Heroin use is epidemic in Ohio.
In 2014, more people died from drug overdoses in Ohio than in any other state. That year, heroin killed 1,196 of the 2,531 Ohioans who died from drug overdoses. The most common cause of drug death in the state in 2014, heroin has killed at least one thousand people every year since 2014.
Remarkably, heroin is no longer the most fatal drug in Ohio. In the same way that heroin supplanted prescription opioids as Ohio’s most common killer, fentanyl has outpaced heroin. To understand the heroin trade and its awful effects, you have to understand the way prescription opioids have entered the black market.
Heroin attracted a steady following for most of the 20th century. However, in Ohio and elsewhere, its use was mainly limited to big cities like Cleveland and Cincinnati. That started to change in the 2000s, as heroin appeared in small towns across the state where it previously hadn’t been a problem.
The ’90s marked the beginning of the sudden heroin boom. That’s when large pharmaceutical companies convinced the medical profession to prescribe large amounts of prescription opioid painkillers such as Vicodin and Percocet for chronic pain patients.
The companies flooded Ohio and the rest of the United States with prescription pain pills. Ohio pharmacists gave patients 784 million doses of prescription opioids on average every year between 2011 and 2013. That’s enough to give every Ohioan 67 doses.
With such an abundant supply of prescription opioids, it’s no surprise that more and more people misused or became addicted to prescription opioids. Ohioans started to misuse prescription opioids, for example, after an operation or after sampling medication that a patient in their household had left in the medicine cabinet. Over the span of roughly ten years, there was a large pool of people who found themselves suddenly addicted to prescription opioids.
That’s where heroin comes in. Prescription painkillers are very similar chemically to heroin, but they’re much harder to obtain, especially since doctors began cutting back on prescribing opioids for pain management. Many heroin users — as many as three in four — misused prescription painkillers before they started on heroin. Prescription painkillers are expensive, and they’re controlled by doctors and pharmacists.
As prescription painkillers became harder to obtain, Ohioans began to switch to heroin. These new heroin users are most likely to live in Southern and Northeast Ohio. Those areas of the state depend economically on industries that require manual labor, such as farming, mining and heavy industry.
Workers in these industries often experience injury and chronic pain, which has led to the large supply of prescription opioids in the area. Use began to expand as heavy industry and mining shut down or became automated. Large-scale unemployment and poverty lead to large-scale drug use. Ohio became trapped in a vicious cycle of economic turbulence and drug use.
The market for opioids was growing. Meanwhile, prescription opioids became harder to obtain legally or illegally. According to those struggling with opioid addiction, drug dealers have met demand. Dealers make trips to shopping centers and motels in small towns. They bring heroin and other drugs, including cocaine and methamphetamine.
Street drugs are extremely dangerous. Heroin for sale in Ohio is mixed, or cut, with all sorts of substances, including baby formula, laxatives and rat poison. Contaminated heroin makes users more likely to overdose or, if they shoot the drug with a syringe, contract bloodborne diseases such as hepatitis or HIV.
Heroin in Ohio is also frequently mixed with fentanyl or carfentanil, some of the most powerful opioids available. Heroin-fentanyl mixtures are even more dangerous than heroin cut with contaminants. Ohio officials blame heroin-fentanyl mixes for the frightening surge in heroin deaths between 2014 and 2017.
Heroin is extremely addictive, and it’s now available in every county in Ohio. Thousands of Ohioans are addicted to heroin. The only way to help the people fighting heroin addiction is to get them into treatment.