Fentanyl cause of rise in drug-related deaths

Drug overdose deaths in 2015 in Clermont County, including deaths where fentanyl was present, are higher than previous years.

Michelle Lydenberg, Clermont County Public Health injury prevention coordinator, has been doing detailed reviews of county overdose deaths since CCPH received some funding in 2014, which means she has looked at data from 2013-2015.

“We are seeing a rise of fentanyl, which is reflective of what we’re seeing across the state,” Lydenberg said.

Fentanyl is a prescription opioid that is most commonly used in surgical settings. It is stronger than heroin and other opioids and is used for severe pain and anesthesia. It is also inexpensive, Lydenberg said.

“It’s important that people are aware that fentanyl is much stronger,” Lydenberg said.

The rise is happening across the country, but particularly in the greater Cincinnati area. In 2013 there were four cases in the county where fentanyl was present, in 2014 there were 21 and in 2015 there were 51, Lydenberg said.

Overall, there were 56 overdose deaths in 2013, 68 in 2014 and 94 in 2015. Most of those who overdose are single white men in the 24-54 year age range, but Lydenberg has seen a rise in females, from 28 percent in 2013 to 33 percent in 2015.

So far this year, there are 26 confirmed drug overdoses, 14 of which involved fentanyl. However, it takes about 16 weeks to get toxicology done and there are 40 possible overdoses still waiting to be confirmed as of June 30, according to the Clermont County Coroner’s Office.

When fentanyl appears in toxicology screens it could be on its own or mixed with heroin. Lyndernberg also found that heroin is being mixed with benzodiazepnies, such as Xanax or Valium, but that is not on the rise. About 12 percent of cases showed benzodiazepnies.

“People don’t necessarily know they’re taking fentanyl,” Lydenberg said, adding that if they don’t know that can lead to an overdose because it’s stronger.

The majority of heroin that the Clermont County Sheriff’s Office is seizing is mixed with fentanyl, said Chief Deputy Steve Leahy.

Fentanyl has been around for up to 10 years now. People used to cut open fentanyl pain patches and consume the interior but now Leahy has been seeing fentanyl mixed with heroin.

“Fentanyl is so potent and strong it’s causing the overdose,” Leahy said.

Some addicts likely seek fentanyl out if they are having issues getting enough heroin to get the level of high that they are looking for. Others are purchasing what they believe to be what they normally get.

The heroin that users typically purchase is not pure, but usually is 20-40 percent heroin mixed with something else, such as aspirin. Now, dealers are throwing fentanyl, a huge suppressant of the respiratory and central nervous system, into the mix, Leahy said.

Fentanyl benefits addicts because they have to consume less to get the level of high they’re seeking.

“What’s happening is it’s killing them,” Leahy said.

Dealers benefit because they get a reputation as a dealer that sells strong drugs, and addicts often want the best high they can get for their money, Leahy said.

Naloxone does work on fentanyl overdoses, but it often takes two doses. The Sheriff’s Office saved 27 people with naloxone in 2015. The Sheriff’s Office, along with the Goshen Police Department and the Amelia Police Department, are the three organizations in the county that carry naloxone, Lyndenberg said.

The rise in fentanyl is an issue all over the state, so much so that representative from the Center for Disease Control came to the area last fall and did an investigation on fentanyl related overdose deaths in Ohio, Lydenberg said.

One of the reasons that heroin and fentanyl are so prevalent in Ohio is the county’s proximity to larger hubs, such as Cincinnati and Northern Kentucky, Leahy said.

Lyndenberg also found when looking at data that in 66 percent of cases in 2015 the victim had a criminal record, in 53 percent of cases the victims were not alone when they overdosed and in 12 percent of cases Hepatitis C or liver disease was present, up from none in 2013, according to the press release from Clermont County.