Franklin County's slight drop in drug overdose deaths in 2021 belies ongoing problem

While Franklin County had a slight decline in overdose deaths in 2021 compared to the previous year, it is still the second highest total recorded as the number of fatal drug overdoses continues to soar throughout Ohio and the U.S.

Franklin County had 825 people lose their lives to a drug overdose in 2021, with 89% of those reported deaths involving fentanyl, according to a report released earlier this month by the Franklin County Coroner’s Office. The death toll reflects a 4% decrease from the record 859 overdose deaths in 2020 but still represents a 48% increase over the 556 overdose deaths in 2019.

Drug overdose crisis:More than 5,000 Ohioans died of a drug overdose in 2020

Public health officials and local organizations dealing with the overdose problem say that while a decline is a good sign of successful efforts, more work is needed to combat drug fatalities. This includes education about the dangers of potent synthetic opioids being laced into other drugs and the damage to loved ones of those who die.

Greater Columbus, like many other metropolitan areas in the United States, has seen an increase since 2017 in overdose deaths. Franklin County, whose numbers include the city of Columbus, reached its highest levels of overdose deaths in the second quarter of 2020, during the COVID-19 pandemic lockdowns. 

Dr. Mysheika Roberts, Columbus Department of Health commissioner, said that as things began opening up after the pandemic lockdowns, the city and county health departments were able to more effectively reconnect drug users with harm reduction services that helped reduce the overdose death numbers, if even only by a few dozen.

“The fact that here we are in 2022, two and half years into a pandemic, and now we're starting to see numbers going in the right direction, is a very optimistic sign," Roberts said.

Despite the slight decline in Franklin County, the number of Ohioans who have died annually of overdoses has steadily risen since at least 2007 and began surging in 2018, according to a Dispatch analysis of mortality data from the Ohio Department of Health.

Between 2019 — the year before the start of the COVID-19 pandemic, when 4,028 people died from overdoses — and 2021, annual deaths from overdoses increased by 28.4% statewide, reaching a high of 5,174 deaths in 2021. However, statewide figures for last year are preliminary and will likely be much higher when a final count is tallied.

Ohio's overdose rate was already the fourth highest in the country in 2020.

Fentanyl-laced drugs leading to rise in overdoses, deaths

Franklin County Coroner Dr. Anahi Ortiz's office reported that street drugs being laced with deadly fentanyl, a synthetic opioid 50 to 100 times more powerful than heroin, has been behind much of the surge in overdose deaths in the county in 2021 and across the nation.

In the United States, 56,000 people died from overdoses involving synthetic opioids in 2020, more than 18 times the number of deaths in 2013, according to the Centers for Disease Control and Prevention.

Mike Gersz, director of outpatient services at Maryhaven, a Greater Columbus addiction services and behavioral health provider, said his staff first started seeing fentanyl as a trickle and then a deluge. The pandemic, he said, made the problem many times worse.

"I don't think we have any sort of grasp of what the pandemic is going to do to future substance use,"Gersz said. "But we already know that it has cost many, many lives, and it's had an incalculable impact on society."

Now, Gersz said his staff is seeing a new and disturbing trend when dealing with people abusing substances: non-opioid drugs like cocaine and amphetamines being spiked with fentanyl.

In 2017, 27% of overdose deaths in Franklin County involved fentanyl and cocaine; by 2021, that number was up to 39%. During that span, there was a one-year decline from 35% of overdose deaths involving fentanyl and cocaine in 2019 to 28% in 2020, but experts say that decline could be due to a lack of reporting during the pandemic.

Franklin County also continues to see increases in overdose deaths involving both fentanyl and amphetamines, with the number rising from 3% of overdose deaths in 2017 to 16% in 2021.

Gersz pointed to the recent deaths of two Ohio State University students, who died in May of accidental fentanyl overdoses after taking what they believed to be generic amphetamines.

"They were literally poisoned — people are being poisoned," Gersz said. "This risk now is not just for people who suffer from chronic substance use. This is now a problem for even the recreational users."

Read more: Autopsy reports confirm two Ohio State students died of accidental fentanyl overdoses

While most who died were white, Black overdose deaths rising

A majority of those who lost their lives in 2021 to a drug overdose in Franklin County were white, according to the report from the Franklin County Coroner’s Office. However, from 2017 to 2021 the percentage of overdoses among white people overall decreased from 76% to 65%, while the percentage of Black overdose deaths increased from 21% to 29%.

The percentage of Blacks who overdosed on fentanyl or cocaine both increased, according to the report.

Roberts emphasized the importance of educating the public that drug dealers are lacing drugs other than opiates with fentanyl, and warned people against taking a relaxed attitude toward the deadly drug if they use other drugs, like cocaine or marijuana.

“We need to inform the community, particularly the African American community, that any drug can be laced with an opiate,” Roberts said.

Read more:Addiction treatment 'deserts' in Franklin County highlighted by Ohio State research

In 2021, most overdose deaths in Franklin County involved those ages 35 to 44, accounting for 25% of overdose deaths. That was followed closely by the 45 to 54 and 25 to 34 age groups, accounting for 24% and 22% of overdose deaths respectively.

Approximately 70% of the overdose victims in Franklin County were male and 30% were female, according to the report.

From 2017 to 2021, Franklin County observed a decrease in overdose deaths among the 25 to 34 age group, changing from 33% to 22%, and the 15 to 24 age group from 9% to 6%. Overdose deaths increased among the 45 to 54 age group and the 55 to 64 age group.

Franklin County is also seeing an increase in overdose deaths from 2017 to 2021 in the homeless population, growing 5% from 36 to 44 in 2021. A majority of the overdose deaths occurred in five zip codes, which included neighborhoods on the West Side, South Side and the North Side near North Linden, according to the report. The zip codes are: 43228, 43204, 43207, 43223 and 43224.

Roberts said the work to reduce overdose fatalities has been a concerted effort on the part of local health agencies, first responders and community partnerships.

“We’re starting to see the fruits of that hard labor,” Roberts said.

While local organizations note the decline, Maryhaven, and other groups are prepared for a drug epidemic that persists for many years to come, Gersz said.

"I know that the problem isn't going away anytime soon," Gersz said. "Even though the county statistics may have inched down a little bit — what we are seeing is still absolutely an epidemic."

Ortiz and other experts say there are several things drug users can do to avoid becoming the latest overdose death statistic. They include never using alone, using fentanyl test strips to detect traces of fentanyl before using, and having the overdose-reversing medication Naloxone handy just in case.

International Overdose Awareness Day events Wednesday

Several events are planned on Wednesday in connection with International Overdose Awareness Day, held annually on Aug. 31.

A discussion of the opioid epidemic and overdose problem and possible solutions for individuals, family members and the community as a whole will be discussed during The Columbus Dispatch's Columbus Conversations: "What is the state of the opioid crisis in our community?" at 6 p.m. Wednesday at Ohio State University's Fawcett Center Conference Theater, 2400 Olentangy River Road.

Amelia Robinson, Dispatch opinion and community engagement editor, will host the discussion, which is a partnership between Ohio State University, Central Ohio Hospital Council, WOSU Public Media and The Dispatch.

Panelists for the discussion include:

• Erika Clark Jones, CEO, Alcohol Drug And Mental Health (ADAMH) Board of Franklin County
• Dr. Krisanna Deppen, program director, OhioHealth Grant Addiction Medicine Fellowship
• Brian Pierson, vice president, community health and well-being, Mount Carmel Health System
• Dr. Erin McKnight, medical director of the Medication Assisted Treatment for Addiction Program at Nationwide Children’s Hospital
• Matt Parrish,  a Columbus Division of Fire captain
• Dr. Emily Kauffman, emergency medicine physician, OSU Wexner Medical Center East
• Juliet Dorris-Williams, executive director, The P.E.E.R. Center
• Andrea Boxill, administrator, Alcohol and Drug Services, Columbus Public Health

Franklin County Public Health is hosting an event to honor those lost to overdoses and to provide education and free help from 3 to 7 p.m. Wednesday at its Recovery Wall mural at 435 W. Town St. 

At the event, local agencies will educate people about treatment and prevention options for those living with or impacted by addiction. Franklin County Public Health also will distribute free doses of Narcan, fentanyl test strips and medication disposal bags.

Cole Behrens is a reporter at The Columbus Dispatch covering public safety and breaking news.

CBehrens@dispatch.com

@Colebehr_report