The Ohio Department of Health released the 2015 Ohio Drug Overdose Data in August. The data clearly show an increase in deaths from heroin and fentanyl at unprecedented rates. The administration highlighted the progress that is being made from policies and practices implemented in the past four years, namely the reduction in prescription opioids dispensed with 81 million fewer doses dispensed to Ohio patients in 2015 when compared to 2011. Ohio has also increased the use of the overdose reversal drug naloxone with nearly 20,000 doses administered by Ohio EMS in 2015. Without a doubt, policy efforts over the past five years are making an impact, but the sad truth is that in looking back to 2003, unintentional overdose deaths have increased in all categories.
Reports tout that the percentage of prescription opioid related deaths compared to all unintentional overdose deaths declined for the fourth year in a row. That sounds good until looking closer and realizing that the number of people dying from prescription opioid overdose isn’t in meaningful decline (only five fewer people died in 2015 than in 2014), but the total number of people overdosing is increasing–almost 200 percent in the past decade and 21 percent in the past year, an increase of over 500 people from 2014 to 2015.
This chart clearly shows that Ohio has had an increasing rate of unhealthy and dangerous alcohol and drug use in all drug categories since 2003. The age adjusted annual death rate from unintentional overdose death in 2003 was 5.8 people per 100,000 Ohioans. In 2015, that rate increased to 27.7.
Until 2015, the number of prescription opioid overdose deaths has consistently been higher than any other category of drug since 2003 and increased by 202 percent from 2003 to 2015. This is a big increase, but loses its shock value when seeing heroin overdose deaths increase by 1,537 percent and fentanyl with a nearly 29,000 percent increase. That is not a misprint; it is the cause of rightfully focused attention on the opioid crisis. But also note that between 2003 and 2015, rates of overdose death increased for alcohol (850 percent), hallucinogens (771 percent), and benzodiazepines (1,226 percent). No category showed a decline, and in 2015, Ohio had more overdose deaths from cocaine (685) than from prescription opioids (667).
What we can’t forget is that as prevention and treatment resources from state and federal funding began to decline in the late 1990s, this negatively impacted access, capacity, and workforce for a full continuum of behavioral health services. Here’s a look at federal block grant funding to Ohio from FY 2000 to FY 2016. When adjusting for inflation, that’s a 26 percent decrease in funds. (NASADAD, February 2016)
With the release of the 2015 overdose death data, The Governor’s Cabinet Opiate Action Team announced several New Strategies to Fight the Opiate and Fentanyl Crisis in Ohio (2016-17). Read them carefully, noting identified strategies to create pathways to treatment and recovery and to prevent drug use before it starts. Many of these strategies, like many already implemented over the past five years, will positively impact unhealthy alcohol and drug use beyond opioids. But more can and must be done to ensure that strategies and resources deployed today create the necessary capacity and workforce for prevention, treatment, and recovery regardless of the substance used. The lessons of the last 16 years tell us one thing for sure: if we fail to invest now, we can only expect things to keep getting worse.