1. Health Care The following entities provided data for the Health Care Section of the Community Assessment:  Jefferson County CAD System  Samaritan Medical Center  Jefferson County Medical Examiner’s Program

2. Jefferson County CAD System Jefferson County, NY, Fire and Emergency Management Overdose/Poison Incident Calls 2011-2014 2011 – 349 overdose/poison incident calls. 63 (18.1%) in the City of Watertown 286 (81.9%) in Jefferson County 2012 – 349 overdose/poison incident calls. 95 (27.2%) in the City of Watertown 254 (72.8%) in Jefferson County 2013 – 309 overdose/poison incident calls. 85 (27.5%) in the City of Watertown 224 (72.5%) in Jefferson County 2014 – 286 overdose/poison incident calls. 73 (25.5%) in the City of Watertown 213 (74.5%) in Jefferson County Conclusions: o Overdose/poison incident calls fluctuate, and increased in the City in 2012 largely due to the widespread availability of bath salts/synthetic marijuana. It is projected that greater City activity has occurred since 2012, even with the mitigation of bath salts/synthetic marijuana. o From a population-base comparison perspective, overdose/poison incident calls fluctuate but are typically slightly higher in the City of Watertown vs. the rest of Jefferson County. o Jefferson County total population – 22% City of Watertown 78% Non-city residents

3. Jefferson County, NY, CAD System Fire and Emergency Management Overdose/Poison Incident Calls 2011-2014

4. Samaritan Medical Center Hospital Emergency Department Data All Drug Overdoses 2011-2014 2011 – 164 ED Drug Overdose Visits – 107 (65.2%) ED visits related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid. – 57 (34.8%) ED visits related to suicide and self-inflicted injury. 2012 – 137 ED Drug Overdose Visits – 105 (76.6%) ED visits related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid. – 32 (23.4%) ED visits related to suicide and self-inflicted injury. 2013 – 188 ED Drug Overdose Visits – 134 (71.3%) ED visits related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid. – 54 (28.7%) ED visits related to suicide and self-inflicted injury. 2014 – 239 ED Drug Overdose Visits – 175 (73.2%) ED visits related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid. – 64 (26.8%) ED visits related to suicide and self-inflicted injury.

5. Samaritan Medical Center Hospital Emergency Department Data, all Drug Overdoses, 2011-2014

6. Samaritan Medical Center Hospital ED Data, Opioid vs. all other Drug Overdoses, 2011-2014 Most current drug overdoses in the community are from substances other than opioids. 2011 – – 44 (26.8%) ED visits due to opioid overdose. 10 Accidental; 34 Suicide attempt/Self-inflicted injury. – 120 (73.2%) ED visits due to all other substance overdose. 97 Accidental; 23 Suicide attempt/Self-inflicted injury. – 164 – TOTAL VISITS 2012 – – 30 (21.9%) ED visits due to opioid overdose. 15 Accidental; 15 Suicide attempt/Self-inflicted injury. – 107 (78.1%) ED visits due to all other substance overdose. 90 Accidental; 17 Suicide attempt/Self-inflicted injury. – 137 – TOTAL VISITS 2013 – – 13 (6.9%) ED visits due to opioid overdose. 8 Accidental; 5 Suicide attempt/Self-inflicted injury. – 175 (93.1%) ED visits due to all other substance overdose. 126 Accidental; 49 Suicide attempt/Self-inflicted injury. – 188 – TOTAL VISITS 2014 – – 26 (9.8%) ED visits due to opioid overdose. 8 Accidental; 18 Suicide attempt/Self-inflicted injury. – 213 (90.2%) ED visits due to all other substance overdose. 167 Accidental; 46 Suicide attempt/Self-inflicted injury. – 239 – TOTAL VISITS

7. Samaritan Medical Center Hospital ED Data, Opioid vs. all other Drug Overdoses 2011-2014

8. Samaritan Medical Center Hospital Inpatient Data, all Drug Overdoses 2011-2012 2011 – – 23 (21.3%) Inpatient stays related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid. – 85 (78.7%) Inpatient stays related to suicide and self-inflicted injury. – 108 – TOTAL STAYS 2012 – – 28 (30.8%) Inpatient stays related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid. – 63 (69.2%) Inpatient stays related to suicide and self-inflicted injury. – 91 – TOTAL STAYS 2013 – – 44 (32.8%) Inpatient stays related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid. – 90 (67.2%) Inpatient stays related to suicide and self-inflicted injury. – 134 – TOTAL STAYS 2014 – – 36 (27.9%) Inpatient stays related to accidental poisoning by drugs, medicinal substances, and biologicals; and by other solid or liquid. – 93 (72.1%) Inpatient stays related to suicide and self-inflicted injury. – 129 – TOTAL STAYS Suicide and self-inflicted injury cases have a high likelihood for hospital admission.

9. Samaritan Medical Center Hospital Inpatient Data, all Drug Overdoses 2011-2014

10. Samaritan Medical Center Hospital Inpatient Data, Opioid vs. all other Drug Overdoses 2011-2014 2011 – – 41 (38%) Inpatient stays due to opioid overdose. 3 Accidental; 38 Suicide attempt/Self-inflicted injury. – 67 (62%) Inpatient stays due to all other substance overdose. 20 Accidental; 47 Suicide attempt/Self-inflicted injury. – 108 – TOTAL STAYS 2012 – – 34 (37.4%) Inpatient stays due to opioid overdose. 5 Accidental; 29 Suicide attempt/Self-inflicted injury. – 57 (62.6%) Inpatient stays due to all other substance overdose. 23 Accidental; 34 Suicide attempt/Self-inflicted injury. – 91 – TOTAL STAYS 2013 – – 27 ( %) Inpatient stays due to opioid overdose. 4 Accidental; 23 Suicide attempt/Self-inflicted injury. – 107 ( %) Inpatient stays due to all other substance overdose. 3 Accidental; 104 Suicide attempt/Self-inflicted injury. – 134 – TOTAL STAYS 2014 – – 33 (25.6%) Inpatient stays due to opioid overdose. 7 Accidental; 26 Suicide attempt/Self-inflicted injury. – 96 (74.4%) Inpatient stays due to all other substance overdose. 29 Accidental; 67 Suicide attempt/Self-inflicted injury. – 129 – TOTAL STAYS

11. Samaritan Medical Center Hospital Inpatient Data, Opioid vs. all other Drug Overdoses 2011-2014

12. Samaritan Medical Center Hospital Inpatient/ED Data, all Drug Overdoses by Zip Code 2011-2012 2011 – – 13601 zip code area113 (41.5%) – Outside the City area159 (58.5%) – TOTAL PATIENTS272 2012 – – 13601 zip code area125 (54.8%) – Outside the City area103 (45.2%) – TOTAL PATIENTS228 Drug overdose inpatient/ED patients who lived in the 13601 zip code increased 10.6% from 2011 to 2012. Drug overdose inpatient/ED patients who lived outside the City area decreased 54.4% from 2011 to 2012.

13. Samaritan Medical Center Hospital Inpatient/ED Data, all Drug Overdoses By Zip Code 2011-2012

14. J efferson County, NY, M.E. Program Drug Overdose Deaths 2010-2014 - Total Deaths 2010 – 8 drug overdose deaths. 2011 – 18 drug overdose deaths. 2012 – 16 drug overdose deaths. 2013 – 14 drug overdose deaths. 2014 – 16 drug overdose deaths (projected). M.E. program data demonstrate a 125% increase in overdose deaths from 2010 (8) to 2011 (18). Overdose deaths were 8 in 2008 and 9 in 2009.

15. Jefferson County, NY, M.E. Program Drug Overdose Deaths 2010-2014 - Total Deaths

16. Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Manner of Death 2011 Manner of drug overdose death: – 9 Unknown – 3 Suicide – 6 Accidental – 18 - TOTAL 2012 Manner of drug overdose death: – 1 Unknown – 3 Suicide – 12 Accidental – 16 – TOTAL 2013 Manner of drug overdose death: – 2 Unknown – 3 Suicide – 9 Accidental – 14 - TOTAL 2014 Manner of drug overdose death: – 1 Unknown – 3 Suicide – 12 Accidental – 16 - TOTAL

17. Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Manner of Death

18. Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Location of Death 2011 – – 9 deaths in the City of Watertown. – 9 deaths in Jefferson County/non-City. 2012 – – 8 deaths in the City of Watertown – 8 deaths in Jefferson County/non-City. 2013 – – 5 deaths in the City of Watertown. – 9 deaths in Jefferson County/non-City. 2014 – – 10 deaths in the City of Watertown – 6 deaths in Jefferson County/non-City. 50% of overdose deaths in Jefferson County are occurring in the City of Watertown. From a population perspective, this suggests more drug abuse activity in the City vs. countywide. Jefferson County total population – – 22% City of Watertown – 78% Non-city residents

19. Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Location of Death

20. Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Lethal Toxicology 2011 – – 15 (83.3%)deaths due to opioid overdose. – 3 (16.7%) deaths due to other drug overdose. – 18 - TOTAL 2 unresponsive at first responder arrival; CPR performed. 16 deceased on scene. 2012 – – 13 (81.3%)deaths due to opioid overdose. – 3 (18.7%) deaths due to other drug overdose. – 16 - TOTAL 3 unresponsive at first responder arrival; CPR performed. 13 deceased on scene. 2013 – – 7 (50%)deaths due to opioid overdose. – 7 (50%) deaths due to other drug overdose. – 14 - TOTAL 4 unresponsive at first responder arrival; CPR performed. 10 deceased on scene. 2014 – – 11 (68.8%)deaths due to opioid overdose. – 5 (31.2%) deaths due to other drug overdose. – 16 - TOTAL 4 unresponsive at first responder arrival; CPR performed. 12 deceased on scene. Majority of drug overdose deaths in Jefferson County are attributed to opioids. Majority of cases are found to be deceased on scene.

21. Jefferson County, NY, M.E. Program Drug Overdose Deaths 2011-2014 – Lethal Toxicology

22. Data Limitations Jefferson County Dispatch-assigned overdose/poison incident calls are an indicator of the community problem. However, dispatch overdose/poison incident assignments do not take into account the number of calls out for psychiatric, cardiac, respiratory, and other conditions where the cause may be eventually overdose/poison-determined. Dispatch- assigned calls are not amended for true conditions after-the- fact. There are likely greater numbers of actual overdose cases than those captured in the CAD system. Likewise, overdose/poison calls could be an allergic reaction to a legally prescribed drug. Hospital inpatient and ED data could only be obtained from Samaritan Medical Center. However, because SMC experiences the highest volume of cases, it is felt this data is a good indication of community activity.