By Hannah Drown
cleveland.com
CLEVELAND, Ohio — Ohio is making significant strides in the battle against drug overdoses, with Gov. Mike DeWine recently announcing $4 million in grants that will aid first responders in acquiring and distributing life-saving tools, such as naloxone kits and fentanyl test strips.
The grants, which will be distributed over the next two years, were awarded through the Comprehensive Opioid, Stimulant and Substance Use program, which works to reduce the impact of substance abuse on the community.
Funds may be used by law enforcement and other first responders in communities challenged by high overdose rates to develop, expand or enhance programs that support those impacted by the misuse of opioids, stimulants and other substances.
The latest announcement is part of a broader state effort that has begun to show modest, though promising results, including an estimated 2% decrease in overdose deaths in Cuyahoga County in 2023 and continued downward trend in drug-related fatalities statewide.
The decline in overdose deaths follows a statewide push to improve the availability of resources aimed at combating the opioid crisis, particularly after a 22% surge in drug fatalities the year after the COVID-19 pandemic began in 2020. Among these efforts was the distribution of 1 million test strips in 2023 to detect the presence of deadly fentanyl in opioids sold on the street. The mass test strip distribution represented a critical step in safeguarding communities, given that 81% of Ohio’s overdose fatalities have been linked to fentanyl.
Another important investment has been Project DAWN, a network of overdose education and naloxone distribution programs that began in 2014. Last year, it achieved a 42% increase in the distribution of naloxone kits. The lifesaving medication, often referred to as brand name Narcan, blocks the effects of opioids and can reverse an overdose. The community kits contain a single-use nasal spray of naloxone, though medical staff often administer the medicine as an injectable.
Reflecting on these developments, Bruce Vanderhoff, director of the Ohio Department of Health, expressed optimism about the impact of these statewide initiatives.
“It’s only one year, but we’re really confident that a lot of the efforts that are underway in Ohio are having an impact,” Vanderhoff said.
Despite the positive strides, experts and first responders caution that the crisis is far from resolved.
“This is still a massive issue throughout the state,” said Amanda Lynn Reese, chief program officer for Harm Reduction Ohio, a non-profit that provides advocacy, education and supply distribution to help fight the opioid crisis. “What’s happening in our communities is tragic. The supply is dangerous, and these drugs are dangerous, but people are still going to do them and we have to help them stay safe.”
The urgency of the opioid crisis in Ohio was underscored in July 2023, when Cuyahoga County reported nine suspected overdose deaths within a 24-hour period. In 2022, emergency medical service agencies in Cuyahoga County administered more naloxone than in any other county in the state.
Fentanyl is 50 times more potent than heroin and low cost, prompting drug dealers to mix it with other drugs in potentially lethal doses. Often, those who overdose are unaware that fentanyl has been added to the drug they have taken.
Parma firefighter/paramedic Robert Bures shared insights from the frontlines, noting an increase in the required doses of naloxone to counteract overdoses. When he first joined the department, a typical dose of naloxone was .4 to 2 milligrams, and paramedics only used 2 mg in extreme cases, he said.
But today, Bures says the need is often much higher. Community-distributed overdose kits contain 4 mg of naloxone, and during one of his recent shifts, a patient received 12 mg.
“We’re definitely seeing that when we are getting called out, especially if we’re suspecting fentanyl, it’s taking more Narcan than it used to,” Bures said. “Drugs are not only stronger, but you don’t know what people are cutting it with anymore.”
A study by the Substance Abuse Treatment, Prevention and Policy research journal found that 83% of patients in suspected fentanyl cases required more than two doses of naloxone. The authors suggest that the standard dose may need to increase as much as threefold to combat the crisis’ shift toward more potent opioids and avoid overdose deaths.
Despite the rise in naloxone administration per call, Bures said that the number of overdose calls has decreased. Data from the Cuyahoga County Medical Examiner’s Office shows that drug-related deaths in Parma have been nearly cut in half since 2016.
Bures said it’s hard to nail down why the overdose numbers are lowering, with so many factors contributing to the crisis. But he hopes it’s because fewer people are using opioids, and not that they now have access to naloxone without having to call 911.
“When people have their own kits, we may never be alerted to that,” Bures said. “People might be using Narcan at home without ever calling us in the first place, which they absolutely should still do.”
Community-distributed naloxone kits are intended to be a first line of defense in an emergency to keep patients alive until paramedics arrive, and instructions on the packaging indicate to administer the product and call 911 simultaneously. But, Bures said, a lot of patients have been in and out of the hospital many times and don’t want to go back.
Bures believes others may worry about calling the police, afraid to inadvertently report their own illegal behavior. But with the introduction of the Good Samaritan Law, which gives immunity from drug charges for those who overdose, as well as those who call 911, he hopes that fear is diminishing.
“That was a huge thing for a long time,” Bures said. “People were so afraid that the police were going to come, charge them for drugs and throw them in jail, and that’s simply not the case anymore.”
Bures said that when it comes down to it, he believes the decrease in overdose calls likely is from the coordinated community initiatives taking place throughout the county – good public education, getting resources to the people who need them and finding partners who can get treatment help to those who are ready for it.
“I think the numbers are going to continue to go down because people now have access to naloxone which can save their lives, as well as education and information,” Bures said. “People know so much more and have gotten smarter about it.”
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