'At a loss': Coroner's office sees alarming trends among those dying from overdoses

The number of fatal overdoses last year in Indianapolis soared, eclipsing the number of people who died in shootings and other methods to become the leading cause of death in cases examined by the coroner's office, according to new data.

In its annual report examining trends among the decedents it takes in, the Marion County Coroner's Office recorded 799 people last year died from accidental drug intoxication. The alarming statistics surpassed the number of people examined by the office who died from heart disease − long at the top of the list − blunt force trauma and firearms for the second year in a row.

When accounting for people who died by suicide from an overdose or their manner of death was undetermined, the number of people climbs to 826.

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While the coroner's office does not examine every death in the county, meaning some "natural" deaths are not included in the report, officials say the skyrocketing number of overdoses illustrates the worsening drug crisis in the county.

“It’s unfortunate that these deaths are rising at such a significant rate,” said Alfarena McGinty, chief deputy coroner.

The majority of deaths are linked to the highly-lethal synthetic opioid fentanyl, the report shows, accounting for nearly 78% of the deaths. Fentanyl has increasingly been cut in other street drugs in the past few years across the country, oftentimes without the user’s knowledge. The amount of fentanyl considered deadly is so small, it could rest on the tip of a pencil.

Fentanyl’s mixing in illicit street drugs last year prompted the Drug Enforcement Administration to embark on its “One Pill Can Kill” campaign, referring to the mass production of counterfeit pills cut with fentanyl.

The coroner’s report further flagged another alarming trend: Officials investigated a “significant” increase of decedents ages 60 to 69 who fatally overdosed last year. The report notes this suggests the population of illegal drug users is growing older, and further said they investigated many older decedents who had a history of substance abuse when they were younger and began using again after years of sobriety.

McGinty theorized this could be because the older population of users may not realize that the strength of illicit drugs has skyrocketed over the decades. She said it's possible many of the people who fatally overdosed were users during the crack epidemic, pointing to an increased number of people who died from cocaine.

“I’ve been at the coroner’s office for 25 years ... we didn't see a lot of deaths due to a lot of cocaine,” McGinty said. “So when people think that they're going to go back and use cocaine and crack, it's really fentanyl."

Fentanyl is approximately 100 times more potent than morphine and 50 times more potent than heroin.

To addiction and recovery experts, the numbers align with what they’ve noticed in the field. Substance abuse rose during the Coronavirus pandemic and Marion County could be feeling the lingering effects the shutdowns had in the recovery community, they said. Simultaneously, the city and country saw a rise in violence and economic turmoil. Indianapolis last year experienced a record-breaking number of homicides.

“It’s like a perfect storm,” said Stephanie Anderson, vice president of Strategic Initiatives and Quality Improvement for Mental Health America of Indiana. “Maybe the restrictions and being socially isolated and the fear that came from the pandemic is getting better, but the definite social unrest has not gotten any better.”

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The number of overdose deaths this year shows no sign of slowing down. McGinty said the city in late July recorded 548 overdose deaths, surpassing last year’s number of 540 at the same time.

“It could definitely be another record-breaking year, unfortunately,” McGinty said.

In an effort to curb the number of overdoses, many city offices in the public safety realm, including the coroner’s office, are making plans for the arrival of funds from a major settlement between states and opioid providers.

McGinty said the coroner’s office reviewed ZIP codes in Indianapolis where overdose deaths were highest, which they hope will inform them on how to use $1.2 million allotted to them from the settlement once it comes in.

Funding coming down the pipeline

Indiana may receive $507 million in major settlement between states and opioid providers.

In August, the Indianapolis City-County Council agreed to allot more than $3.7 million between the coroner’s office, Department of Metropolitan Development, the Office of Public Health and Safety, the Indianapolis Metropolitan Police Department and the Indianapolis Fire Department for substance use disorder and mental health programs.

Addiction experts said the money is coming at a crucial time.

Kyle Morris, a real estate agent at FC Tucker who’s also in recovery, said the silver lining is the clear correlation between substance abuse and the unrest from the pandemic seen in the past few years, which may make it easier to address the issue. He cautioned, however, that the state has a long way to go.

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“I think things are encouraging but I think we’re at a pivot point,” Morris said. “This could either get way worse, or this could get way better. And we literally have the ability with some finances and some resources right here. And the more we think about how this can be used correctly is how we dictate the future to a certain extent.”

Brandon George, of the Indiana Addiction Issues Coalition, added the money should be used in areas where funding sources don’t already exist or are sorely lacking, such as recovery houses, and avoid a repeat of what happened with the state's tobacco settlement money. In that settlement, Indiana was spending $7.5 million on tobacco control despite raking in $550 million from cigarette manufacturers.

The opioid settlement fund requires the money go toward opioid remediation and at least 70% be used for future remediation.

The settlement dollars have yet to come, but several city offices in a City-County Council meeting announced their intentions for the money.

McGinty said the coroner’s office intends to use the $1.2 million it’s expected to receive for vouchers for mental health or substance abuse treatment that they’ll provide to surviving families and peers living in ZIP codes they’ve identified where overdoses are highest.

Yet she remains flummoxed over how to address the number of deaths from fentanyl.

“Is it fentanyl test strips? Is it the harm reduction efforts...with the naloxone?” she pondered. “I’m just at a loss. Like what is going to stop this issue from happening?”

Contact Sarah Nelson at 317-503-7514 or sarah.nelson@indystar.com

This article originally appeared on Indianapolis Star: Overdoses are Marion County Coroner's Office leading cause of death