Drug crisis in Ohio: What solutions are making a difference?

During a year of record deaths from drug overdoses in Butler County and across Ohio, glimmers of hope also exist as organizations and local governments have begun to find solutions that might make a difference.

More than 30 news organizations statewide have partnered to share those solutions and help communities think about which ones might be adaptable locally.

Your Voice Ohio will be holding forums next month in Dayton, Middletown, suburban Cincinnati, Wilmington and Washington Court House to brainstorm with local residents about new ideas for combating the drug crisis.

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More than 40 percent of the 453 cases handled by the Butler County Coroner’s Office in 2016 were overdose related, and 80 percent of the 192 overdoses were heroin/fentanyl-related overdose deaths, according to Butler County Coroner Dr. Lisa Mannix.

On Nov. 15, 2017, the health department issued a health warning stating that in the past 24 hours four cases were under investigation as drug overdoses with the potential of a potent fentanyl analog such as carfentanil being potentially responsible for the problem.

Mannix told this news outlet that November was a bad month for accidental drug overdoses in Butler County.

Health Commissioner Jenny Bailer said the fight against drug overdose deaths will require a team effort.

“Working together as a team with other agencies inside and outside of the county will help keep residents informed about how the battle against drug overdoses and the opioid crisis is progressing,” she said.

Preparing to combat the drug problem in 2018

After a year of record-setting deaths and pain caused throughout the community by opioids, public agencies are starting 2018 with new tactics and teams to improve their efforts on overdoses.

The problem is stark. More than 80 percent of the 204 fatal overdose cases handled by the Butler County Coroner’s Office through the start of November 2017 were caused by heroin, fentanyl and/or carfentanil.

There are many toxicology reports yet to be returned, so coroner officials expect those numbers to increase when the official totals are released in late February or early March.

“Heroin’s bad enough, but when it’s laced with fentanyl and carfentanil …,” said Fairfield Police Chief Mike Dickey. “It’s a critical problem that all agencies, including the DEA, have made a major focus in attacking.”

Dickey said police agencies are hearing about heroin or opioid overdoses “almost on a daily basis,” but there are still some people who are almost numb to the issue because it hasn’t directly impacted them.

“I sincerely hope that 2018 will be the point when we reach critical mass on this epidemic,” he said. “If the public across the country has not recognized the severity of this problem, then it will likely affect someone in their immediate family or social circle. There isn’t a day that goes by that our police or our EMS service don’t get a call for an opioid overdose.”

As Butler County police and fire departments take the issue head-on in 2018, it needs to be a multi-faceted approach, not just relying on delivering those who overdose into treatment, said Middletown police Lt. David Birk. There needs to be more education and stricter penalties for those who sell heroin, he said.

A hit of heroin is a tenth of a gram, he said, and if a dealers have less than five grams of heroin — which is 50 doses — they can get probation and parole.

“Individuals aren’t selling it to continue their habit,” he said. “They’re selling it to make money. We need tougher penalties for that individual selling. You don’t go to prison until it’s at least an F-3.”

Using data

Hamilton County has led the way in using data to better track and learn new ways of responding to overdoses. Since 2015, EMS calls for overdoses have been mapped.

“There were remarkable geographic trends and times of day and week,” said Leigh Tami, Cincinnati’s director of the office of performance and data analytics.

They found that overdoses peaked on Wednesday afternoons, specifically about 2 p.m., and particularly on the near west side. The time of overdoses — afternoon, middle of the week — by itself caused everyone to shift thinking.

Medic units, which had been run ragged by about one overdose call each hour, were rescheduled and moved to neighborhoods with the greatest need at specific times. In some cases, EMS units roved in neighborhoods rather than return to stations. Response time was reduced, as well as staffing costs, resulting in better care and more efficient use of taxpayer dollars.

Cincinnati first responders also learned to be less aggressive in reviving victims. They discovered using less naloxone, the overdose reversal drug commonly known by its brand name Narcan, led to higher rates of hospitalization where doctors could encourage treatment or counseling. Too much naloxone and the victim went into painful withdrawal, became angry, ordered paramedics to go away and intervention opportunities were lost.

Though in the heart of the crisis, Hamilton County’s death rate is lower than 14 other Ohio counties since 2010, most of them along the Ohio River and in the Miami Valley.

While local counties don’t all collect data in the same way as Cincinnati, many use the state’s EpiCenter alert system, which sends out alerts to local health officials when an unusually high number of overdoses is occurring in a certain area. Local fire departments are tracking the neighborhoods where overdoses are occurring and altering their staffing accordingly.

Quick response teams take action

Heroin Response Teams in Hamilton and Middletown have been in place and recording successful results in completing their mission of getting addicts into treatment.

The county’s two largest cities launched heroin response teams in 2015 to reach overdose addicts in response to an overwhelming number of overdose deaths from heroin. The teams target individuals who have overdosed and try to pull them into sobriety.

Middletown’s quick-response team — a police officer, a paramedic and social worker — meets with overdose patients shortly after their incident with the goal in getting that person into a treatment program.

The Hamilton team selects four or five people a week they can get directly into treatment, they call it the “Golden Ticket” program.

Attorney general holding conferences

Ohio Attorney General Mike DeWine, who’s running for governor, has been holding several Ideas for Advocacy conferences across the state, most recently looking at ways addiction treatment can be worked into services for survivors of trauma.

“I am committed to continuing the aggressive work of finding solutions and bringing people together to share what we know is working, so that we can help as many Ohioans as possible, as fast as possible,” DeWine said.

Staff Writer Chris Stewart contributed to this story.

Overdose deaths in Butler County 

The Butler County Coroner’s office has seen a dramatic increase in overdose deaths because of the heroin epidemic. It’s impacted the number of overall cases the coroner’s office handles on a yearly basis, which has seen a continual rise in the past several years.

2017*: 482 total cases | 204 overdose deaths | 166 opioid-related overdose deaths

2016: 453 total cases | 192 overdose deaths | 153 opioid-related overdose deaths

2015: 420 total cases | 189 overdose deaths | 149 opioid-related overdose deaths

2014: 400 total cases | 137 overdose deaths | 103 opioid-related overdose deaths

2013: 339 total cases | 118 overdose deaths | 60 opioid-related overdose deaths

2012: 325 total cases | 103 overdose deaths | 30 opioid-related overdose deaths

*Through Oct. 31, 2017

Source: Butler County Coroner’s Office

How to go

Your Voice Ohio forums will be held throughout the region. All sessions are free to attend, but because of limited seating, people are asked to RSVP online. To sign up, go to: The Opioid Epidemic in Middletown

Dayton — 2 p.m. Sunday, Feb. 11, Main Library, 215 E. Third St.

Middletown — 6:30 p.m., Monday, Feb. 12, MidPointe Library, 125 S. Broad St.

East Cincinnati — 6:30 p.m., Tuesday, Feb. 13, Madisonville Recreation Center, 5320 Stewart Ave., Cincinnati.

HOW TO GET HELP

Naloxone (Narcan) is available via pharmacies, doctor’s offices, or at no cost from the Butler County Health Department. Call 513-863-1770 to learn more.

Call the Heroin Help Line at 513-781-7422

Needle/syringe exchanges:  Cinci Exchange Project  2:15 to 5:15 p.m. Thursdays at 400 Crawford St. in Middletown.

Original article: Drug crisis in Ohio: What solutions are making a difference?

Posted: Wayne Baker, Doug Oplinger on Jan 23 2018