Illicit Fentanyl Continues to Fuel Increase in Drug Overdose Deaths in Ohio

Report also Shows Progress in Reducing Prescription Opioid Abuse

(August 25, 2016) The number of unintentional drug overdose deaths in Ohio increased again in 2015, driven by a sharp rise in fentanyl-related deaths, according to a new report released by the Ohio Department of Health (ODH). The number of fentanyl-related deaths in Ohio has increased from 84 in 2013, to 503 in 2014 and rose to 1,155 in 2015. Overall, drug overdose deaths in Ohio increased from 2,531 in 2014 to 3,050 in 2015.

The report also dramatically demonstrates the rapidly changing nature of the battle against drug abuse. As the state has worked with physicians to curb prescription opiate abuse, the number of prescription opiate overdose deaths have begun to level off.

“Ohio was one of the first states to see the rise of fentanyl over the past couple of years, as the opiate epidemic continues to evolve to more powerful drugs,” said Dr. Mark Hurst, medical director of the Ohio Department of Mental Health and Addiction Services. “We knew when we started this battle five years ago that progress wouldn’t be easy, but we are well prepared to stay on the leading edge of fighting this epidemic thanks to the multi-faceted strategies we have put into place.”

Fentanyl is a powerful synthetic narcotic that is estimated to be 30 to 50 times more potent than heroin, and 50 to 100 times more potent than morphine. The vast majority of fentanyl reports by law enforcement in drug seizures result from illegally produced and trafficked fentanyl, not diverted prescription fentanyl.

Last fall, Ohio requested assistance from the federal Centers for Disease Control and Prevention (CDC) to help better understand the increase in fentanyl-related deaths. CDC issued a report that provided insight into fentanyl-related overdose deaths in Ohio, and also noted that “the state has launched a comprehensive response” to address the issue.

The use of naloxone, the opiate reversal drug, has been vital to saving lives and that is why Ohio has increased funding to purchase naloxone for first responders through local health departments. In 2015, Ohio EMS personnel administered 19,782 doses of naloxone – 7,207 more doses than in 2013. More than one dose of naloxone may have been administered to a single patient to reverse the opiate overdose.

A targeted campaign to raise awareness about the signs of a drug overdose was launched in May to urge family members and friends of people who use drugs to obtain naloxone to administer during an overdose while waiting on first-responders to arrive. The campaign focuses on 15 Ohio counties that accounted for 80 percent of the state’s fentanyl-related overdose deaths in 2014.

“In the midst of this growing opiate epidemic, we are seeing positive indications that our aggressive efforts are working to reduce opioid prescription pain medications available for abuse,” said ODH Medical Director Mary DiOrio, MD. “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. Also, the percentage of prescription opioid-related deaths compared to all unintentional overdose deaths declined in Ohio for the fourth straight year.”

DiOrio attributes the decline in the number of opiates dispensed to Ohio patients with efforts to reduce the prescription pill supply, increased law enforcement efforts, empowering prescribers and pharmacists to use Ohio’s prescription drug monitoring system, the Ohio Automated Rx Reporting System, and working with medical professionals to establish opioid prescribing guidelines for healthcare professionals who treat chronic pain and acute pain.

“The state has been very aggressive in implementing new strategies to strengthen Ohio’s fight against opiates, but we are reminded today of the difficult road ahead as the epidemic evolves at a rapid pace,” said Andrea Boxill, coordinator of the Governor’s Cabinet Opiate Action Team and deputy director of the Ohio Department of Mental Health and Addiction Services. “In the face of the continued rise in drug overdoses, we believe that Ohio has one of the most comprehensive approaches in the nation to combat opiate abuse and drug overdoses, and we will continue to evolve our efforts to address the changes that we are seeing in the drug market.”

Several members of the osteopathic profession have worked closely with state policymakers to address the epidemic including State Rep. Terry Johnson, DO; Cynthia S. Kelley, DO, of Akron; Cleanne Cass, DO, of Dayton; R. Aaron Adams, DO, of Portsmouth; Mark N. Malinowski, DO, of Chillicothe; and Executive Director Jon F. Wills. Kelley, Cass, and Malinowski helped write acute pain opioid prescribing guidelines, which specifically mention osteopathic neuromusculoskeletal medicine as an alternative to opioids.

LINKS:

Detailed list of Ohio’s efforts to combat the opiate crisis
2015 Ohio Drug Overdose Report, 2-page summary
2015 Ohio Drug Overdose Full Report
Article about acute pain guidelines in Buckeye Osteopathic Physician (spring 2016)