Wednesday, Feb 21, 2018
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Fighting Fentanyl

Local and state figures on fatal heroin-related overdoses suggest that Ohio’s heroin epidemic is finally plateauing. Even so, heroin-related fatalities in the Toledo area appear to be rising this year, although at a much slower rate. Moreover, the resurgence of the lethal drug Fentanyl, here and around the state, makes this epidemic even more risky and unpredictable.

Fentanyl-related drug overdose deaths in Ohio rose from 84 in 2013 to 502 last year, the Ohio Department of Health recently reported. Overall, the number of drug overdose deaths rose from 2,110 in 2013 to 2,482 in 2014. The state should be commended for releasing preliminary figures on drug overdoses promptly.

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In the Toledo area, Fentanyl started to show up in heroin-related overdoses in August of last year, Dr. Robert Forney, Lucas County’s chief toxicologist, told The Blade’s editorial page. Such overdoses involving Fentanyl, a super-potent painkiller, now make up about 20 percent of this region’s heroin-related fatalities. Of the region’s 102 heroin-related deaths so far this year, 21 involved Fentanyl.

Fentanyl has been on the street for decades, becoming a national scourge in 2006. The drug faded somewhat in recent years, but last year made a lethal nationwide comeback. Its resurgence underscores the need for state and local governments to continue innovative and effective ways to prevent and treat drug addiction. The state plans public information efforts about Fentanyl, said Eric Wandersleben of the Ohio Department of Mental Health and Addiction Services.

Heroin-Fentanyl cocktails are sometimes sold as products with alluring names such as “Magic” and “Super Smack.” But often buyers don’t know that the heroin has been mixed with Fentanyl. Fifty times as potent as heroin, Fentanyl is a cheap way to spike the heroin cocktail.

Lucas County Sheriff John Tharp told The Blade’s editorial page that officers working on his special drug response unit are reporting more Fentanyl cases. Officers say some addicts are wary of the drug, but others seek it because of its potency.

Street heroin — generally 10 percent to 90 percent pure — is mixed, or cut, with a variety of products, including lactose, Dormin, Benadryl, Sleepinal, and even talcum powder. Dealers use additives to dilute, or stretch, the product. With Fentanyl, dealers and distributors can use less heroin and still increase the potency, making the product far more dangerous and unpredictable.

Before this year, heroin-related fatalities had been skyrocketing. In the Toledo area, such deaths rose last year to 145, from 80 in 2013. But increases in heroin-related fatalities appear to be leveling off, or at least slowing. As of Aug. 21, the region reported 102 fatal-heroin related overdoses this year, Dr. Forney said, putting the Toledo area on track for a 10-percent increase this year.

“To me, flat would be good news,” Dr. Forney said. “But no one should be smiling. There are a lot of people dying.”

The average age of overdose victims in the Toledo area has stayed at 39, Dr. Forney said. In keeping with national trends, the percentage of male victims here has dropped from 82 percent to 70 percent, while women have increased to nearly 30 percent of the fatalities. Whites still make up 84 percent of fatalities in the Toledo area, with African-Americans continuing to account for 10 percent.

Ohio has made progress in drug education, treatment, and regulations that have raised awareness, expanded effective medication-assisted treatment, and reduced the number of inappropriately prescribed pills. Still, treatment is available for fewer than one in three people who need it.

Opioid prescriptions in Ohio dropped last year by 40 million doses. The number of people “doctor shopping” for prescription painkillers, identified through the Ohio Automated Rx Reporting System, has declined sharply over the past five years. And under new prescribing guidelines, the number of patients who receive dangerously high dosages of prescription painkillers has fallen by more than 10 percent since late 2013.

Meantime, the Toledo area has been a statewide model for battling the epidemic of addiction through treatment and education. Local efforts include Sheriff Tharp’s Drug Abuse Response Team, a mobile detox program run by A Renewed Mind, and an emerging recovery hot line and adult felony drug court.

An estimated 10,000 people are addicted to opioids, including heroin, in the Toledo area. The resurgence of Fentanyl makes state and local efforts to prevent and treat this lethal epidemic even more urgent.

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