Is Montgomery County the nation’s leader for drug ODs? No one knows

Current data lacking on which counties have the highest overdose rates.

A series of stories produced by NBC News this month declared Montgomery County, Ohio, as the “most opioid addicted county” in the nation. The story gained more traction on the internet.

But is the county really number one? The answer is no one really knows.

The claim that Montgomery County tops all U.S. counties in overdoses came from a quote from Sheriff Phil Plummer, who said, “Per capita, we’re number one in the nation in overdose deaths.”

But when pressed for numbers to back up that claim, no local or state officials — including Plummer — could point to any current data. That’s because the most recent comprehensive national data on overdose deaths is from 2015.

RELATED: Overdose crisis: Montgomery County is the national example for filmmakers and media Death certificates in suspected overdose cases take a long time to complete because coroner's officials must wait on toxicology tests that are increasingly backlogged due to the current drug epidemic.

A Dayton Daily News analysis of available data shows Montgomery County is certainly among the hardest hit by the opioid crisis, but there is no conclusive data from either 2016 or 2017 to know which county nationally is the per capita leader.

This much is certain: The county was not number one in 2016, and may not even have cracked the top 10. The newspaper’s analysis found at least five counties and one large metro area with higher overdose rates than Montgomery County in 2016, and some states still have not calculated their final death totals.

Hard-hit Appalachia

The list shows how hard the opioid crisis is hitting the Appalachian states, because West Virginia has three counties on the list and Kentucky two. The city of Baltimore, which is separate from Baltimore County, also topped Montgomery County in per capita overdose deaths.

RELATED: Kroger, county partner on drug disposal bags to fight opioid overdoses Number one on the 2016 list was Cabell County, W.Va., with 137 deaths per 100,000 population, more than double the Montgomery County rate of 65.7 deaths per 100,000.

The others known to be above Montgomery County include:

  • Harrison County, Ky., 123.4 deaths per 100,000.
  • Berkeley County, W. Va., 82.8 deaths per 100,000.
  • Mercer County, W. Va., 74.4 deaths per 100,000.
  • City of Baltimore, Md., 72.9 deaths per 100,000; and
  • Campbell County, Ky., 67.2 deaths per 100,000.

To do the comparison, the newspaper examined data from the Centers for Disease Control and Prevention on counties that reported high overdose death rates in 2015, and then updated those numbers for 2016. It’s possible other counties had higher overdose rates in 2016, but national data likely won’t be released until the end of the year.

During a call with journalists earlier this month Trump administration officials said it’s difficult to say if one specific community is the worst overall for overdoses.

“I would not call Dayton, Montgomery County or any other community in the United States the worst of anything. Everyone is working this very, very hard. This particular issue morphs over time,” a senior administration official said. “It’s a snapshot in time. And Montgomery County, and Dayton are really having a real hard time right now. But we’ve had other communities that have had a real hard time in the past also.”

On an anecdotal basis, many areas are seeing soaring increases in overdoses in the first half of 2017 and Montgomery County’s numbers are indeed staggering.

The coroner’s office reports an unofficial count of 385 deaths as of June 22, eclipsing 2016’s record of 349 before the first half of the year is up.

RELATED: County surpasses 2016 fatal overdose total before June At the current rate, the county could end 2017 with more than 800 overdose deaths, as fentanyl and even more deadly analogues flood the market.

If the current overdose pace continues in the second half of 2017, the county’s per capita death rate would rise to 152.9 per 100,000, which could turn out to be the worst in the nation. But other hard-hit counties may also see the same spike, so it’s impossible to know.

“The numbers are going up obviously, and that’s unacceptable regardless of if we are one, two or three,” said Dan Suffoletto, public information supervisor for Public Health Dayton and Montgomery County.

Plummer echoed that, saying his goal is to spread the word about how dire the problem is here so that lawmakers and the government agencies that control the purse strings will pay more attention.

“We had a new DEA guy and a new FBI leader here, they said, ‘this is unprecedented,’ they’ve never seen it like this anywhere,” Plummer said. “So we’ve got a problem and we need help.”

“The national attention is to get more resources,” he said. “If we’re number one, send help.”

What the data says

Ohio was fourth in the nation for drug overdose deaths per capita in 2015, the last year for which complete data is available, putting the state behind West Virginia, New Hampshire and Kentucky.

RELATED: One man has been given Narcan 20 times by Dayton police Montgomery County that year ranked seventh or eighth in Ohio for overdose deaths per capita, depending on the source. The CDC and the Ohio Department of Health reported slightly different numbers at the county level.

According to the CDC’s numbers, eight Ohio counties ranked in the top 25 in the nation for per capita overdose deaths in 2015. They were Brown, Clark, Butler, Ross, Clinton, Clermont, Montgomery and Trumbull.

Worst in the nation that year were two counties at the southern tip of West Virginia, which each reported more than 100 deaths per 100,000 people.

RELATED: How Mexican drug cartels move heroin to Miami Valley street corners

The increasing presence of fentanyl in Montgomery County has soared overdose rates and put the county at or near the top of a list of counties with the highest overdose rates in the nation.

First detected in the Miami Valley in 2013, fentanyl and its analogues can be hundreds of times stronger than heroin. The drug surpassed heroin as the leading cause of overdose deaths here in 2016.

One of the most potent analogues is carfentanil, used to tranquilize large animals. Carfentanil was cited in just two Montgomery County deaths in 2016, but Montgomery County Coroner Kent Harshbarger said in March it had already been detected in a number of deaths in early 2017.

It was later confirmed that a combination of carfentanil and cocaine caused the March deaths of Spirit Airlines pilot, Brian Hayle, 36, and his wife, Courtney, 34, at their home in Centerville.

RELATED: Centerville pilot, wife OD from cocaine, carfentanil, autopsy shows While accidental overdose deaths in Montgomery County increased 46 percent in 2016 — from 239 to 349 — fentanyl-related deaths jumped 135 percent, according to data from the county health department and coroner's office.

The 240 fentanyl-related deaths in 2016 accounted for 69 percent of the accidental overdoses in the county, according to the coroner’s office.

Where the county ranks nationally is unimportant to Helen Jones-Kelley, executive director of Montgomery County Alcohol, Drug Addiction & Mental Health Services.

“Whether we are number one, number 10 or number 100 is so much less significant than the fact that we have citizens dying daily,” she said. “We are redoubling and tripling our efforts to keep the numbers from going even higher than that.”

Who is #1?

Just over the Ohio River from the southern tip of Ohio is Cabell County, W. Va. — home to the city of Huntington, the Marshall University Thundering Herd and about 96,000 people. According to 2016 death certificates which are still being processed, 132 people died of drug overdoses there last year, 119 of them due to opioids.

That puts the overdose death rate in Cabell County at 137 per 100,000 people, the highest of any county examined by the Dayton Daily News. Although complete data isn’t available, it also appears West Virginia had the highest overdose death rate among states in 2016, with 48 deaths per 100,000 of population.

So far in 2017, Cabell County has recorded 58 overdose deaths, 80 percent of them involving fentanyl alone or in combination with other drugs, according to data provided by the West Virginia Department of Health and Human Resources. That number could rise depending on toxicology test results.

RELATED: Middletown council member: Can we stop responding to overdoses? In Ohio, the crisis shows no signs of abating.

Department of Health data shows 3,050 Ohioans died of accidental drug overdoses in 2015. Estimates for 2016 put the number of deaths above 4,000 and intervention specialists at a heroin conference in March said 2017 could see 5,000 deaths in the state.

Counties large and small are struggling to deal with the escalating death toll. Fayette County Sheriff Vernon Stanforth told 10TV in February that the county’s EMS officers and Washington Court House police responded to 30 reported overdose calls over a 10-day period, resulting in six deaths.

The numbers are almost impossible to imagine in a county of less than 30,000 people.

RELATED: Fighting heroin crisis: What Ohio governor candidates plan to do Plummer said Montgomery County's status as a hub of opioid activity has made the area a leader in the fight to stop the epidemic.

States where fentanyl’s devastation is just beginning are calling Ohio, and Montgomery County specifically, for advice, he said.

“We’ve accepted the problem here,” Plummer said. “Now we’re going to help solve it.”

Digging deeper

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