3 On Your Side Investigates: Overdosed and Underreported? - MSNewsNow.com - Jackson, MS

3 On Your Side Investigates: Overdosed and Underreported?

JACKSON, MS (Mississippi News Now) -

Nearly 64,000 people died from drug overdoses in 2016, according to the Centers for Disease Control. Most of those came from opioid abuse.

Even though Mississippi ranks 40th in drug overdose death rates nationwide, the state's drug czar said they really don't know how bad this epidemic could be because some aren't reporting these deaths.

"I had already been hearing the horror stories coming out of Ohio and West Virginia," said Mississippi Bureau of Narcotics Director John Dowdy.

Dowdy said he saw the writing on the wall months ago;  a formula for abuse that would mean an increase of drug overdose deaths in Mississippi.

"You get overprescribing, then you get an influx of heroin," added Dowdy. "Now we're getting influxes of fentanyl and people are dying left and right." 

As MBN started getting numbers for 2016, Dowdy noticed a problem. The Magnolia State had 99 drug overdose deaths, provided from coroners across the state.

However, information from the department showed only 26 of the state's 82 counties -- one third -- sent him overdose information.

"I knew that there was no way that could be accurate," added Dowdy.

The MBN director pulled death certificates and found 211 died from drug overdoses, twice the number reported to him by coroners in Mississippi.

"I still don't think that number's accurate because we had 220 submissions for toxicology to the state crime lab," said Dowdy.

Failing to report those deaths is against the law in Mississippi, specifically 41-29-159, which says coroners must notify MBN within 24 hours of an overdose.

"You have coroners that have been ignoring that law since that law got put on the books eleven years ago," said Dowdy.

Two coroners accused of not reporting numbers in central Mississippi completely disagree with Dowdy's statement.

"I think if he was bothered by this, he would be picking up the phone and talking to us about it instead of in an interview, pointing fingers, like we’re a problem," said Scott County Coroner Joe Bradford. "By him saying that coroners are trying to cover up or whatever, he's saying that law enforcement here is doing the same thing. Here in Scott County, that's something we don't do."

Bradford said he reported one drug overdose in the last three or four years because that's all they've had.

When 3 On Your Side reached out to him, Bradford called his local MBN agents to see if he had done anything wrong.

"They told me that there wasn't a problem with Scott County. They couldn't believe what they were hearing. They wanted to know who said that," added Bradford.

When asked if those agents might be surprised that those allegations came from Dowdy, Bradford smiled.

“That’s right. I do," Bradford added.

Terry Tutor, who has served as Simpson County's coroner for the last twelve years, agrees with Bradford.

He told 3 On Your Side they haven't had an overdose there in six years.

Tutor believes Dowdy found more death certificates than reported overdoses because of doctors who didn't follow protocol.

"Your doctors still sign overdose death certificates. Emergency rooms. They come in. They OD," said Tutor. "They're supposed to call the coroner. Sometimes they do, sometimes they don't. How many of those death certificates came from actual coroners?" 

Dowdy disputes that, arguing that the state kicks back death certificates that aren't signed by coroners. He believes there are other reasons for this underreporting in play, too.

"You've got rural counties, you've got a prominent family in that particular county. Their son dies of a drug overdose, let's say heroin," said Dowdy. "The family doesn't want the family image tarnished because their child died from a heroin overdose, so the person who can control all of that is the coroner, who's an elected official, who obviously has to run for re-election every four years."

To Tutor, that adds up to one conclusion.

"We're not doing our job," Tutor said sarcastically. "I don't know how long he's lived in Mississippi or how long he's lived in rural areas, but in my community, we don't keep anything secret. [His allegations are] very offensive and I don't really appreciate it at all."

Tutor thinks there's another reason behind the push for more accurate numbers, which in Dowdy's view would be higher numbers: money.

"He's gotta have the numbers in order to keep his men that he's gotta have," said Tutor. "They're not gonna allocate him 100 men if he doesn't have the need for it, so he's got to have the figures to produce it." 

The state's drug czar says those numbers will help them zero in on counties where doctors may be prescribing and identify them, especially since Mississippi physicians aren't required to join the state's prescription-monitoring program, intended to catch doctor shoppers who go from office to office.

He also agreed that the opioid fight, for them, is somewhat financially driven.

"When I was talking to a grant writer who does this for other states, and he says 'you only had 99 drug overdose deaths during that particular year. Don't waste your time. Don't waste your paper. They'll laugh you out of Washington because that's not a problem,'" said Dowdy.

Who makes sure coroners follow the law? The state medical examiner has the power to remove a coroner, but current laws on the books have no teeth in terms of fines or penalties.

Dowdy said legislators are thinking about beefing up those rules.

"I've heard about the fines they can levy on us and stuff like that. If we're gonna be held accountable by fines then MBN oughta be held accountable for their mistakes, going into the wrong house, arresting the wrong person," added Tutor.

Whatever Dowdy's tactics may be to encourage more coroners to report, it seems to be working. Mississippi had 49 county coroners report overdoses last year, 23 more counties than the year before.

However, MBN makes no distinction between those counties that failed to report and those counties that simply had no overdoses to report.

Here is the full transcript of Dowdy's interview on the subject of coroners and reporting:

Reporter: Can I ask you just -- can we talk about how some of this data is not fully accurate because you can’t -- you’re relying on your coroners here?

John Dowdy: Yeah. Um. So...uh, you know, one of the things is I was starting to look at, you know, where we were as far as the problem is concerned. I had been, I had already been hearing the horror stories coming out of Ohio and West Virginia and New Jersey and other states about the fact that, you know, you had overprescribing problems. And the pattern is the same. I mean, we’ve seen it across the board. You get overprescribing, then you get an influx of heroin. Now we’re getting influxes of fentanyl and people are dying left and right. And that was part of the reason for the urgency for us to get out in front of this as much as we could because I didn’t want us to go down that path although, unfortunately, it’s getting worse in Mississippi. So, in looking at how bad the problem is, one of the things I wanted to do is find out, ‘What do we look like in terms of drug overdose deaths in Mississippi?’ The only way that we can accumulate that information, though, is by the mechanism that is set up by law that mandates the coroners report drug overdose deaths to the Bureau of Narcotics. So in 2016, we had 26 of the 82 coroners report 99 drug overdose deaths here in the state of Mississippi, and I knew that, there was no way that could be accurate. So what we did is we went back and we looked at the Bureau of Vital Statistics. They’re the ones who keep all of the death certificates that are filed here in Mississippi, and in doing that, they have a coding that they put on there that shows the cause of death. By doing that, in 2016, we ascertained that there were 211 death certificates filed with the state Bureau of Vital Statistics claiming “drug overdose” as the cause of death. I still don’t think that number is accurate, because we had 220 submissions for toxicology that came back as drug overdoses to the state crime lab. So

Reporter: So how many coroners didn’t report?

Dowdy: What’s the math? The difference between 82 and 26, so --

Reporter: -- 50-something --

Dowdy: Yeah. You had basically a fourth of the coroners in the state reporting 99 drug overdose deaths. And I recognize that was a major problem, so again just another part of what we’re trying to do to tackle this is we made an all-out push this year to try to reach out to the coroners and make them understand why it is important for them to report the drug overdoses to us here at MBN and so, still looking, trying to get the numbers for 2017 finalized, but right now, we’ve had 235 confirmed drug overdose deaths reported to us this year by coroners in the state. I don’t know how many of those 82 coroners are responsible for those numbers, but I do know for a fact that we still have coroners in this state that absolutely will not report drug overdoses to, to the Bureau of Narcotics even though they’re mandated by statute to do that.

Reporter: Why?

Dowdy: I have no idea. I have suspicions as to why. You know, you’ve got rural counties. You’ve got a prominent family within that particular county, and their son dies of a drug overdose or, let’s say heroin. The family doesn’t want the family image tarnished because their child died from a drug overdose, so the person that can control all of that is the coroner, who’s an elected official, who obviously has to run for re-election every four years. So, I suspect that that probably happens more often than not.

Reporter: So you have coroners ignoring the law?

Dowdy: Absolutely. Absolutely you have coroners who have been ignoring the law since that law got put on the books 11 years ago.

Reporter: Crazy.

Dowdy: It is. One of the things we’re doing this year is we’ve introduced a piece of legislation. The current law as it exists basically does not provide for any type punishment for the failure to report. We’re asking the Legislature this year to put in a penalty system in the coroner reporting statute so that, you know, going forward, if we determine that a coroner has failed to report a drug overdose death, we have the ability to punish them, albeit civilly, but we would have some teeth, you know, to--

Reporter: Doesn’t that hurt -- doesn’t that affect how you investigate? Because if you’re not getting accurate information, you know, you may not know what doctors to go after. You may not know what areas have the most crisis.

Dowdy: Right. It’s problematic on multiple levels, okay? One of the things that we did with our push this year is we, you know, we were asking the coroners, ‘Hey look, if you roll up on a death scene, it’s apparent that it’s a drug overdose death, you know, call the MBN agent assigned to your county and we’ll come out there. We’ll respond, and we can work it as a crime scene because there’s a lot of evidence there at the death scene that we can get and ultimately try to find out where the source of the drugs were from. I can tell you from 2013 through the present, about 85 to 87 percent of all drug overdoses in Mississippi have been attributed to opioids, and it can be a combination of prescription pain pills. It can be heroin. Heroin, fentanyl, or a combination of all three, but opioids are the cause of about 85 percent of all drug overdoses in Mississippi for the last four years. So, it’s important for us to get out there on the front end --

Reporter: How many scenes have you been to?

Dowdy: A boatload this year.

Reporter: So how does it affect -- by them not reporting to you, what does that -- how does that impact how you do your job?

Dowdy: Well it keeps us from being able to identify -- do we have a bad doctor that’s overprescribing? It keeps us from potentially being able to develop leads on a drug trafficking organization. Additionally what it does is it impedes the state’s ability to compete for grant monies coming out of the federal government to address this particular situation because, you know, we were contemplating putting in for some grants and when I was talking to a grant writer that does this for other states and they said, ‘You only had 99 drug overdose deaths during that particular year. Don’t waste your time. Don’t waste the paper. Don’t waste the effort. They’ll laugh you out of Washington because that’s not a problem.’ It certainly would be beneficial to us as a state, you know, being a small state, a rural state, to be able to get extra funding in here to, you know, bolster our law enforcement efforts to be able to possibly do more to curb the illicit trade of opioids because, you know, we’re fighting it on every front. We’ve got situations where, you know, used to, you have a house burglary. It was usually guns, cash, jewelry. Now routinely in just about every house burglary, prescription pain medications are being removed from the home if they have them in there.

Reporter: They’re looking for them.

Dowdy: They’re looking for them.

Reporter: Your coroners, they don’t have to be medical doctors in Mississippi?

Dowdy: No. I think the only thing they’re required to do is have a high school education to be able to be elected a coroner in Mississippi.

Reporter: So you have coroners who just have a high school education?

Dowdy: I’ve never looked at the education level of the coroners. The ones that I know, and the ones that I deal with on a regular basis, they have way more than a high school education and they’re good. You know, we’ve got some good coroners in this state that are doing some really difficult work, but they are very serious about their partnership, you know, with us, in trying to combat this.

Reporter: You are getting help, from 26 or whoever’s reporting.

Dowdy: Yes, and I’ll just give you an example. Here six months ago, one of the coroners in Madison County reached out to one of the MBN agents here in the Jackson metropolitan area, responded to a death scene. The reason that they called was that it appeared to be a drug overdose, and they found next to the deceased individual a number of pills that looked like oxycodone. So we went ahead and retrieved those, bagged them, sent them to the lab, ascertained exactly what it was, and the coroner went about doing what they do to determine cause of death. Before we could get the actual cause of death from the crime lab, the forensic side of the crime lab had already done the analysis on the pills that we found on the scene and they were actually pure fentanyl, and that’s part of the battle that we’re fighting now. We’ve learned through intelligence in our partnership with DEA that the cartels in Mexico are now manufacturing fentanyl. They have massive pill press operations that the cartels are operating down in Mexico, and they're taking the fentanyl and putting it into pill form, and they’re coloring it to match or closely match what the legal side of the pill looks like, whether it be hydrocodone, oxycodone, whatever. And they’re pushing those in the United States, and we’ve already determined that the pills we found out there are identical to pills we bought from a source down on the Mississippi Gulf Coast, and are also identical to pills we’ve now learned were the result of five drug overdose deaths in Phoenix, Arizona.

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