Research and Impact

Alliance research shows shift to fentanyl overdose deaths

A new report released by the OHIO Alliance for Population Health shows a troubling shift in drug use trends amongst Ohioans. Over the last several years, overdoses have continued to rise and so has the use of the dangerous drug fentanyl.

In 1999, there were 327 overdose deaths in Ohio. In 2020, that number has increased to 5,018, according to the Ohio Department of Health. This troubling trend mirrors national data as well. The Centers for Disease Control and Prevention identified three waves of opioid overdose deaths since the 1990s: prescription opioids, heroin and now fentanyl.

While all three drugs have the potential for overdose, according to the U.S. Drug Enforcement Administration (DEA), fentanyl causes overdoses at much smaller quantities, just two milligrams. In a medical setting, the margins between pain relief and an overdose are small with fentanyl; however, in a recreational setting, the difference between using enough for pleasure and using enough to kill is miniscule.

To quantify how much drug use trends have shifted in Ohio, the Alliance collects data on drug seizure by law enforcement agencies. Their findings are consistent with the Ohio Department of Health’s data. When seizure data for specific drugs was matched with overdose data, the OHIO Alliance found that fentanyl was seven times as deadly as cocaine and heroin.

Fentanyl also has an overdose rate 37 times higher than methamphetamine and 86 times higher than benzodiazepines.

Dr. Joe Gay, a staff member with the Alliance, said the Alliance was aware fentanyl was being used and overdoses were happening, but the extent still came as a surprise.

“For a little more than a decade there has been a significant problem with opioids and overdoses. So, that there was an overdose problem was not a surprise at all,” Gay said. “I would say to a degree fentanyl caught us not completely off guard … but it was a little surprising how bad it’s gotten now.”

Gay added that fentanyl itself has infiltrated the supply and all hard drug users in Ohio are at risk of facing fentanyl contamination. In the last decade, methamphetamine has become increasingly abused in the state. Cocaine and prescription painkiller use has also remained an issue. To compound these issues even further, fentanyl is being used to cut drugs like heroin, methamphetamine and cocaine. It’s also being used to produce counterfeit painkillers. According to the DEA, 26 percent of all tested counterfeit pills contained a lethal dose of fentanyl.

The Alliance team has found a discrepancy in the distribution of overdose deaths. Most diseases that cause early death occur at marginally varying rates throughout the state. However, according to Gay, overdoses take place in orders of magnitude.

“There is a tenfold range in overdose deaths based on counties. There are some counties with very high rates and some with very low rates. So, you wonder why,” Gay said. “We’re exploring what the basis of these differences is. Poverty is an issue, community intactness is an issue, but it’s still not entirely clear what the driving factors are.”

To combat the risk of fentanyl, the Alliance urges Ohioans to understand the signs of an overdose and how to treat one. Right now, the best defense against overdose deaths is naloxone, an overdose treatment drug better known as Narcan. Narcan is available prescription free at pharmacies and can be ordered online through Harm Reduction Ohio.

The Alliance also urges individuals to protect themselves by avoiding the mixing drugs, being aware of the heightened risks of an overdose following a period of sobriety or avoiding the use of drugs. The organization also encourages drug users to seek treatment from providers certified by the Ohio Department of Mental Health and Addiction Services.

November 15, 2021
Staff reports