A similar trend is occurring in Clark County. There were 25 confirmed accidental overdose deaths from January 2022 through the end of June 2022, and according to the Clark County Combined Health District, there are 26 confirmed accidental drug overdose deaths in 2023.
The U.S. Drug Enforcement Administration earlier this year warned of an animal tranquilizer known as xylazine, or “Tranq,” is becoming more popular in Ohio for illicit drug use involving fentanyl. Fentanyl still remains prevalent among accidental dug overdoses.
“Illicit fentanyl is now the leading cause of death for unintentional drug overdose deaths in the United States,” said Barb Marsh, chief operating officer at OneFifteen, a nonprofit offering recovery services.
A downward trend is being seen in Warren County. In 2023, Warren County has had nine accidental drug overdose deaths, all of which had multiple drugs in their system, including fentanyl, according to the Warren County Health District. In all of last year, Warren County had 30 accidental overdose deaths, which broke down as follows: four related to just fentanyl, 20 related to fentanyl and other drugs, four related to multiple drugs not including fentanyl, one related to oxycodone intoxication, and one related to cocaine.
“Based on how drug overdose deaths are trending in Warren County for 2023, we are hopeful that there will be fewer drug overdose deaths in 2023 than in 2022,” said Allison Combs, public information officer of the Warren County Health District.
In Greene County, suspected overdoses with an emergency department visit were down slightly in the first quarter of 2023 with 89 total suspected overdoses, not just overdoses resulting in deaths, compared to the fourth quarter of 2022 with 92 suspected overdoses. The first quarter of 2022 also saw 121 suspected overdoses, which is lower in 2023 for the same quarter, according to Greene County Public Health.
The opioid epidemic goes back to the 1990s, Marsh said, with the overprescribing of opioids.
“During the 1990s and early 2000s, the majority of the deaths were actually fueled by prescription opioids,” Marsh said.
But as Centers for Disease Control guidelines for prescribing opioids went into effect, Marsh said there were fewer deaths connected with prescription opioids, but then there was an increase in deaths involving heroin.
“In the last 10 years, the landscape has again changed, and with opioid-related deaths, it’s primarily due now to illicit fentanyl,” Marsh said.
In 2021, 106,699 drug overdose deaths occurred, according to the CDC. The rate of drug overdose deaths involving synthetic opioids other than methadone increased 22%, while the rate of deaths involving heroin declined 32% between 2020 and 2021.
“Those are huge numbers that we’re seeing individuals dying due to illicit fentanyl,” Marsh said.
“Fentanyl is still a thing,” said Helen Jones-Kelley, executive director of Montgomery County Alcohol Drug Addiction and Mental Health Services (ADAMHS). “It is still a big deal.”
Agencies like OneFifteen and others offering recovery services said the end of the COVID-19 emergency has made a difference.
“We have seen an increase in people accessing treatment again on a regular basis,” Marsh said.
OneFifteen’s crisis stabilization services are operated by Samaritan Behavioral Health, which opened in 2019 and has seen 6,000 individuals since then. They see approximately 500 nightly visits per month of individuals coming into their crisis stabilization center, Marsh said. That has increased from 480 visits per month last year, she said.
Montgomery County ADAMHS is also seeing more people reaching out for help this year so far.
“Our system stayed open,” said Jones-Kelley. “I just think that people weren’t reaching out during that time or they believed that if they did, there weren’t services, because we have more of a waiting list right now.”
People who were using illicit drugs were also more likely to be using the drugs alone during the pandemic, which also put them at a higher risk of death, Marsh said. Harm reduction, like being around others with access to naloxone, can help prevent deaths. To find ways to get naloxone, visit naloxone.ohio.gov.
Increasing access to medication-assisted treatment programs has been an effective tool in combatting substance use disorders, Marsh said.
“Medications, in combination with behavioral therapy, have been proven effective in supporting individuals with sustained recovery. Specifically buprenorphine, methadone, and naltrexone are the medications that are used,” Marsh said. Prior to COVID, there were more rules on prescribing medication-assisted treatments, including that patients had to be seen in person.
“In response to the COVID-19 public health emergency, the DEA implemented temporary regulations that allow medication-assisted treatment or the medications to be prescribed via telehealth,” Marsh said. The relaxed rules helped expand access to treatment, and at least one study found the proportion of drug overdose deaths involving buprenorphine did not increase after the rules were relaxed.
“Since the public health emergency has ended, the rules have reverted back to requiring an in-person evaluation, but they are granted a 30-day window for that in-person visit now. It’s not required at the first visit,” Marsh said. There are also additional exceptions for the in-person visit.
Throughout the opioid epidemic, there have always been fluctuations in the number of drug overdose deaths, which Marsh said should be taken into consideration in both looking at immediate responses to alert the public, as well as to help come up with future strategies.
“We really want to be able to look at the data over time, so we want to look at the treads and patterns and really take that data to then make data-driven decisions on our interventions in the community,” Marsh said.
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