The record number of Montgomery County overdose deaths in 2017 rose so fast that by June the number exceeded the previous year’s total of 349 and health officials braced for up to 800 dead.
“It was scary,” said Helen Jones-Kelley, executive director of the Montgomery County Alcohol, Drug Addiction & Mental Health Services (ADAMHS) board. “We’re certainly not celebrating the number of people who did overdose and die, but it’s a lot less than the number anticipated.”
Though the very worst fears didn’t come, still, overdoses had taken 558 lives by Dec. 21, or 209 more than in 2016.
The dichotomy signals that community efforts to battle the opioid epidemic may be taking hold, but much work remains to put the years-long crisis in full retreat, officials say.
Deaths spiked with a high of 81 in May, however, fewer than half that number died in each of the last six months, held to 30 in November and 16 this month as of Friday.
“We all hope for that pattern to continue because that means fewer people are losing loved ones to this problem,” said Montgomery County Health Commissioner Jeff Cooper at a meeting of the Community Overdose Action Team (COAT), Montgomery County’s collective response formed during the fall of 2016 as a response to the crisis.
‘It’s like a rebirth’
Carlie Smith was ready to die earlier last year. If not from an opioid overdose, she figured to end her life another way.
“It got to the point where I just told myself if the day came I could not get my drugs, that would be the day I would die,” said Smith, 33.
“I tried to overdose so many times. I can actually remember being jealous of the people that got to die,” she said. ““My plan was to throw myself in front of a moving vehicle or throw myself over a bridge. I just couldn’t decide what was going to be the least painful.
“I was at the end my rope,” said Smith, who struggled to get free of opioids for most of her 16-year-old son’s life and the entirety of her 8-year-old daughter’s.
Instead, the Miamisburg woman was handed a lifeline.
Members of the area support group Families of Addicts helped steer Smith to treatment, and she said a “divine power” kept her in recovery and allowed her to share Christmas morning with her children this year for the first time in more than a decade.
“It’s like a rebirth,” she said.
After 13 years of addiction, Smith stopped using opioids in May, the month the county recorded the most opioid deaths of a years-long crisis.
Smith was one of more than 3,100 people as of Dec. 4 who got treatment through services that became more streamlined and responsive during 2017, according to ADAMHS.
Almost no Montgomery County community was spared during 2017. Overdose fatalities occurred in at least 23 jurisdictions. More than half of all deaths were outside of Dayton’s city limits, Cooper said.
“It touches all individuals, all citizens, all communities at some point,” he said.
The indiscriminate toll of opioids proved bluntly clear with the deaths of a commercial airline pilot and his wife, who were found in unresponsive in March by their four children in a Centerville home. Toxicology reports showed Brian Halye, 36, and Courtney Halye, 34, died from cocaine and one of the most powerful opioids known, carfentanil, a large animal tranquilizer.
Seven more in addition to the Halyes died in Centerville in 2017, Montgomery County Coroner’s Office preliminary records show. Overdose deaths were also reported in Brookville, Germantown, Kettering and Washington Twp.
Inhaling or coming into skin contact with granules of ever-more-potent fentanyl analogs brought some unsuspecting overdose victims in 2017.
In November, a Fairborn firefighter-paramedic driving an overdose patient to the hospital himself began showing overdose symptoms, prompting his partner in back to help stop the ambulance and administer Narcan to the driver.
At least three toddlers overdosed on opioids in the county during 2017, including 13-month-old Mari’oona Allen who died after coming into contact with fentanyl and carfentanil in her grandmother’s house, according to the coroner. The girl’s grandmother, Trina Miller, was found dead in a Riverside motel three days later.
Thirteen-year-old Nathan Wylie apparently sought out his father’s stash in Dayton on March 28 and died April 1. His father Robert Wylie, 41, was convicted of two charges and sentenced in November.
Ohio Department of Health data released for 2016 show Montgomery County had the highest overdose death rate in the state — 42.5 per 100,000 people — among the total 4,050 deaths, which will undoubtedly be higher for 2017.
The death rate — which some contended was the highest in the nation — and shocking overdose cases like the Halyes, brought national newspapers, magazines, film makers and network news crews to Montgomery County over the year, generating reports from Dayton-area streets, support group meetings, treatment centers — and the county morgue.
Closing treatment gaps
A major goal for those fighting the epidemic locally during 2017 was to identify and close gaps in drug treatment services, said public health officials.
Through 2017, the Community Overdose Action Team grew to more than 200 people from 100-plus organizations — including law enforcement — working on eight focus areas from increasing treatment accessibility to decreasing the illegal supply of drugs, said Barbara Marsh, Public Health – Dayton & Montgomery County assistant health commissioner.
Marsh said the county began 2017 with no certified peer recovery supporters. Now, there are 40 to show others the way to sobriety.
“That is a huge success and we want to continue to increase individuals who are in recovery that have experience to be part of the overall strategy of reducing the deaths,” she said.
One gap filled during COAT’s first full year resulted in the availability of 24/7 outpatient detox services, said Jones-Kelley.
“If a person is ready to start working, right then they put them on a special protocol to get them through their detox and connected to treatment provider of choice and that’s working well,” she said.
Other major 2017 initiatives included additional syringe services and expanded assessment and treatment options for inmates at the county jail. The overdose reversal drug Narcan was distributed to more police and the public, while the organization fostered more partnerships with community and faith-based organizations and expanded the number of recovery housing beds.
Overdose deaths dropped dramatically from 81 in May to 43 in June and leveled off to about 36 a month by summer’s end. In September, Dayton police went two consecutive days without responding to an overdose call, an occurrence Maj. Brian Johns couldn’t recall during the four-year-long opioid crisis.
Getting to the supply
Keeping powerful drugs from reaching users also played a role in turning the overdose death numbers mid-year, authorities said.
The federal Drug Enforcement Administration launched its “360 Degree Strategy” in the county during 2017 to not only crack down on dealers, but also help curb the overprescribing of pain pills and put a greater emphasis on drug prevention through community outreach, relationship building and public service announcements.
While the opioid crisis is unprecedented on a national scale, there was a reason the DEA picked Dayton as a 2017 pilot city, said Timothy J. Plancon, special agent in charge of the DEA’s Detroit Field Division.
“Few communities have experienced and suffered from this epidemic as dramatically as Dayton, Montgomery County and the Miami Valley area,” he said. “Chances are most people here have been directly impacted.”
The Miami Valley Bulk Smuggling Task Force was formed about five years ago. By August, it had taken almost 200 pounds of heroin and fentanyl off the streets, more than 200 pounds of cocaine and over 5,000 pounds of marijuana. Also seized were more than 6,000 prescription pain pills, which officials say is the root of the opioid crisis. The R.A.N.G.E. Task Force kept another 19 pounds of heroin and fentanyl from reaching users.
The drug interdiction efforts saved lives during 2017, said Montgomery County Sheriff Phil Plummer.
“When we have a good pop, you can see the overdoses go down, so we are definitely getting to the supply,” he said. “We track that pretty regularly, and you can see a two or three day decline on overdoses when we have a good bust.”
Altogether, the multi-jurisdictional smuggling task force — including officers from the Montgomery County Sheriff’s Office, other local police and state and federal agencies — has seized drugs with a street value of $35 million and more than $5.5 million in cash, plus produced 349 arrests, according to task force records.
Earlier in 2017, the county received 15 or more overdose calls a day. By December, the average was closer to four, Plummer said.
“All the programs are starting to work. The decline this year — this month alone — is incredible for how few overdoses we’ve had,” he said last week.
Many addicts fearful of a quick death from fentanyl and its analogs have moved to methamphetamine, a drug which gives authorities more time to provide treatment, Plummer said.
“That’s a victory,” he said. “They are not dying.”
Second and third chances
Looking ahead in 2018, the region’s two major health care provider networks along with other partners plan to open a stand-alone community drug crisis stabilization unit.
The goal: help those addicted to opioids and other drugs more quickly get detox and treatment services and alleviate some of the burden on hospital emergency departments, said Bryan Bucklew, president and CEO of the Greater Dayton Area Hospital Association.
The centrally-located facility — that would house patients generally less than 24 hours — could treat a number of overdose patients with no other health risks, Bucklew said in October.
One gap left to be filled is connecting those in recovery with employment opportunities that allow “second chances and third chances” at careers, said Jones-Kelley.
“We’re going to be looking at how we continue to work with employers to get them to understand addiction and give people a chance — because people are going to relapse,” she said. “Let’s not throw them out of employment because that’s only going to send them deeper into a sense of hopelessness.”
Diane Wax is thankful her daughter Carlie Smith was alive to spend this Christmas and New Year’s with the family, including the grandchildren Wax helped raise during her daughter’s absence.
“A lot of people don’t make it. Every time I worried that it could be the last time that I would see her,” Wax said. “I feel blessed that she’s survived.”