Overdose data at heart of feud over curbing drug abuse
A puzzling bureaucratic feud simmers in the background of joint efforts to stamp out Pennsylvania's deadly opioid crisis.
Perhaps it's just a misunderstanding.
The dispute centers on data — namely statistics of Pennsylvania residents who have died from opioids or heroin.
David Hickton, U.S. attorney for Western Pennsylvania, says the numbers are imperative in learning where so-called overdose hotspots are. Earlier this month in a news conference, he called out coroners in rural areas across the state for what he described as resisting to share overdose data from death certificates and coroners' investigations.
“We need to understand where the hotspots are so we can surge resources to create intervention,” he told me in a follow-up conversation last week. “We want to catch the epidemic instead of chase it.”
The Pennsylvania Coroners Association responded with disbelief.
Its president, Charles Kiessling Jr., the coroner of Lycoming County, said Hickton was misguided in his accusations.
Coroners have minimal staffing, Kiessling explained. Many of them work part time and have other jobs. For example, some are funeral directors.
Toxicology reports in suspected fatal overdoses don't just materialize overnight.
“We don't have an in-house forensic pathologist in house,” Kiessling said. “Ours is in Allentown — 144 miles down the road.”
Logistical delays are understandable and perhaps rectified by a few strategical meetings, Hickton said.
Still, he took aim at the coroners association for other perceived stonewalling tactics.
Hickton said he's learned that Susan Shanaman, an attorney and legislative liaison to the coroners association, discouraged some coroners from sharing overdose data with the Drug Enforcement Administration.
He theorized as to why:
In some small towns, families of possible overdose victims do not want the cause of death listed on a death certificate.
“I acknowledge that is a struggle in rural communities where everybody knows everybody,” Hickton said. “People don't want to feel embarrassed. But we have to get past that stigma.”
He also wondered whether the coroners association wanted to hoard the statistics in order to receive grant money for its own database.
Shanaman questioned Hickton's information source.
“I can tell you that the reports I have done for the coroners and medical examiners on the yearly drug deaths have been done without grant money and with considerable work from the coroners and medical examiners and have been released publicly and are on the PSCA website for anyone to review,” she said. “Nor am I aware of any grant money being sought by them.”
Shanaman believes in concentrating on overdose survival statistics as a portal for addiction treatment.
“I also believe that the current emphasis on collecting death numbers is not helping in resolving this drug epidemic,” she said. “If we continue to fight over which group gets paid to do another report on the death numbers generated by the persons who are elected to do the death investigations, then we are doing nothing more than establishing a drug policy which deals with drug use one grave at a time.”
Hickton agreed that all data surrounding drug overdoses is important. There were 3,383 reported fatal drug overdoses in Pennsylvania in 2015 — 81 percent of which are believed to have been caused by heroin or opioid use.
“I want to put a spotlight on anyone who is under the illusion that we are going to stand for hoarding or hiding data, especially for those trying to treat this data as currency,” he said. “The data belongs to the public, and it should be freely shared.”
Hickton has threatened legal action against anyone holding back data.
Do the verbal jabs simply amount to lack of communication?
Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991 or firstname.lastname@example.org.