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Since 2007, drug overdoses have been the main cause of accidental deaths in Ohio. During the 2010s, Ohio has seen thousands of its residents become addicted to opioids and die from the drugs. In 2014 drug overdoses killed more people in Ohio than in any other state.

Opioids are the main drug of abuse in Ohio. Opioid use grew starting in the 1990s and early 2000s. Increased prescriptions for opioid painkillers such as OxyContin and Percocet began to flood Ohio with prescription pain pills. That flood led more people than ever to become addicted to opioids.

Also during the early 2000s, heroin became available in every town in Ohio as drug dealers expanded their operations to towns that had been flooded by prescription pills. People addicted to opioids often switch to heroin because heroin is cheaper and access to it is not controlled.

The expanding heroin scene brought lethal problems. In 2014, deaths from fentanyl-laced heroin spiked. Fentanyl is cheaper than heroin to produce, so heroin producers mix the two, which is extremely dangerous, to lower costs and boost their profits.

Fentanyl is a powerful synthetic opioid used medically for dire pain, such as pain experienced during late stage cancer or due to severe burns. It’s so powerful that doses as small as three milligrams can be fatal. It’s much more dangerous than heroin, which is a known killer itself. Now, fentanyl is mixed in with much of Ohio’s heroin supply.

Fentanyl is the main reason drug overdose deaths in Ohio reached another record high in 2016. The Ohio Department of Health reported that at least 4,050 Ohioans died from a drug overdose in 2016, up from 3,050 in 2015.

Ohio Department of Health reported that at least 4,050 Ohioans died from a drug overdose in 2016, up from 3,050 in 2015.

Cocaine and methamphetamine use are both on the rise in Ohio. As drug dealing has expanded, both drugs have become more available. In addition, opioid users have started to use cocaine and meth.

Dangerous drinking in Ohio is also on the rise. In both 2014 and 2015, an all-time high of at least 380 people died from drinking. Binge drinking has increased particularly among college students and women in Appalachian Ohio.

Prescription Opioid Misuse in Ohio

During the 1990s and 2000s, prescription opioids began to flood Ohio. During the ’90s, drug companies worked hard to make prescription opioid use standard for pain patients. They lobbied medical groups for years to convince doctors that prescription painkillers were nonaddictive and safe. They exaggerated scientific research to make those claims. In 2017, Ohio’s government sued five pharmaceutical companies. The state accused the companies of causing the opioid crisis.

Pharmacists in Ohio filled an average of 784 million doses of opioids each year between 2011 and 2013. In 2012 alone, doctors handed out the equivalent of about 70 doses of opioids for each person in Ohio in 2012.

Because of the lobbying, doctors began to prescribe record amounts of prescription painkillers. In 2010, the United States consumed 99 percent of the world’s hydrocodone (the active ingredient in Vicodin), 80 percent of its oxycodone, and 65 percent of its hydromorphone.

According to the Ohio Department of Health, pharmacists in Ohio filled an average of 784 million doses of opioids each year between 2011 and 2013. In 2012 alone, doctors handed out the equivalent of about 70 doses of opioids for each person in Ohio in 2012.

Since identifying the issue, the state government and the medical profession have successfully cut the number of opioid prescriptions. The reduced number of opioid painkiller prescriptions will mitigate new cases of addiction, but it won’t help the people who are already misusing opioids. Those people need treatment.

Woman holding needle with drugs

Ohio Residents Transition from Opioids to Heroin

The boom in painkiller prescriptions helped create the heroin epidemic. Many people addicted to prescription opioids have switched to heroin use. Heroin is easier to get than prescription opioids; it’s not controlled by medical professionals. In 2016, three in four heroin users had previously misused prescription opioids.

Heroin is available in ordinary houses and street corners across Ohio. Traffickers have moved from urban areas into suburbs and small towns where demand has expanded. Ohio’s small towns are now a lucrative place of business for cartel-affiliated drug dealers. They sell heroin and other drugs in large quantities in new areas of the state.

Intravenous injection use is the most common way Ohioans use heroin, though smoking it is increasing in popularity. Injection carries unique risks: it places users at high risk of HIV, hepatitis and other bloodborne diseases.

Most of Ohio’s heroin supply is white powder, rather than black tar. White powder heroin is perceived by users to be purer than black tar. That is true when it’s refined. However, both versions of the drug are easy to cut, and contaminated heroin kills thousands of Ohioans every year. Heroin killed 1,424 Ohioans in 2015.

Fentanyl Has Arrived in Ohio

Fentanyl is the drug most often mixed with heroin. The opioid is used as a prescription painkiller in extreme cases, such as during hospice care and for late-stage cancer and severe burns. Fentanyl is many times more powerful than heroin. Three milligrams of fentanyl can be fatal.

Fentanyl is also easier to manufacture than heroin. Heroin is refined from poppy plants. The poppy crop is subject to all the same variances as any other plant. In addition, it’s grown in conflict-ridden areas such as Afghanistan or countries, such as Mexico, where it is policed and crops are eradicated. So the supply of heroin is often disrupted.

Compared with heroin, fentanyl is easy to make. Organized crime can easily buy its precursors. Pharmacies in China send precursors or even ready-made fentanyl in bulk to Mexico. There, cartels refine it and mix it with heroin.

Law enforcement officials suspect that cartels began to cut costs with fentanyl in 2014 because that’s when fentanyl deaths in Ohio and across the country started to spike. In Ohio, 503 people overdosed from fentanyl or fentanyl-laced drugs that year, mostly in November and December.

During 2015, fentanyl-laced heroin became standard issue in Ohio. That year, 1,155 people in Ohio died from fentanyl-related causes.

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Cocaine and Meth Use Throughout the State

Stimulants such as cocaine and meth have long been drugs of abuse in Ohio. In particular, Ohio cities were hit hard by the crack cocaine epidemic in the 1980s and 1990s. Crack never left Ohio, although arrests for crack are on the decline. Powder cocaine arrests have stayed about the same.

The number of cocaine deaths was fairly stable between 2003 and 2010, when an average of 234 Ohioans were killed annually by cocaine overdose. However, cocaine deaths increased to more than 300 annually in 2011 and have gone up every year since.

Cocaine deaths increased to more than 300 annually in 2011 and have gone up every year since.

Meth availability is also on the rise in Ohio. Police say it’s available in all parts of Ohio, but especially in southern and eastern parts of the state. Meth-related arrests increased between 2015 and 2016. Meth is manufactured by Ohio users in small amounts, but mostly it’s produced in Mexican industrial labs by organized crime groups and shipped across the border.

Dangerous Drinking Takes Hundreds of Lives

Ohio has seen a surge in drinking deaths in recent years. In 2003, 40 Ohioans died from alcohol-related causes; in 2015, 380 did.

In part, that’s due to the opioid crisis. According to state health officials, alcohol is one of the drugs most often used with opioids. When opioid users take a fatal dose, some have alcohol in their system. Alcohol contributed to their death, but it may not necessarily have been the primary cause.

However, dangerous alcohol use on its own is also going up. One in five women in Appalachian Ohio binge drink regularly. In particular, young women in that part of the state drink heavily. Appalachian Ohio women under 26 are five times more likely to binge drink than women over 50.

Another group of young people, college students, are also responsible for the rise in dangerous drinking. A 2016 report from The New York Times revealed that Ohio State University students are more likely to binge drink than students at other colleges.

Drinking and driving kills hundreds of Ohioans every year. In 2016, drunk drivers killed 346 people and injured 7,199 in Ohio. Fortunately, that number is much lower than in 2012, when 494 people were killed in alcohol-related crashes. That same year, the Ohio State Highway Patrol made 24,529 arrests for operating a vehicle impaired. The decline may be related to the harsher penalties for drinking and driving Ohio implemented in 2017.

While drinking and driving might be on the decline, every other kind of substance abuse is on the rise. Ohio is in the midst of a serious crisis. It has gotten worse every year since the turn of the century. Ohio must help drug users get treatment.

Medical Disclaimer: aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Peter Johnson
Peter Johnson,
Peter Johnson is a writer and journalist who has covered politics, policy, and social issues for outlets like The Atlantic and The Stranger. He contributed to an award-winning series about the opioid addiction epidemic in 2010 as a researcher with InvestigateWest.

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