In 2016 President Trump’s administration declared the opioid crisis ravaging the U.S. a national public health emergency. Opioids have been destroying neighborhoods and families at a rising rate since the early 2000s but one of the cities and states hit the hardest is now be setting an example for the rest of the country.
Dayton, Ohio, and state of Ohio been torn apart by the ongoing opioid crisis. Ohio ranks only behind West Virginia in opioid-relate deaths per capita but something different is happening in the Buckeye State in 2018 – numbers are going down. Overdoses and deaths in Montgomery County, Ohio, home to Dayton, have dramatically dropped in 2018.
Opioid-related overdoses and deaths used to be so common in the county that the coroner would regularly run out of room to store bodies in the mortuary. The county resorted to rented climate-controlled trailers. In November of 2017 Montgomery County had tallied 548 overdose deaths. At the same time in 2018, that number has dropped 54% to 250.
Dr. Randy Marriot directs the handing off of opioid-addicted patients from first responders to Ohio’s Premier Health as part of the community’s focus on helping addicts at the ground level. Marriot is pleasingly shocked by the decrease. “They just began to abruptly drop off,” said Dr. Marriott.
Until the recent numbers came out Dayton was one of the hardest hit cities in one of the hardest hit counties in one of the hardest hit states of the ongoing epidemic. Dayton’s decreasing numbers are lined up with the decreasing rates across the country but is one of the only cities across the country to report such a dramatic decline in overdose deaths.
Once home to soaring overdose rates, Dayton and the rest of Ohio may now be laying the foundation on how to tackle the opioid epidemic with real results. Ohio officials and addicts alike point to five major contributing factors: the expansion of Medicaid programs, the drop in carfentanil on the streets, the increase of naloxone, expanded community efforts for people leaving treatment, and the coming together of law enforcement and public health officials for the common goal of decreasing the amounts of deaths and addicts.
Many point to the expansion of Medicaid in Ohio, enacted by Governor Kasich in 2015, as a prime reason the numbers are beginning to drop. It’s estimated that the expansion of Medicaid has given an additional 700,000 Ohioans access to healthcare like mental health services.
The expansion also brought the increased use of three FDA-approved medications to fight opioid abuse, and an expansion of private and public facilities to meet the growing number of individuals seeking drug and alcohol treatment.
The Exit of Carfentanil and Entrance of Naloxone
All forms of opioids have plagued the streets of Dayton but none more than the deadly drug carfentanil. Carfentanil is an analog of the synthetic opioid fentanyl. The drug is approximately 10,000 times the potency of morphine according to the Centers for Disease Control and Prevention. Carfentanil began decreasing on Dayton’s streets around summer of 2017. Drug Enforcement Agency (DEA) officers admit a grim but probable cause – that the dealers scaled back because they were killing too much of their clientele.
The decline of carfentanil has come with a rise in naloxone availability. Naloxone, popularly known by its brand name Narcan, can reverse the effects of opioid overdose if used in time. Once naloxone was difficult to obtain but is now readily available in Dayton. Almost all first responders in the city carry the life-saving drug.
Though the naloxone approach has garnered criticism, Dayton Police Chief Richard Biehl commands all his officers to carry it. “We really jumped on it because we saw it as absolutely consistent with our public mission to save lives,” Chief Biehl said.
Expanded Resources After Treatment
Much like a prisoner can feel lost after serving their time and being released, an addict can feel lost after they get outside of their own prison of active addiction. Ohio correction and public officials noticed a revolving door of addicts going in and out of local hospitals and jails. Many of them had sought treatment but weren’t able to keep clean on their own. The Dayton community has stepped up to give recovering addicts more options in recovery.
Per capita, Dayton has many more resources for recovering opioid addicts than other cities in the country which includes several Narcotics Anonymous (NA) meetings daily. Dayton also established Getting Recovery Options Working (GROW) a network of first responders and recovery professionals that can get an addict into recovery directly after an emergency like an overdose.
The opioid crisis will never be solved if public health officials and law enforcement disagree on the treatment of opioid addicts and how to handle the crimes that come with them. Author of “Dreamland: The True Tale of America’s Opiate Epidemic” Sam Quinones testified before Congress during a hearing on the opioid crisis that “the more cops and public health nurses go out for a beer, bridge that cultural chasm between them, the better chance the country had at solving the problem.”
Dayton has set the example of getting community health workers like nurses and doctors together with law enforcement officials to bridge the gap on how they see addiction. The two units share strategy, data, and work to keep addicts from falling through the cracks. This cooperation has helped in the decrease of repeat offenders and overdoses.
Increased funds, community effort, and fresh strategies have helped opioid-related deaths fall in Dayton at a much more dramatic rate than the rest of the country. A town which was once a poster child of the opioid epidemic is now the model of how to fight it. Ohio residents and public officials alike will continue to put more effort against opioids until the numbers stay down.