs 52%
Heroin 45%
Benzodiazepines 33%
Prescription Opioids 25%
Cocaine 27%
Ethanol 20%
Overall, 130 percent increase in the number of fentanyl mentions from (really picked up in last 4 months of 2016)
Heroin increased 23%
Sources:
Analysis of Drug Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division.
Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.

16. Most Frequent Drug Category in Overdose Deaths, 2016
Fentanyl/FRS/NPSOs 52%
Heroin 45%
Benzodiazepines 33%
Prescription Opioids 25%
Cocaine 27%
Ethanol 20%
Overall, 130 percent increase in the number of fentanyl mentions from (really picked up in last 4 months of 2016)
Heroin increased 23%
Source: Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.

17. Deaths by Drug Category By Quarter 2016
Totals
46 Fentanyl/Fentanyl related substances mentions/non-prescription synthetic opioid mentions
61 Heroin mentions
34 Prescription Opioid mentions (most common: Oxycodone--in PA 70% of PO mentions were from decedents 75+ old)
33 Benzodiazepine mentions (Most common: Xanax)
Source: Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.

18. Total Overdose Deaths 2014-2017
Annualized for the remainder of 2017
Total number of overdose deaths in the county is rising.
As of June 24th there were 80 overdose deaths which was the total annual deaths in 2015
Projected values show 160 deaths by the end of 2017
Sources:
Pennsylvania State Coroners Association Report on Overdose Death Statistics, 2014
Analysis of Drug Related Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Field Division
Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Lancaster County Coroners Office

19. Overdose Deaths by Gender 2014-2017
Male Female
Sources:
Pennsylvania State Coroners Association Report on Overdose Death Statistics, 2014
Analysis of Drug Related Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Field Division
Analysis of Overdose Deaths in Pennsylvania, Prepared by the DEA Philadelphia Division and the University of Pittsburgh.
Lancaster County Coroners Office

20. 2017 Overdose Fatalities: a Closer Look
71% Male
Median Age: 37
Majority White (estimated)
29 out of 60 municipalities
% White
2016 Approximately 88% White (PA 77%)
Source: Lancaster County Coroner’s Office

21. Given the current statistics related to overdose and overdose deaths in Lancaster County, it’s frightening to imagine where we would be without the efforts currently underway.
It’s also clear that so much more needs to be done.
As one group, we are better able to collect and analyze real-time data pertaining to drug overdose deaths, emergency department treatment and hospitalizations, as well as reduce redundancies and streamline our efforts.
Joining Forces is the result of considerable time and research to identify the best evidence-based practices that not only allow us to better understand why people are susceptible to addiction, but also how we capitalize on proven outcomes to better facilitate recovery.