By Brooke Schultz

Based on a sample of 130 overdose fatalities, the Delaware Drug Overdose Fatality Review Commission has released recommendations targeting housing, trauma training and expanded recovery resources in the criminal justice system to combat substance use.

In 2019, there were 431 overdose deaths recorded in the state. The commission’s second annual report, released Tuesday, details five policy recommendations based on its review of a sample of 130 overdose fatalities that occurred in 2019.

The report stems from data that came before 2020, a year marked by COVID-19, which saw a rise in overdose deaths. In the first half of that year, there was a 47% increase over the same six-month period in 2018 and 2019. There are 32 suspected overdose fatalities in 2021 so far.

In an interview Tuesday, Jill Fredel, a spokeswoman for the Department of Health and Social Services, said that the state won’t know the full scope of overdose fatalities in 2020 until March or April.

She said that it’s anticipated that overdose deaths will exceed the 431 of 2019.

“With the pandemic that happened, that’s an indicator of the issues going on. There’s a lot more mental health and substance abuse incidents going on because of that,” said Thomas Killian, director of the Division of Substance Abuse and Mental Health. “And I think we’ll see the numbers affected mainly because of that going on in the country.”

In the deaths the commission reviewed from 2019, 38% were unhoused or had unstable housing. Those without stable housing were significantly likelier to have been previously incarcerated.

A portion of those in the sample (37.4%) had experienced one or more traumatic events — including 15% who witnessed an overdose — but only 8.5% had received counseling.

Nearly half, 40%, had at least one prior nonfatal overdose; some had as many as nine.

More than half, 51.2%, of overdose deaths occurred in New Castle County, 19.7% in Kent County and 29.1% in Sussex.

Within the sample, the average demographic consisted of White, single males who averaged 39 years old. A majority (79.2%) of those who died due to overdose were men, while the remaining 20.8% were women. A majority (76.9%) were White, while 15.4% were Black, 4.6% were Latino and 3.1% were listed as other. While 66.7% were identified as single, 28.2% were married and 5.1% were divorced at death.

With that in mind, the report makes several recommendations. The commission contends that there should be safe and secure housing through the “Housing First” model for unhoused or unstably housed individuals.

Continuing-education availability should be expanded for licensed clinicians to increase knowledge of trauma-intervention services.

Intervention should occur for those whose contact with law enforcement does not result in arrest or incarceration; and substance abuse-treatment services should be initiated immediately following incarceration for inmates awaiting sentencing.

A notification system should be established within the Delaware Prescription Monitoring Program to ensure prescribers are aware of patient nonfatal overdoses.

Outreach and follow-up with individuals who engaged in substance abuse-related treatment should also be improved.

Mr. Killian said that the state does have a number of programs in motion already.

Over the summer, due to the rise of suspected overdose fatalities, DHSS had several initiatives to target spreading aid. There are three Bridge Clinics, located in each of the counties, to help connect people to treatment. Kent County’s is located in the James W. Williams State Service Center, at 805 River Road, Dover; Sussex’s is at the Thurman Adams State Service Center, 546 S. Bedford St., Georgetown; and New Castle’s is at 14 Central Ave. (just off U.S. 13), New Castle.

The state rolled out the Hope Line — (833) 9-HOPEDE or (833) 946-7333 — which is dedicated to assisting Delawareans cope with stress and address behavioral health needs during the pandemic.

The line, which is free, is available 24/7, and connects callers with a variety of resources for information, including support from clinicians and peer specialists, plus crisis assistance.

The state also partnered with organizations to canvass neighborhoods that have seen higher rates of overdose, distributing naloxone or Narcan, a lifesaving medication that can reverse an opioid overdose.

The report can help create a “laser focus,” Mr. Killian said, though 2019’s data isn’t a surprise, he said.

“It’ll help us focus on those areas where there may be some gaps and really focus in on getting those treatments,” he said.

Alexis Teitelbaum, deputy director of DSAMH, said it was identified early on that there was a “huge issue” with people who were experiencing substance use disorder and/or mental health issues and were having interactions with the police, getting arrested, getting put into jail and not getting into treatment.

The Pre-Arrest Diversion Program was an opportunity for the state to partner with state police offices, with troops in each county, to intervene before jail time, Ms. Teitelbaum said.

“We’re able to try to get in front of those arrests and offer the individuals an opportunity to be able to not go to jail but to get into treatment and work towards recovery, and then be able to support them in a better way and help them get into the services that they need to be healthier,” she said.

She noted that the recommendation on safe housing has only become more important amid COVID-19.

“You take someone that already is experiencing barriers, add COVID onto it, and now, you’ve got a lot of really serious situations,” she said, adding that agencies have assisted with housing opportunities at the start of the pandemic, but it continues to be a problem.

“I do think that, you know, we will be seeing the repercussions of that because of the pandemic, because of the housing situation, and then, you add in the number of individuals that are experiencing substance use disorders and then specifically with opiates,” she continued. “We’re going to have to deal with this for a while. The repercussions are going to be long-standing, and it’s something that we’re dedicated to.”