Valley ranks high in drug access, addiction, deaths

By Ed Runyan | March 1, 2015 at 12:01a.m.

By ED RUNYAN

runyan@vindy.com

Portsmouth, along the Ohio River at the bottom of Ohio, has 20,000 residents, a drop from 36,000 in 1950, when it had jobs in the steel-making and shoe-making industries.

Foreign competition doomed many of the good-paying jobs.

If that sounds familiar to Mahoning Valley residents, it should. It’s a lot like the history of Youngstown and Warren, as both lost steel jobs, and Warren lost most of its wiring-harness jobs at Packard Electric.

Portsmouth, in Scioto County, is best known today for two things: Southern Ohio Correctional Facility in nearby Lucasville and prescription drug abuse.

In 2010, a dozen pill mills had opened in southern Ohio, and Portsmouth was the epicenter. The clinics, which contained doctors passing out opiate pain medications like candy, were shut down a few years later amid criminal charges, but the effects on Southern Ohio residents remain.

Between 2007 and 2012, Scioto County was second-highest in the state for the number of residents who died of drug overdoses, according to the Ohio Department of Health.

Many southern Ohio counties still lead the state in per-capita drug overdose deaths and per-capita opiate prescriptions legally filled at pharmacies, according to statistics from the ODH and Ohio Board of Pharmacy.

Officials have made no secret of the link between high overdose death rates and high per-capita rates of pain-pill prescriptions, saying many of today’s heroin addicts started out abusing pain pills.

Scioto County is the classic example. It had the highest rate of Ohio’s 88 counties in 2011 for pain pill prescriptions and second-highest rate of overdose deaths. Its prescription rate dropped to No. 8 in late 2014, according to data from the Ohio Board of Pharmacy’s Ohio Automated Rx Recording System (OARRS), which tracks pain-pill prescriptions.

That same data indicates that two counties in the region — Trumbull and Jefferson — also are among the state leaders in per-capita pain-pill prescriptions and overdose deaths.

The Valley

Trumbull ranked 11th-highest in the number of pain pill prescriptions filled in Ohio in the last quarter of 2014 and sixth-highest in the number of overdose deaths between 2007 and 2012. Jefferson County ranked 10th highest in pain-pill prescriptions and fourth highest in overdose deaths.

Mahoning and Columbiana counties ranked down on both lists, with Mahoning 29th-highest in pain medication prescriptions and 20th-highest overdose-death rate; Columbiana ranked 37th highest for pain-medication prescriptions and 47th highest in deaths.

OARRS also started releasing a slightly different measurement of pain-pill use several years ago called Daily Milligram Equivalents per Patient, which also takes into account the dosage of the drug.

Trumbull had the highest number in the state on that list in 2013, the most recent statistics available, at 287.79 milligrams per patient, followed by Vinton County in southern Ohio at 275.35. Mahoning County wasn’t far behind at No. 6 with 249.46 and Jefferson No. 7 at 241.99.

The Trumbull County Mental Health and Recovery Board noted the relationship between economic conditions and drug abuse in its 2014 Community Plan, saying Trumbull County was No. 1 or No. 2 in the state among 13 urbanized counties for unemployment in 2011 and 2012 as its workforce dropped by 6,800 jobs (6 percent) between 2009 and 2012.

“Declines in the size of the county’s labor force and in the number of employed workers have been accompanied by increases in poverty, fatal opiate overdoses, and unprecedented utilization of state–operated psychiatric hospitals,” the report said.

The most recent statistics provided by the coroner’s offices in Trumbull and Mahoning counties last week showed that Trumbull’s overdose deaths climbed in 2014, while Mahoning County’s number dropped.

Trumbull County recorded 54 drug overdose deaths in 2014, 36 of them having heroin as either the only drug in the person’s system or one of multiple drugs. Trumbull had 39 such deaths in 2013.

Mahoning County had 50 drug overdose deaths in 2014, and 23 were attributable to either heroin alone or in combination with other drugs. It had 63 overdose deaths in 2013.

Jeff Orr, commander of the Trumbull Ashtabula Group Law Enforcement Task Force, one of Trumbull County’s primary narcotics investigative teams, said he doesn’t know all of the reasons why Trumbull County has one of the largest drug addiction problems in the state. But he is certain of one reason: “We overprescribe here for opiates (pain pills). We way overprescribe. There’s no reason for [doctors] to put these in the hands of the county.”

Orr said having unnecessary opiate pain medications in the community causes people to get them who shouldn’t, such as teenagers. “They get addicted to them young, and after a period, they get addicted to heroin,” he said.

“That overabundance of drugs out there — they are not taking them. They are selling them, and they are being taken by people taking them for the first time,” Orr said.

“It’s coming off of the street or coming out of the house,” he said. “This county is sick.”

Orr said another indication of the scope of the overdose problem is the number of people who are being saved from death through Naloxone, the overdose-reversal drug used in

hospitals and by ambulance personnel. The drug also is available through the Trumbull County Board of Health for families or individuals wanting one for a loved-one who is an addict.

Orr said he estimates Naloxone saves 500 lives per year in Trumbull County.

Fighting back

TAG is part of the ASAP Opiate Task Force, a coalition of drug counselors and other professionals and volunteers that meets monthly. They have held informational meetings and day-long events and written a plan for combating the problem.

They’ve also had take-back events where the public can get rid of unused pain medications. They have obtained grants to put permanent drop-off boxes in locations such as the Champion and Brookfield township government buildings.

Orr said a former state law used to make it more cumbersome for people to drop off prescription medications — a law that made it illegal to transport controlled substances in anything but the original container.

Now, a person can transport them in a plastic bag or other container, but he or she might have to prove that they have a prescription for them if they would get stopped by police, Orr said.

Someone concerned about dropping off a pill bottle with their name and other information on the bottle can try to remove the label or drop the pills into the drop box and retain the original bottle, he said.

A lot has happened since Southern Ohio’s pill-mill problem became apparent in 2010. Ohio House Bill 93, enacted in 2011, made it harder for pill mills to operate.

Law enforcement also has prosecuted pharmacists, including the owner of the former Overholt pharmacy in Champion Township and two of his pharmacists. And, doctors have written fewer prescriptions, according to the Ohio Board of Pharmacy.

A January 2015 OARRS report said the number of prescriptions written in 2014 had dropped by 656,000 from 2013 — to 24.4 million.

It also said doctors had started to use the OARRS computer database more in 2014 compared with 2013 to check whether patients were “doctor shopping,” meaning getting prescriptions from multiple doctors. By 2014, doctor shopping dropped by about two-thirds compared with 2009, OARRS reported.

Dr. Humphrey Germaniuk, Trumbull County coroner, said drug abuse, especially of opiates such as heroin and OxyContin, is a problem throughout the country.

One reason is society’s reliance on prescription drugs.

“Do they really need a heavy-duty narcotic for a problem that doesn’t require a heavy-duty narcotic?” he said.

Kathy Parrilla, a registered nurse and public health nurse for Trumbull County, believes one simple change could take drugs of abuse out of circulation. It pertains to people who get a standard prescription for pain pills after a medical procedure or injury.

“If we have a need for five pain pills to get us through, why do we write for 30?” she asks.