Officials from the Centers for Disease Control and Prevention met Friday with state health officials in Dayton to address an alarming surge in overdose deaths related to an illicit version of the painkiller fentanyl and fentanyl-laced heroin.
“We saw a sharp increase in the number fentanyl-associated overdose deaths from 2013 to 2014, so we actually contacted the CDC and asked for their assistance,” said Dr. Mary DiOrio, medical director for the Ohio Department of Health.
DiOrio joined local stakeholders, including law enforcement and representatives of the Montgomery County Coroner’s Office, for a briefing at the ADAMHS Board for Montgomery County in downtown Dayton.
Statewide, drug overdose deaths rose from 2,110 in 2013 with 84 involving fentanyl (3.9 percent), to 2,482 in 2014 with 502 involving fentanyl (20.2 percent), according to state health department figures. And preliminary data for 2015 indicates the number of fentanyl-associated cases in Ohio is poised to exceed last year’s numbers.
The new wave of opioid addiction is even more deadly than previous drug epidemics because of the unknown nature of the drug, according to presentations from local health officials, who noted recent overdoses have been attributed to illegally produced and trafficked fentanyl, not diverted pharmaceutical-grade fentanyl used in hospitals.
“Part of issue with this illicit fentanyl is that it’s produced with all clandestine material with absolutely no quality control by whoever’s manufacturing it,” said Ken Betz, director of the Montgomery County Coroner’s Office.
In addition, fentanyl — a synthetic opioid that is about 30 to 50 times stronger than heroin — is commonly mixed with heroin, cocaine and other drugs, which amplifies their potency and is largely responsible for the spike in accidental overdose deaths, experts say.
“Fentanyl is incredibly powerful and can kill people very quickly, so this is one of the reasons why we’re really keen on investigating this so we can fully understand it,” DiOrio said.
Like heroin and other opioid drugs, fentanyl affects areas of the brain that control pain and emotions, producing a state of euphoria in which people sometimes stop breathing.
However, there are medications available to reverse opioid overdoses, including naloxone — known by its brand name, Narcan — which is now available at most pharmacies in Ohio without a prescription and used extensively by police officers and first-responders.
Evidence of Narcan’s effectiveness can be seen in an apparent decline in overdose deaths in Montgomery County that bucks the statewide trend, according to Betz, who said there were about 100 accidental overdoses cases in Montgomery County though the first six months of the year — less than half the 264 overdose cases reported in 2014.
“In our opinion, the decline in accidental deaths is attributable to the aggressive use of Narcan,” Betz said. “Death rates in surrounding counties have remained consistent or gone up.”
The state health department is partnering with local agencies to raise awareness and expand interdiction with Narcan, while at the same time developing strategies to prevent drug overdoses in the first place with the assistance of those on the front lines in the battle against opioid addiction.
In addition to Dayton, state health and CDC officials will visit three different cities in Ohio in the coming weeks.
“We’re going into areas that really are focusing their efforts on trying to address the problem, and that’s why we’re in Montgomery County today,” DiOrio said. “We want to talk to the people who are doing the work so we can learn from their experiences. That’s why we’re stressing that if you have a loved one or friend of family member who has an addiction to opiates, you should really talk to someone about getting naloxone to have on hand.”
DiOrio said health officials hope to build on efforts started in 2011, when the Ohio cracked down on so-called pill mills and doctors who over prescribed opioid painkillers, which were the gateway drugs for many heroin and fentanyl addicts.
“We have done a great job in our state when it comes to addressing the prescription overdose problem,” DiOrio said. “Now that we have fentanyl coming in, we know we need to have new measures to address the problem.”