Ohio 2016 overdose deaths rise 36% from total that led nation year before
By Alan Johnson and Catherine Candisky -- The Columbus Dispatch Published: May 28, 2017 6:00 AM
They died in restaurants, theaters, libraries, convenience stores, parks, cars, on the streets and at home.
At least 4,149 Ohioans died from unintentional drug overdoses in 2016, a 36 percent leap from just the previous year, when Ohio had by far the most overdose deaths in the nation, according to county coroner's figures compiled by The Columbus Dispatch. And it's getting worse; many coroners say their overdose fatalities for 2017 are outpacing the grim toll from 2016.
Last year's total smashes the record of 3,050 set in 2015. An average of 11 people died each day in 2016 from heroin, fentanyl, carfentanil or other drugs.
The new number was obtained by The Dispatch by contacting coroners offices in all 88 counties. The Ohio Department of Health collects overdose data to release annually in August. But given the growing drug crisis in Ohio, and the fact that General Assembly is now debating the biennial budget — including more than $170 million in funds added by the Ohio House to battle the drug epidemic — updated numbers are particularly important now.
Ohio's final 2016 total will be even higher because not all coroners have completed their overdose tally, and coroners in six smaller counties (representing 1.8 percent of Ohio's population) did not respond to the newspaper's repeated requests for 2016 totals.
The rapid rise in drug deaths is most pronounced in large urban counties, such as Cuyahoga — where 666 deaths easily led the state in 2016. The others are Franklin, Hamilton, Lucas, Montgomery and Summit. In one year, the overdose death count in Ohio's six biggest counties doubled.
The 2016 numbers bring the state death toll from drugs to 17,000 since 2003. The devastation is evident statewide, among big cities and small towns, urban and rural counties, rich and poor.
Dr. Lisa Deranek, the Medina County coroner and an emergency room physician, is dealing with multiple deaths a week from opioid overdoses as head of the coroner's office at the same time she treats overdoses in the emergency room. Sometimes she revives the same person several times a week.
Deranek said she and others on the front lines are exhausted.
“It’s a growing, breathing animal, this epidemic,” she said.
While heroin continues its role as a killer, coroners' 2016 autopsy reports show that fentanyl, a synthetic opiate 50 times more powerful than morphine, and carfentanil, an animal tranquilizer so strong that an amount the size of a grain of salt can be deadly, have flooded Ohio and are largely to blame for the huge spike in deaths.
Last week, Cuyahoga Medical Examiner Dr. Thomas P. Gilson told a U.S. Senate committee studying ways to combat illicit drugs, "The opiate crisis is a slow moving mass fatality event that occurred last year, is occurring again this year and will occur again next year."
Cuyahoga County recorded 400 fentanyl-related deaths between Nov. 21, 2015, and Dec. 31, 2016, more than double the fentanyl-related deaths of all previous years combined. Gilson's office is projecting nearly 600 in 2017.
Those in the county who are addicted to drugs would fill the stadium where the Cleveland Browns play (capacity 73,000-plus), while those who switch to fentanyl each year would fill the Cleveland Cavaliers arena (20,000-plus).
Even worse, he said the opioid crisis, which so far has affected mostly whites, is moving into minority communities.
"With seemingly purposeful intent, cocaine is now being mixed with fentanyl, and it's analogus in an effort to introduce these drugs into the African American population," Gilson said.
"Cocaine had been the only drug that victims were predominately African American. The covert introduction of fentanyl into the cocaine supply has caused a rapid rise in fatalities and in 2017, the rate of African American fentanyl related deaths has doubled from 2016.”
In much smaller Allen County, located in northwestern Ohio, Coroner Gary A. Beasley said drug users are gambling with their lives. Allen County, which includes Lima, saw overdose deaths more than double to 36 in 2016, up from 15 in 2015. All involved fentanyl — 14 died from fentanyl alone and 22 from mixture of heroin, fentanyl and other drugs.
“People don’t know what they are buying,” Beasley said. “It’s deadly.”
Gary Guenther of the Summit County coroner's office said that of 308 deaths there, nearly half involved carfentanil. As soon as word hit the streets about the new lethal drug, "people wanted to get it," he said. "It doesn't make any sense."
Information from Franklin County Coroner Anahi Ortiz was difficult to obtain. Appointed coroner in 2014 and elected last year, Ortiz has not released full overdose statistics for 2016. She has mentioned some numbers in public appearances, but she would not release that information to The Dispatch.
Ohio's overdose death toll would have been an estimated 2,300 higher in 2015 if not for lives saved with naloxone, an antidote for opioid overdoses, according to the state Department of Mental Health and Addiction Services. Emergency responders, other drug users, family members and friends have administered naloxone thousands of times to revive dying people. The state legislature acted to make naloxone available at pharmacies without a prescription.
The 2016 total for those revived by naloxone is not yet available, but is expected to be higher.
Ohio, which narrowly topped the nation in drug overdose deaths in 2014, held the unenviable No. 1 position again in 2015 — 800 deaths ahead of second-place New York, according to a Kaiser Family Foundation analysis using statistics from the Centers for U.S. Centers for Disease Control and Prevention. Totals for all states for 2016 are not yet available.
William Denihan, who is retiring after 15 years as head of the Cuyahoga County Alcohol, Drug Addiction and Mental Health Services Board, said he has mixed feelings about leaving with the drug epidemic "so out of control. I call it a tsunami. To leave at this point is distressing."
"We've done so much, but the numbers are going the other way. I don't see the improvement."
Denihan said he spoke at a recent meeting at the Cleveland Clinic for an audience of doctors and nurses. "I asked for a show of hands of people who had lost a loved one or knew someone who had lost someone to a drug overdose. Almost every hand raised."
“We’ve never seen anything like this. The drugs keep getting more potent,” said Cheri L. Walter, chief executive officer of the Ohio Association of County Behavioral Health Authorities. “People can recover; they just need to get into treatment.”
Walter recommends targeting drug prevention and education efforts beyond school children to include young and middle-age adults who make up the bulk of those who are dying.
Gov. John Kasich's administration has taken a number of steps to stem the tide of opioid deaths, most recently approving $20 million for drug research technology. The administration allocated nearly $1 billion a year, much of in included in Medicaid health coverage expansion, to cover treatment for low-income addicts. But that total was not increase in Kasich's budget proposal for the two years starting July 1.
Ohio was a national pioneer in cracking down on "pill mills," but health officials say that sent addicts to stronger drugs such as heroin.
The Ohio House added $170 million to Kasich's proposal to fight the epidemic, mostly through prevention and treatment. The Senate is now considering the budget.
Dr. Mark Hurst, who is serving a dual role as medical director at both the state mental health and health departments, said the death toll is rising because "the migration has continued to more potent drugs." While naloxone has kept deaths from climbing even higher, Hurst cautioned, "It's a treatment for overdoses but it doesn't cure addiction.
"This is going to turn around. I wish I could tell you when it's going to turn around."
Dispatch reporters Randy Ludlow and Kimball Perry contributed to this story.
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