Fentanyl a big part of Ohio overdose deaths, state data shows

Staff report

COLUMBUS

More Ohioans died from unintentional drug overdoses in 2014 than in any other year on record, according to preliminary statistics released by state health officials Thursday.

The initial data from the Ohio Department of Health indicate 2,482 deaths last year, up nearly 18 percent from 2,110 in 2013. The Mahoning Valley accounted for 115 of the 2014 deaths.

Increasing use of the powerful opioid fentanyl, sold under the prescription names Actiq, Duragesic and Sublimaze, was a big part of the increase, accounting for 502 drug poisoning deaths in 2014. That compares to fewer than 100 such deaths in 2012 and 2013.

Fentanyl is 30 to 50 times more potent than heroin, according to the ODH.

Youngstown police Chief Robin Lees said as far as he knows, there has been no fentanyl-laced heroin being sold in the city.

“Wherever it’s coming from, it’s not coming into Youngstown,” Lees said.

In Trumbull County, however, fentanyl was found in the drug screen of two people who died of overdose in late 2014 and another 14 of the 35 during the first four months of 2015, according to the Trumbull County Coroner’s office.

The problem was especially acute in early April, when Jeff Orr, commander of the Trumbull Ashtabula Group Law Enforcement Task Force, sounded the alarm during a week in which six people died in Trumbull County of overdoses.

The county had another spike in overdose deaths earlier this month, but it takes two months to get toxicology results, so it’s too soon to say whether fentanyl is tied to that spike, Orr said.

Trumbull County had nearly 50 drug overdose deaths the first six or seven months of 2015, evidence that the total for the year is likely to exceed the previous high of 64 in 2007.

“We’re trying to get the word out to heroin addicts that if there ever was a time not to use, it’s now because the next time could be their demise,” Orr said.

Dr. Joseph Ohr, forensic pathologist at the Mahoning County Coroner’s Office, could not be reached.

“At the same time we are experiencing positive progress in our fight against drug addiction, such as fewer opiates being dispensed and a decrease in high-doses of opiates, we are also seeing some individuals begin to use more dangerous drugs to achieve more intense effects,” said Dr. Mark Hurst, medical director of the Ohio Department of Mental Health and Addiction Services. “As they build up tolerance to drugs they’re using, they may progress, for example, from prescription pain pills, to heroin, to fentanyl which is often cut into heroin.”

In response, state agencies are partnering to improve interdiction, raise awareness, expand treatment options and reduce the number of inappropriately prescribed pills.

Additionally, Ohio is working with the federal Centers for Disease Control and Prevention to fully analyze Ohio’s fentanyl-related drug overdose data so that local and state officials, law enforcement and doctors better understand the nature of the fentanyl problem in Ohio and how to address it.

The state has begun seeing some progress:

The number of opiate prescriptions dispensed to Ohio patients in 2014 decreased by more than 40 million doses compared with 2013. Fewer doses lessen the opportunity for opiates to be redistributed or abused.

The number of individuals “doctor shopping” for controlled substances including opiates as identified through the Ohio Automated Rx Reporting System decreased from more than 3,100 in 2009 to approximately 960 in 2014.

Patients receiving prescription opiates for the treatment of pain at doses greater than an 80 mg morphine equivalent dose decreased by 10.8 percent from the fourth quarter of 2013 when Ohio’s opiate prescribing guidelines were announced, to the second quarter of 2015.

The percentage of opiate prescribers registered to use OARRS increased by 30.3 percent from the fourth quarter of 2013 to the second quarter of 2015. This upward trend will continue because prescribers are now required to show that they are registered in OARRS for re-licensing.

Ohio patients receiving prescriptions for opiates and benzodiazepine sedatives at the same time dropped 8 percent from the fourth quarter of 2013 to the second quarter of 2015. Multiple drug use was the single largest contributor to unintentional drug overdoses in 2014.