A pain killing drug that was responsible for a handful of overdose deaths two years ago is on a track to claim more lives this year.

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.

Deaths from fentanyl have become such a concern, that the Ohio Department of Health requested assistance from the Centers for Disease Control last September after releasing 2014 drug overdose data showing that fentanyl-related overdose deaths increased from 84 in 2013 to 502 in 2014.

The same trend is being experienced in the Valley.

Dr. Joseph Ohr, Forensic Pathologist with the Mahoning County Coroner's office reports eight fentanyl related deaths in 2014.

In 2015 that number increased to 14 deaths.

Trumbull County recorded one death from fentanyl in 2014. That number jumped to nine deaths in 2015.

Dr. Ohr says that Mahoning County has five confirmed fatal fentanyl deaths in January, February and part of March. He says that number could increase to ten fentanyl deaths depending on the outcome of pending toxicology reports.

If that trend continues, Ohr says the county could see 20 to 40 fatal fentanyl overdoses before the end of the year.

The Columbiana County Coroner's office recorded five fentanyl related deaths in all of 2015.

The coroner has confirmed that year-to-date in 2016, two people have overdosed and died from fentanyl in Columbiana County

The coroner points out that there are eight pending drug screen tests, and some of them may turn out to be fentanyl.

Dr. Ohr says that in 2014, fentanyl was usually mixed in pill form with another substance.

People who suffered fatal overdoses usually dozed off and died in their sleep several hours later.

Indications from recent fentanyl overdoses, according to Dr. Ohr, are that the victims don't know what they are putting into their bodies.

Dr. Ohr says most of the new overdose cases he sees result from fentanyl being snorted or injected. He says most of the time the fentanyl is mixed with heroin.

He says he sees cases where the user is found dead with the needle still in their arm.

Family members of the victims tell investigators that users express concern over what is in the heroin they are using.

Asked why drug dealers would sell heroin that kills the buyers, Dr. Ohr says that dealers probably don't know or care, because there are plenty of other customers.

Representatives of the CDC 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 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 include the following:

  • Gender: Male
  • Race: White
  • Education: Some college or less
  • History: Substance abuse problem and current mental health issue

Additional risk factors included recent release within the last month from an institution such as 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.

"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."

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.

The Ohio Department of Health says that since the state started to aggressively fight opiate abuse, the state has begun seeing some 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. 

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.

Learn more about fentanyl here.