Numbers from the Georgia Department of Public Health (DPH) indicate that 170 individuals in Bartow County died from drug overdoses in the last decade — with 105 attributed to opioids.
The data culled from the department's Online Analysis Statistical Information System (OASIS), which does not include complete numbers for 2019, also notes that at least 10 Bartow County residents experienced fatal heroin overdoses between 2010-2018.
While the state opioid death rate for 2018 stood at 8.2 per 100,000, the rate for Bartow County was 13.2 — a rate almost 61% higher. Meanwhile, the overall drug overdose death rate for Bartow in 2018, 18.8 per 100,000, likewise eclipsed the state average of 13.3.
The discrepancy was even starker a year prior. While the overall drug overdose death rate for Georgia in 2017 was 14.7 per 100,000, in Bartow the overall drug overdose death rate was 23.8. The same trend held true for the 2017 opioid overdose death rate; at 16.2 per 100,000, Bartow exceeded the state rate of 9.7 by about 67%.
While the annual drug overdose numbers in Bartow did fluctuate over the past decade — hitting a high mark in 2017 with 25 deaths and a low point of 13 deaths in 2013 — the annual number of opioid-related overdose deaths over the same timeframe wavered only slightly. Outside of 2013, which saw five opioid-overdose deaths in the county, the death toll hit double digits in every other year. With 17 fatal opioid overdoses, 2017 was Bartow’s deadliest.
Additional DPH data indicates that opioid overdoses resulted in 138 emergency department visits and 48 hospitalizations in Bartow County last year. In each circumstance, the local rate easily doubles the state average. While the overall emergency department visit rate for opioid overdoses in Georgia was 45.9 per 100,000, for Bartow the figure was 130.1; while the state rate for opioid overdose hospitalizations was 20.6, Bartow’s was 41.4.
The numbers are even more disparate when it comes to heroin overdose-related hospitalizations.
DPH data indicates 44 emergency department visits in Bartow last year for such overdoses, with seven hospitalizations.
The state hospitalization average in 2018 was 3.2 per 100,000; in Bartow, the rate was 6.8. And while the state emergency department visit rate was 13.2, Bartow County more than tripled Georgia’s average with a rate of 43.7.
The 2017 data paints a similar picture. That year, the DPH recorded 125 emergency department visits in Bartow County for opioid overdoses, including 30 for heroin.
The state rate for all opioid emergency department trips was 52.6, while the Georgia average for heroin-related emergency department trips was 14.9. For Bartow County, the rates were 111.8 and 30.3, respectively.
The DPH’s 2019 Bartow County Community Health Survey
notes that while opioid prescription rates did decline from 2014-2017, the overall prescription rates in Bartow remain considerably higher than the national average. Whereas the opioid prescription rate on the national level in 2014 was 75.6 per 100 patients, in Bartow the rate was 112.1. And while the national rate had fallen to 58.7 in 2017, Bartow’s rate was 97.9.
Meanwhile, Georgia Prescription Drug Monitoring Program (PDMP) data indicates the age-adjusted opioid prescription rate for Bartow was 974.7 per 1,000 in 2018, with the percentage of patient days with overlapping opioid and benzodiazepine prescriptions tabbed at 17.3.
DPH program consultant Sobia Sattar said that Bartow County has many characteristics of "opioid high-risk counties" outlined in a University of Michigan study published earlier this year
. Most notably, that study identifies Bartow as a county with “low rates of medication for opioid use disorder (MOUD) treatment providers,” with a pronounced lack of “publicly-listed opioid treatment programs, buprenorphine-wavered clinicians and extended-release naltrexone prescribers.”
As for where Bartow County residents are getting their opioid prescriptions, Sattar said the hard data remains under lock and key — even to the DPH itself.
“The [Centers for Disease Control and Prevention, or CDC] has a program called IQVIA Prescription Provider Data,” she said, “but the data is not available to the public or the [Georgia Department of Public Health] due to lack of a signed agreement between the two.”
On the subject of the biggest barriers to substance abuse treatment in Bartow, Sattar listed a lack of provider access and availability, a lack of health care access and insurance and a fear of social stigma.
She also cited a lack of access to and training for naloxone administration and a lack of access to medication-assisted treatment for opioid users. Furthermore, she identified a lack of mental health services and psychosocial support services in the local community — which, in turn, can make providers reluctant to prescribe medications like buprenorphine, which is commonly administered to treat opioid withdrawal symptoms.
In the 2019 Bartow County Community Health Survey, researchers asked Bartow County residents to identify what they considered to be the most important health problems in the community. More than 58% of respondents named “alcohol/drug abuse” as Bartow’s most pressing public health concern.
When asked to name the most important “risk behaviors” in the community, 73% of Bartow respondents cited drug abuse, with alcohol abuse cited by 42% of participants.
A 2017 CDC report
indicates that high amounts of opioids are prescribed in counties with larger numbers of non-Hispanic white residents, higher rates of diabetes and arthritis and higher rates of Medicaid enrollment and unemployment.
As Sattar notes, the geographic placement of Bartow itself could make it highly susceptible to substance abuse.
“Access to drugs is a significant factor, and counties near the highway are a gateway to bring in drugs and easy availability,” she said. “This was discussed multiple times in meetings for the community health assessment group.”
Keeping in line with national opioid overdose trends, the overwhelming majority of Bartow County’s deaths involve Caucasians. Indeed, of the 20 opioid fatalities in the community last year, 18 involved white individuals.
But where Bartow deviates from national data sets is the gender of drug overdose victims. While the majority of drug overdose deaths in the United States involve males, in Bartow last year females comprised 11 of the 20 countywide deaths.
According to DPH figures, 11 of Bartow's 2018 drug overdose deaths involved individuals between the ages of 30-59. Eight were between the ages of 20-29; just one was over the age of 60.
DPH data also indicates that Bartow County opioid overdose victims skewed younger in 2018. Of the county’s fatal opioid overdoses that year, three involved people ages 45-59, while five involved people ages 30-44.
Meanwhile, the “early adulthood” demographic represented nearly half of Bartow’s opioid overdose deaths last year. Of the 14 fatalities reported, six involved individuals between the ages of 20-29.
Community Torn is a five-week series exploring the many ways substance abuse impacts Bartow, with an emphasis on the voices of those most impacted by the community's drug crisis. Using a multidisciplinary approach encompassing public policy specialists, health care providers, law enforcement officials and judicial system representatives, the series seeks to demonstrate the true toll of substance dependency throughout the county.