Ohio’s fatal drug overdoses topped 3,000 in 2015

Since 2010, accidental drug overdoses in Ohio have taken the lives equal to the population of its smallest county, Vinton.

Nearly a quarter of the 12,921 who died did so in 2015, another record-setting year for drug overdose deaths. The deaths were up 20.5 percent to 3,050 despite continued efforts by state agencies and communities to combat opiate abuse, according to the Ohio Department of Health’s preliminary drug overdose report for 2015, which was released on Thursday.

Unintentional overdoses have been the leading cause of accidental death in Ohio since 2007, outpacing fatal auto crashes, which totaled 1,110 in 2015, according to the Ohio Highway Patrol.

Although heroin was involved in 47 percent of accidental overdose deaths, fentanyl – an opioid that is 30 to 50 times more potent than heroin – was cited as the primary drug driving fatal overdoses upward. Fentanyl was involved in 1,155 fatal overdoses – more than twice the number from 2014 and 14 times more than in 2013.

Between 2010 and 2015, Ohio adults died at a rate of 18 per 100,000. Brown County had the highest at 40, followed by Montgomery and Clermont counties, both at 35.

Of Ohio’s three most populated counties, Hamilton County was the only one to rate above the state with nearly 26, making it the 16th highest. Cuyahoga County’s rate was 18 and Franklin County’s 17.

Five counties had fewer than 10 overdose deaths total since 2010, with Holmes at the bottom with three.

Fairfield County’s rate is below the state at about 11 deaths per 100,000 adults. The county lost 16 people to unintentional overdoses in 2015, up from 15 in 2014, according to the state report.A bright spot amidst the preliminary 2015 fatal overdose report, released Thursday, is the fourth straight year that prescription painkillers, like Vicodin and Oxycontin, has represented a smaller percent of the overall number of overdose deaths. If not for the presence of fentanyl, overdose deaths may have actually decreased about 7 percent.

Ohio Department of Health Medical Director Mary DiOrio credits much of the continued decline to changes in prescribing guidelines being embraced by doctors who also are increasingly monitoring of the Ohio prescription database to better prevent multiple doctors prescribing pain killers to the same patient.

“There were 81 million fewer opioid doses dispensed to Ohio patients since the state took initiatives to curb opiates, and the number of people who try to get controlled substances from multiple doctors has dramatically decreased,” DiOrio said.

The Ohio Board of Pharmacy reports the number of people doctor shopping – those receiving prescriptions from five or more prescribers in a month – has dropped from 2,205 in 2011 to 720 in 2015.

Officials face a bigger hurdle when it comes to getting a handle on fentanyl, though. While there is prescription fentanyl, typically used in hospice care of cancer patients, the fentanyl on the streets is being made in secret labs.

The bulk of fentanyl-related overdoses in 2015 were in southwestern Ohio with the most in Hamilton County, at 195. The largest one-year increase among counties with the most fentanyl-related deaths was in Clark County where fentanyl-related overdoses increased sixfold to 48.

Investigators have determined much of the fentanyl is being made in China and being shipped either directly to the United States or to Mexico, said John Born, director of the Ohio Department of Public Safety.

Ohio law enforcement is working to share more drug information with each other and analysts with the Ohio National Guard to improve targeted enforcement efforts, Born said. Already this year, the Ohio Highway Patrol has seized nearly three times the amount of heroin as in all of 2015.

“While we’ve seen success, the ultimate success on this is going to be on (decreasing) the demand,” Born said.

Although the current General Assembly is in its final months, it’s expected to take action before year’s end on boosting penalties for trafficking fentanyl. A bill Sen. Frank LaRose, R-Copley, introduced in November 2015 takes aim at lowering the amount of fentanyl possession that qualifies for a first-degree trafficking charge.

While that bill remains in committee, LaRose and Tracy Plouck, director of the Ohio Department of Mental Health and Addiction Services, said legislators and the governor’s administration are committed to addressing the issue this year.

“We want to continue getting people who are struggling with addiction to treatment … but if someone is trafficking drugs into our state and wreaking havoc in our communities, we want to make sure there are appropriate penalties,” Plouck said.

The effort is one of several expected yet this year. In April, a mid-biennium opiate bill was introduced to tackle multiple efforts, including increased access to treatment and even more access to the overdose reversal drug naloxone in places like treatment centers and schools.

Boosted efforts needed to tamp down the prevalence of fentanyl in Ohio is obvious in daily headlines, as spikes of overdoses have continued in several communities this year. Just this week, that spike has been in Cincinnati where at least 33 overdoses, one fatal, were reported from Tuesday through mid-day Wednesday in addition to more than 30 over the weekend. Last week, it was north of Columbus in Marion where there were 17 overdoses, including two deaths, in 24 hours.

As of April, a USA Today Network-Ohio survey of coroner offices of counties where fentanyl has been most prevalent indicated the spike of the past two years has continued in 2016. Just three months into 2016 Cuyahoga County was on the verge of eclipsing the 92 fentanyl-related overdose deaths from 2015.

The Ohio Bureau of Criminal Identification also has detected more cases of fentanyl – 1,265 as of July 15 which was already 155 more than all of 2015. According to the National Forensic Laboratory System, Ohio law enforcement had 3,882 fentanyl-related seizures in 2015 – 35 times more than in 2014.

“The evolution of the (overdose) epidemic is exactly what you see in the evolution of an addict,” said Dr. Mark Hurst, medical director of the Ohio Department of Mental Health and Addiction Services.

That evolution of addiction involves the physical need to take more, or more potent, opiates to get high or even just to reach a feeling of normality. Opiate abuse changes brain chemistry and when someone hasn’t used, they become physically sick with extreme vomiting and diarrhea.

That evolution also makes it unsurprising that some are turning to something even more potent than fentanyl – carfentanil, an opioid used for large animals like elephants that is 100 times more powerful than fentanyl.

Hurst is unsure whether carfentanil will grow to the problem of fentanyl, but said they continue to monitor it along with other new drugs.

jison@Gannett.com

Twitter: @JonaIson

Ohio losing thousands to drugs

Since 2010, nearly 13,000 Ohioans have died from an unintentional drug overdose. Here is a look at deaths in area counties.

Sources: Ohio Department of Health; analysis by Injury Prevention Program; U.S. Census Bureau