New state report on overdose deaths unveils good, bad, ugly

For those who view last week’s long-awaited release of the Ohio Department of Health’s annual report on accidental drug overdoses through the lens of a glass half full, they will confidently find concrete evidence for cheer. For those who view it through the lens of a glass half empty, they will point out credible reasons for continued alarm and anguish.

The reality, however, likely lies somewhere in between those extremes.

Yes, there certainly is room for optimism as data show concrete inroads being made in the war on opiates, but much of the data serve as a clarion call for continued aggressive and coordinated action to lessen the scope of a deadly scourge that remains virulently potent albeit in some new and different forms.

A passing glance at year-to-year totals in the report on drug-overdose deaths in the Buckeye State hardly engenders hope. The number of overdose deaths last year totaled 4,854, which is 804 deaths more than in all of 2016.

That upward trend applied to the Mahoning Valley as well, with 295 OD deaths last year in Mahoning, Trumbull and Columbiana counties, compared with 238 deaths in 2016. Mahoning County saw the highest jump among the three, rising from 83 deaths in 2016 to 112 last year. The 2017 casualty toll brought the total number of accidental deaths from heroin, painkillers, fentanyl, carfentanil, methamphetamines, cocaine and other drugs in the Valley to 1,032 over the past six years.

After Dayton-centered Montgomery County and several southeastern Appalachian counties, the Mahoning Valley continues to rank as the third most deadly region in the state for drug abuse.

CLOSER EXAMINATION REVEALS POSITIVES
It is only when analyzing the data much more closely can one discern some decidedly positive trends.

For example, according to the ODH annual report, prescription opiate-related overdose deaths have reached an eight-year low and heroin-related overdose deaths are at a four-year low in the state.

The steep reduction in prescription opioid deaths corresponds with much tougher prescription restrictions for physicians, beefed-up law-enforcement campaigns and new limitations placed on drug wholesalers.

As Dr. Mark Hurst, director of the Ohio Department of Mental Health and Addiction Services, put it: “The good news is Ohio is seeing significant progress in reducing the number of prescription opioids available for abuse, and as a result, prescription opioid-related overdose deaths that don’t also involve fentanyl are at their lowest level since 2009. This progress is significant because prescription opioid abuse is frequently a gateway to heroin and fentanyl use.”

In another positive trend, stricter policing and stronger prevention and treatment programs have been credited with a dramatic decrease in heroin deaths. In 2017, only 20 percent of all accidental drug overdoses were tied to pure heroin. Two years earlier, that rate was about 60 percent.

In yet another promising sign, drug-abuse deaths in Ohio declined about 25 percent from the beginning to the end of 2017. That notable decline is mirrored in the Valley for the first half of 2018.

Given all of those positive trends, we can understand why many Ohioans may be scratching their heads trying to understand why last year’s total death toll from drug abuse reached an all-time high.

The answer can be found in one word: fentanyl.

That synthetically manufactured opioid that’s 50 times more powerful than heroin, has almost single-handedly canceled out the many gains the state has recorded in its $1 billion per year campaign to lessen the prevalence of substance abuse.

Last year, for example, fentanyl was responsible for 71 percent of all overdose deaths in Ohio. Two years ago, it played a leading role in only 38 percent of such deaths.

The new data also show an alarming increase in the number of deaths from cocaine and methamphatamine abuse. In many of those cases, fentanyl was also laced into the drug for added destructive force.

On balance, then, the report provides some clear-cut marching orders to state and local leaders on the front lines of the addiction battle. Among them are a need for more treatment facilities and more aggressive efforts to lessen the street supply of fentanyl and carfentanil.

Those two critical issues are addressed in legislation championed by Ohio’s two U.S. senators – Republican Rob Portman and Democrat Sherrod Brown. It passed overwhelmingly in the House; now the Senate should follow suit on those measures to loosen rules to expand treatment space and to improve fentanyl detection at U.S. post offices where it tends most often to enter this country illegally.

In short, when it comes to the drug epidemic gripping our state, it’s perhaps best not to become overly optimistic. For now, we’ll opt to see the glass half empty as clearly much more work remains before anything approaching a full victory on the war on drugs can be declared.
 
 
Vindicator Editorial: The Youngstown Vindicator, October 1, 2018
New state report on overdose deaths unveils good, bad, ugly