Dr. Mary DiOrio, medical director for the Ohio Department of Health, said CDC officials visited Montgomery County last year to study the use of the opioid effect-reversing drug naloxone (Narcan) and other initiatives being utilized in the greater Dayton area.
“That was definitely one of the reasons that we came to Montgomery County, because we knew they were doing a lot of great work in this arena and we wanted to talk to the folks who were doing it,” DiOrio said.
The CDC recommended Narcan and clean needles be made available in the wake of fentanyl-related overdose deaths rising in Ohio from 84 in 2013 to 502 in 2014.
Montgomery County accounted for 70 of those, second only to Hamilton County’s 80.
The other Ohio counties with the highest number of overdose deaths were Summit (58), Butler (49), Cuyahoga (33), Clermont (22), Stark (21) and Lucas (20).
CDC officials said there were nearly 1,000 fentanyl-related deaths in Ohio from 2014 through May 2015. In 2015, there were 104 overdose deaths in Montgomery County that either involved straight fentanyl or a mix with heroin.
Most Ohioans who have died from fentanyl overdoses were white men with an average age of 38, the CDC report said. A history of addiction, mental health issues and use of painkillers were key risk factors for overdose victims.
Beavercreek’s Jessica Hoerner lost her brother in 2014 to a fentanyl overdose, her father in 2015 to a heroin/fentanyl mix, and a cousin just days ago to a suspected heroin overdose.
“I just think it’s really scary because it’s just getting worse,” Hoerner said. “I guess I just don’t know how they’re going to be able to stop that, either.”
She said that addicts have to want to accept help.
“Especially with my dad after my brother passed, I had tried everything that I thought I didn’t try with my brother,” Hoerner said. “But it’s really about them being able to get the help that they need to get. I feel like the addiction is so strong, too, it’s like even if they wanted to stop, it just seemed like they couldn’t.”
In Montgomery County, about a quarter of the overdose victims had recently been released from institutions such as jail, prison, a hospital or a treatment facility.
“We expect some level of recidivism,” said Helen Jones-Kelley, executive director of the Alcohol, Drug Addiction and Mental Health Services Board for Montgomery County. “A lot of people will walk out the door and they will try using the drug again at the same level at which they were using it when they went into the institution.
“Their bodies can no longer tolerate that quantity of an opioid and it leads to an overdose. We see it happen time and time and time again.”
To counteract that, Montgomery County Jail officials show at-risk inmates a video from Project DAWN (Deaths Avoided With Naloxone), which is run by Samaritan Behavioral Health and connects those released with Linkages — a program designed to connect inmates to services, housing, employment and treatment for mental health or drug addiction.
“It’s working very well,” said Chief Deputy Rob Streck, adding that a grant enabled the project to expand and add employees.
Streck said many inmates are in detox mode.
“You go in and see them, you see them all balled up on the bunk or on the toilet,” he said. “It’s definitely a rough ride for them.”
On the crime-fighting side, Streck said the Regional Area Narcotics & Gun Enforcement (RANGE) task force goes after mid-level dealers. The Miami Valley Bulk Smuggling task force aims at money men for drug cartels.
Assistant U.S. attorney Sheila Lafferty said fentanyl-spiked heroin has killed children of some of her friends and that prosecuting suppliers is challenging when addicts ask for “toe-tag” heroin or fentanyl despite the risk of death.
“We are trying to work our way up to find out where it’s coming in from and we’re not there yet,” Lafferty said. “It’s dependant on people cooperating and people surviving who would be our witnesses in these cases.
“Your witnesses generally in these cases are addicts. And if those are the same addicts who are requesting ‘toe-tag,’ I’ve got to make sure my witnesses are all alive.”
At least two current cases in Dayton's U.S. District Court involve defendants who allegedly trafficked fentanyl. Two defendants in one case are alleged to have sold drugs that killed two men last year.
In the other case, a defendant is alleged to have sold between 40 and 399 grams of fentanyl, which could lead to a minimum mandatory sentence of five years in prison with a conviction.
Ohio Gov. John Kasich has issued a series of guidelines aimed at reducing painkiller prescriptions and Ohio Attorney General Mike DeWine announced phone banks to inform local agencies about the life-saving capabilities of naloxone.
Jones-Kelley said there also are local education efforts about the use of Vivitrol, which is a monthly shot that reduces opioid cravings.
“We are really working in partnership in this community, which is the other thing that makes us unique and allows people to keep, I think, pointing to us,” Jones-Kelley said. “For us, it’s about saving lives and educating that community. And we’re going to stay at it.”
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