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Knox County Report: Risk of Dying of Drug Overdose Highest Soon after Jail Release

Nearly half of the people who died of drug overdoses in Knox County last year had been arrested and/or jailed within the past five years – and most of those fatally overdosed soon after leaving jail.

District Attorney Charme Allen on Thursday released a new report on the county’s 2016 fatal overdose victims and their interaction with the criminal justice system. The report’s purpose is to try to identify points at which intervention might have prevent their deaths.

Highlights of the report:

  • Among Knox County’s 224 drug-related deaths in 2016, 55 percent had no record of arrest or incarceration in the past five years; 45 percent did;

  • More than a third had interacted with law enforcement within the past year; for 20 percent of those, it was within a month of their death;

  • Of those who had been incarcerated in the past five years, 67 percent died of a drug overdose within 18 months of their release – and 35 percent died within 90 days.

Those statistics mirror research that suggests those who abuse drugs are most at risk from immediately after their release until about three months afterward – and especially in the first two weeks.Intervention pointAllen said the report could show both law enforcement and the larger community at what point "we could intervene" for a "better outcome."If she had unlimited resources, that might mean mandatory treatment starting while one was in jail and continuing on an outpatient basis after release.But money is harder to come by for such programs for those in jail or prison -- federal law prevents using Medicaid money, which pays for a large percentage of addiction treatment for indigent people, for those who are incarcerated.

That's led her team to be "creative" in developing programs and finding funding, Allen said. For example, a partnership with Helen Ross McNabb Center allows some people to start an injectable version of the drug naltrexene -- brand name Vivitrol -- which blocks the pleasurable effects of opioid drugs, she said. That program was initially paid for with a grant from the local nonprofit Trinity Health Foundation, and also uses funding from the pharmaceutical company that makes Vivitrol.

"We’re always open to new ideas as to where we could get funding to get treatment in the jails," Allen said.

Identifying those at risk

Identifying those at risk may also allow the court to make treatment a condition of probation, Allen said, for those who have the insurance and money for treatment and are just choosing not to use it.

"We want to find out, who are they?" she said. "They might not all be indigent."

For those who are, she said, finding that help will continue to be challenging, as treatment facilities already have waiting lists of people who aren't coming out of jail -- but it's a challenge the community will need to meet, she said.

"We’re all in agreement that over 90 percent of our crime (in Knox County) is related to the drug problem," she said.

This report is limited by the fact it uses data from only one year, 2016. But the data is far less limited than it would have been a year ago, as Allen’s office now shares data with other agencies on the Drug Related Death Task Force, which includes Appalachian HIDTA (High-Intensity Drug Trafficking Areas), Knox County Regional Forensic Center, Knox County Sheriff’s Office and Knoxville Police Department.

Sharing the data on a daily basis has allowed the agencies to target investigations, pinpointing community “hot spots” and how opioids are coming into the community, so the supply source can be cut off, the report said.

It's also allowed her office to more successfully prosecute drug dealers with second-degree murder charges, if a schedule I or II drug can be shown to have caused a person's death and that drug traced back to a particular seller.

Prior to forming the task force, Allen said, her office prosecuted seven of those cases.

"They're just very labor intensive," she said.

But since the end of March, when the task force got up and running, they've had nine.

Having data from the forensic center and other agencies quickly and readily available "makes our job easier,"

she said.

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