The Centers for Disease Control and Prevention (CDC) has issued a report examining the increase in unintentional fentanyl-related drug overdose deaths in Ohio. The Ohio Department of Health (ODH) requested CDC’s assistance last September after releasing 2014 drug overdose data showing that fentanyl-related overdose deaths increased from 84 in 2013 to 502 in 2014.
Based on law enforcement drug seizures, Ohio has seen a major increase in drug reports involving fentanyl, a more lethal opiate that is 30 to 50 times more potent than heroin.
CDC staff arrived in Ohio in late October for a three-week stay that included working with ODH on an in-depth analysis of data ranging from death certificates and emergency department records to coroner and medical examiner reports. CDC and ODH staff also visited four regional hotspots (Cuyahoga, Hamilton, Montgomery and Scioto counties) and met with local officials representing public health, addiction services, coroners and medical examiners, law enforcement and emergency medical services among others.
The CDC report concludes that risk factors for fentanyl-related overdose deaths included: male gender, white race, some college or less education, history of a substance abuse problem, and a current mental health issue. Additional risk factors included recent release from an institution within the last month (e.g. jail, hospital, or treatment facility), and a history of a high-dose opioid prescription. The report offers recommendations addressing public health surveillance, response in high-burden counties and high-risk groups, enhancing EMS response, enhancing layperson response, improving prescribing practices and referring patients to treatment, reducing stigma around substance abuse and treatment, integrating prevention services, and public health messaging. The full CDC report can be found here.
The report notes that the state “has launched a comprehensive response to the increase in fentanyl-related deaths,” and that the joint CDC/ODH investigation “represented one of a wide range of activities across Ohio state government in response to the opiate crisis in Ohio.”
“Ohio is in an all-out fight against drug abuse and we appreciate CDC for helping us to better understand the rise of fentanyl deaths in Ohio,” said ODH Director Rick Hodges. “We are also proud that the CDC has recognized our comprehensive efforts to combat drug overdoses, including fentanyl.”
The state is expanding the fight against opiate abuse to counter the misuse of fentanyl and other opiates. Building on efforts that started in 2011, state agencies are partnering to improve interdiction, raise awareness, expand treatment options and reduce the number of inappropriately prescribed pills.
Since Ohio started to aggressively fight back against opiate abuse, the state has begun seeing some promising progress:
· In 2015, the total doses of opiates dispensed to Ohio patients decreased to 701 million from a high of 793 million in 2012, a drop of 11.6 percent.
· The number of opiate prescriptions provided to Ohio patients decreased by 1.4 million during the same time period.
· Data from the Ohio Automated Rx Reporting System showed a 71 percent decrease in the number of people engaged in the practice of doctor shopping since 2010.
· 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.
· 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.
Ohio’s new initiatives to combat drug overdoses include an additional investment of $500,000 per year to purchase the lifesaving overdose antidote naloxone. Also, Ohio officials released last July the Health Resource Toolkit for Addressing Opioid Abuse to help communities fight back. Additional new strategies and tactics can be found here.