Ohio trails only West Virginia in opioid-related overdoses per capita making the opioid crisis in the Buckeye State a serious concern. Both Ohio and federal public safety and health officials have been implementing new policies to curb the epidemic with some success but a mix of cocaine and fentanyl popping up in Northeast Ohio has been linked to a new string of overdoses, especially in the African American community.
Cocaine has long been a problem in the Buckeye State but normally doesn’t produce the number of overdoses seen recently. New data from the Cuyahoga County medical examiner’s office paints a grim portrait as to why – fentanyl. Approximately 45 percent of 2018 drug overdoses from Cuyahoga County were tied to fentanyl-laced drugs, the highest percentage the County has seen in more than a decade. Fentanyl is a powerful opioid many times more powerful than morphine or heroin that can easily cause an overdose.
Cocaine in Cuyahoga County
Cuyahoga County, home to Ohio’s second-largest city Cleveland, is at the heart of the new concern. From 2011 to 2015 cocaine was a factor in approximately 30 to 35 percent of the county’s overdoses but grew to 39 in 2016, 41 in 2017, and all the way up to a whopping 45 percent seen in 2018. Cuyahoga County is seeing a significant rise in cocaine overdoses, but they aren’t the only ones affected. Nearby Mahoning County cited cocaine as a factor in 54 percent of overdose deaths in 2018.
Though overall opioid-related deaths are falling in Ohio for the first time in several years, overdoses related to fentanyl continue to rise. According to Harm Reduction Ohio, cocaine laced with fentanyl and its cousin carfentanil has been on a steady rise since 2014 with a dramatic shift upwards around 2016. In 2014, 7 percent of cocaine seized contained fentanyl but in 2017 that number ballooned to 8.5. Carfentanil-laced cocaine topped out at 4.4 percent in 2017 but has declined in the following months to just .5 in 2018.
Cocaine turning Deadly
Cocaine can cause overdoses on its own but County health officials like medical examiner Thomas Gilson blames the rise in deaths on the potent new combination. Dealers are trying to get their users hooked and though fentanyl is more powerful than cocaine, it’s also cheaper. According to Gilson dealers are mixing the opioid with most street drugs. Not knowing what they’re putting in their bodies increases the dangers for all users. “It’s really kind of a crapshoot when they’re out there, what they’re getting,” said Carole Negus, nursing director at Cleveland mental health center Stella Maris.
Fentanyl-Laced Cocaine and Changes in Overdoses
The new fentanyl and cocaine combination is causing a major shift on demographic data on cocaine and opioid-related deaths. In Ohio African American communities are more likely to use cocaine than opioids like heroin but the new combination of cocaine and fentanyl has flipped those numbers. According to the medical examiner’s office, African Americans accounted for roughly half of all cocaine-related overdoses from 2006 to 2012 with a peak year of 66 percent in 2007. In 2018 African Americans accounted for only 30 percent of cocaine-related deaths. In Hamilton County in 2014 1 in 8 in every overdose victims was African American but in 2018 that number climbed to 1 in 5 for Hamilton’s 347 overdose cases.
“We are witnessing a positive change, or reduction, in death rates for whites, while blacks have exhibited no significant change, or reduction, over that same period,” said Erik Stewart, executive vice president of the Hamilton County Mental Health and Recovery Services Board. African Americans make up only 27 percent of Hamilton County’s population but now have approximately the same number of overdoses as Hamilton’s white population which makes up 68 percent of the county. “The initial waves of the opioid epidemic largely passed by the African American community until the tragic intersection of the cocaine and fentanyl markets,” said Gilson. “It is essential that we expand our prevention efforts to reflect this nationally.”
The trend in Ohio mirrors a national trend. According to a National Vital Statistics report, African Americans had the largest jump in drug overdose deaths from 2011 to 2016.
Help With Fentanyl Test Strips
Unfortunately knowing there could be fentanyl in their supply is unlikely to keep cocaine addicts from using but health officials are hoping fentanyl test strips will cut down on the overdose numbers. In its 2019 budget Cuyahoga County called for $15,000 for the Care Alliance Health Center to buy and distribute fentanyl test strips. Users can use the strip to test for fentanyl in their cocaine, heroin, and other illicit substances. The county is hoping to make the strips available in not only community health centers but bus stations, public libraries, bar bathrooms, and other areas that are popular for illicit substances.
Getting Help for Ohio Addicts
Though it has some of the worst statistics, Ohio is changing the game in how local law enforcement and health officials deal with addiction. The state has moved away from ineffective punishment-only enforcement models and now works to move addicts into proper treatment with special dockets for addiction-related nonviolent crimes and databases to keep addicts from falling through the cracks. Ohio has also implemented harm reduction practices like clean needle exchanges and requiring law enforcement in harder-hit counties to carry the overdose-reversing naloxone, more commonly known as Narcan.
Since the new programs and actions began around 2016 Ohio has seen a drop in overall opioid-related deaths not involving fentanyl. Anyone with an opioid problem in the Buckeye State can call their local public health center or office for recommendations on low to no-cost treatment, needle exchanges, and other ways to help themselves.
