FILE - This Feb. 19, 2013, file photo shows OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. A federal bankruptcy judge on Wednesday, Sept. 1, 2021, gave conditional approval to a sweeping, potentially $10 billion plan submitted by OxyContin maker Purdue Pharma to settle a mountain of lawsuits over its role in the opioid crisis that has killed a half-million Americans over the past two decades. (AP Photo/Toby Talbot, File)

YOUNGSTOWN — With 84 suspected accidental drug overdose deaths at the midway point of 2021, Mahoning County is on track to surpass totals from recent years.

That’s according to data from Mahoning County Public Health recently supplied by the Mahoning County Mental Health and Recovery Board.

In the first six months of the year, there were 81 confirmed deaths. Three cases are pending, but suspected to be confirmed, the Mahoning County Overdose Surveillance Report states.

When comparing January through June 2020 with January through June 2021, this half-year logged a 44.8 percent increase in deaths.

At the same point in 2020, the county logged 58 confirmed or pending overdose deaths; and 56 in 2019, 60 in 2018 and 66 in 2017.

If the trend this year continues, and the number of deaths double in the second half of 2021, the county could log 168 deaths. That would be a 50 percent increase over 2017 figures and a 20 percent increase over 2020 deaths.

There were 140 total overdose deaths in the county in 2020, 103 in 2019, 117 in 2018 and 112 in 2017.

Mahoning County ranked 10th in the state in its rate of overdose deaths, rising from two per 100,000 people in 2010 to 15.4 per 100,000 people in 2020, according to Ohio Attorney General Dave Yost’s office’s 2010-2020 analysis in conjunction with his Scientific Committee on Opioid Prevention and Education (SCOPE).

The statewide rate for 2020 is 11.01 per 100,000 residents. Trumbull County is at 17.1 per 100,000 and has the sixth-highest rate of Ohio’s 88 counties.

“Opioid overdoses might have taken a back seat in our minds last year because of COVID-19, but make no mistake: Ohioans are dying at a devastating rate because of opioid overdoses,” Yost said earlier this year.

TRENDS

There are fewer instances of people legally obtaining prescription opioids and then becoming dependent on them and street drugs, but traumatic experiences still are driving people toward substance-use disorders, said Brenda Heidinger, associate director of the mental health and recovery board.

“With all of the changes made at the state and federal level to prescribing, and cracking down on overprescribing, we don’t see that path anymore, typically,” Heidinger said. “What we do see typically is some type of trauma as a young person or in the teen years. And they turn to substance use to deal with the issues in their life, and it snowballs.”

But illegal access to legally prescribed medications still occurs, Heidinger said.

“We see people, 16, 18, 20 years old, getting into Mom’s or Grandma’s medicine cabinet,” Heidinger said.

It is important to either lock up the substances or dispose of them in a safe way, such as a drug take-back event or drop-off box, Heidinger said.

A list of drop boxes in the county is available at www.mahoninghealth.org/medical-disposal.

Though the opioid epidemic began with the over-prescribing of opioids and patients who turned to heroin on the streets, heroin is pretty much gone, locally, Heidinger said.

“It is all fentanyl and fentanyl derivatives,” she said.

Fentanyl is a lab-created opioid that is much stronger than heroin or morphine.

The substance is being marketed as heroin on the street, but it also is being added to street drugs that did not typically have an opioid in them, such as cocaine and methamphetamines, Heidinger said.

And that is driving death trends now, Heidinger said.

“One of our biggest problems is people who are used to stimulants like cocaine and methamphetamines getting the drugs from distribution networks that are using fentanyl to cut the cocaine and methamphetamine. So people without a fentanyl tolerance overdose because they believe what they are using is cocaine,” Heidinger said.

LOCAL RESPONSE

Though the overdose death figures are grim, recently implemented programs are mitigating the crisis, and keeping the figures from growing even higher, said Heidinger and Duane Piccirilli, executive director of the county’s mental health and recovery board.

Cooperation among county agencies — such as the Mahoning County Mental Health and Recovery Board, the Mahoning County Sheriff’s Office, the Mahoning County jail, Mahoning County Public Health, local police departments, schools, hospitals, in-patient service providers and out-patient service providers — is making a difference in the fight against accidental deaths, the officials noted.

There are peer supporters in Mercy Health hospitals who connect overdosing patients who arrive in the emergency department to services. They can provide the first dose of medication-assisted treatments, such as suboxone, schedule appointments for the next day for treatment services and continued MAT services and follow-up services.

The peer recovery supporters have personal experience with substance use and are better positioned to reach users because they understand the recovery journey, Heidinger said.

Some people can go straight from the emergency room to a treatment appointment, known as a “warm hand-off.” The patients are also given information and offered resources.

When someone is admitted to the jail with a substance-use issue, a case manager makes contact quickly and starts working with the person.

“The process really reduces recidivism,” Piccirilli said.

To make sure officials involved in the issue are on the same page, they meet quarterly to discuss problems and successes and to track data.

Other outreach groups and ongoing programs in K-12 schools seek to influence children and young teens. The long-term programs result in fewer issues with alcohol, drugs and violence in the students’ futures, Heidinger said.

NEEDS

Though options for short-term treatments are available in the county, there is still a need for certified, long-term recovery housing, Heidinger said.

“It is no longer a huge problem to find detox beds, but it is still hard to find residential spots. The longer stays needed after initial treatment have been a bit of a bottleneck. There are not enough certified recovery houses,” Heidinger said.

Some people stay in recovery housing for a year.

There are more long-term beds for men than women in the area, she said. There are only two certified recovery houses for women in the county, with a total of about 20 beds.

In order to get financial support from the mental health and recovery board to operate a recovery house, the owners first have to go through Ohio Recovery Housing to gain certification, Piccirilli said.

The certification process ensures the recovery houses are operating safely and in a way that encourages real recovery.

rfox@tribtoday.com