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Report on Area Drug Deaths Shows South, North Knoxville Hardest Hit

If you die of a drug overdose in Knox or Anderson County, where are you most likely to be?

In a home — yours, or someone else's.

Fifty-five percent of drug-related deaths happened in a residence, according to the Knox County Regional Forensic Center's 2017 Drug Related Death Report, released last week.

In 2017, at least 201 people died of drug-related causes in residences in the two counties. In 2016, the forensic center investigated 138 drug-related deaths where the place of death was a home. And not all deaths go to the forensic center.

Hospitals were the next most common place for drug-related deaths the center investigated, accounting for 37.5 percent — 133 people — in Knox and Anderson counties in 2017.

More: Drug-related deaths in Knox, Anderson counties increased more than 41 percent from 2016-17

"However, hospitals, medical facilities or other facilities/locations do not always notify the medical examiner, which means this report cannot account for drug-related deaths not reported to the Knox and Anderson counties' Medical Examiner's Office," wrote Knox County Regional Forensic Center Senior Director John Lott, who prepared the report. "Therefore, we believe this report is an undercount of the total number of overdose deaths."

Hotels/motels were the next most common location of death, at 4.22 percent (14 people in 2017), followed by parking lots (four people), "outside" (three people), highway/road (2 people), and vehicle (1 person). Four more people had their place of death classified as "other."

Overall, there were 316 drug-related death cases in Knox County in 2017, and 46 in Anderson County.

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Rows of shoes at International Overdose Awareness Day at Volunteer Landing represent those who died of overdose. (Photo: Kristi L. Nelson/News Sentinel)

ZIP codes with most deaths

If residences are the most likely place of death, what areas have the most of these residences?

The report mapped the "location of injury" for deaths, plotting both pain clinics and schools on the map to show how many are located in areas with the most deaths. Pain clinics "are located along easy access routes," Lott said.

But the report also looks at the home addresses of those who died. In 2017, as in 2016, the ZIP codes 37920 (South Knoxville) and 37917 (North Knoxville) were at the top, although 2018 numbers project that 37920 has moved to the fourth spot, and 37917 up to No.1, followed by 37918 and 37921.

'The new leprosy': Report lays bare opioids' impact on Appalachian communities

Since 2010, the top five ZIP codes where most victims of drug-related deaths were living have varied little:

  • 37918 (Fountain City to Halls) was in the top spot in 2010, 2011 and 2015 and in the top 5 all years but 2013.

  • 37917 has ranked in the top five every year since 2011, as has 37920.

  • 37921 (Northwest Knoxville) has been in the top five most years, and in the top 10 every year except 2011.

  • 37914 (East Knoxville) was No. 5 in 2017, No. 6 in 2014-2015, No. 3 in 2013, No. 5 in 2011 and No. 7 in 2010.

  • Frequently in the top 5 are 37919 (West Knoxville), 37912(Lonsdale/Mechanicsville), and 37830 (Oak Ridge); 37716 (Clinton) was in the top 5 two years.

Increase in younger victims

This year's report featured a "special look" for the 15-to-24-year-old age group, for which drug-related deaths in Knox County increased by 133 percent from 2016-2017.

Among the 28 deaths — 20 male, eight female; 22 white and six black — fentanyl or a fentanyl analogue was present in 19 of them. Ten had heroin in their systems. Eight had been given naloxone, an overdose reversal medication.

Four lived in the 37923 ZIP code, four in the 37921 area. Two each lived in 37920, 37919 and 37918.

Lott said the 2017 data and preliminary 2018 data forecast "a continuing increase in drug-related deaths in the younger age groups," as well as an increase in deaths for the 45-54 and 55-64 age groups, who have other health problems that could be exacerbated by drug misuse or who might be transitioning from prescription opioids to illicit street drugs.

More: As drug-related heart infections climb, doctors weigh ethics of operating — or not

He added that the forensic center is seeing medication-assisted therapies, such as methadone or suboxone, "being used as bridges between drug usage."

"This causes these drugs to have high illicit market value and become a drug of abuse," Lott said.

Illicit drugs have overtaken prescription drugs as the leading cause of drug-related deaths in Knox and Anderson counties. (Photo: File)

Furthermore, such "maintenance drugs" are not tracked on the Controlled Substances Monitoring Database, so neither prescribers nor medical examiners know who is taking them, he said. The medical examiner's perspective is that abstinence from all drugs — including naloxone, which could "normalize" drug use or give people a false sense of security — should be the goal, he said.

The forensic center estimated there were 196 drug-related death cases in Knox and Anderson Counties from January-June 2018 — already more than half as many as for the entirety of 2017.

"The Regional Forensic Center is concerned that the eight-year trend of increasing drug-related deaths will continue at a rate of 30 percent or higher growth each year," Lott said in the report. "Our concerns have been validated by a shift from prescription drugs being the leading cause of death to nonpharmaceutical, or illicit, and emerging, designer drugs being the leading cause of death in drug-related deaths. (Yet) even though there have been many actions to reduce over-prescribing practices, there will continue to be a high incidence of prescription drug deaths."

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