YOUNGSTOWN — About 143 people died in Mahoning County of an accidental drug overdose last year, which is about nine fewer than in 2022 and 18 fewer than the high-water mark of 161 in 2021.

It means the surge that was seen as a result of COVID-19 is easing off, said Brenda Heidinger, associate director of the Mahoning County Mental Health and Recovery Board, which coordinates behavioral health and substance abuse services in the county.

The number of OD deaths is not official until the county coroner’s office receives toxicology results for about 15 suspected overdose deaths late in the year, she said.

“Generally we end up pretty close to that number,” she said. “The coroner’s office is pretty good at their job and knows when it appears to be an overdose.”

Coroner’s investigators review suspected overdose deaths, but no official ruling on cause and manner of death is made until after the toxicology results are in.

“We had a spike during the pandemic,” Heidinger said. “We were starting to turn it down in 2019. Then 2020, 2021, we spiked. We started to slowly turn it back down.”

The number of deaths in 2019 was 103 but it surged in 2020, the first year of the pandemic, to 140. It increased again in 2021 with 161, followed by a drop to 152 in 2022 and now a likely drop to 143 this past year.

SUPPORT

Heidinger pointed to a variety of substance abuse programs being restored over the past few years as reasons the numbers are improving.

Among them are peer recovery supporters who work in hospitals and help those who come in with a drug overdose, the Quick Response Team by the Mahoning County Sheriff’s Office, which sends a deputy and an addiction professional from the jail to a person’s home after an overdose, and licensed peer recovery supporters working at the Health Network Community Center on Fifth Avenue in the city.

The QRT program started with a grant in which a sheriff’s deputy along with an addiction professional from the jail or volunteer, called a peer recovery supporter, goes to the person’s home after an overdose — no matter what part of the county it happens in — and they help the person who has overdosed, Heidinger said.

Peer recovery specialists also work in the emergency department at St. Elizabeth Youngstown Hospital and other departments.

There are also peer recovery supporters in many other agencies in the county, such as Meridian Healthcare, Thrive Counseling and COMPASS Family and Community Services.

“They are throughout our system of care now,” she said. “All of our agencies have peer recovery supporters working there.”

Heidinger added that they help the addicts as well as the family members of those who have died.

“If there is a death, we usually send out our DOSS team, (Drug Overdose Survivor’s Support ) to support the family,” she said. “If it’s an overdose save, the QRT team goes out. The idea is that they provide support information to the family, as well as offer again to get the person into treatment immediately,” Heidinger said. “They can make sure the family has Narcan, they can make sure the family has the things they need to get their loved one into treatment.”

The statistics Heidinger provided show that the number of suspected overdose deaths in 2023 included 98 males and 45 females.

She pointed out that through the toxicology testing on the 128 confirmed overdose deaths in 2023, they have determined that 92% of all overdose deaths contained fentanyl as at least one of the drugs in their system, 53% had cocaine and 18% prescription opioids.

Twelve other drugs showed up, including alcohol and marijuana.

MORE FENTANYL

The percentage of fatal overdoses that included fentanyl in 2023 jumped significantly, increasing from 79% in 2022 to 92% this past year.

“It gives you a breakdown of what is in the community,” Heidinger said.

One death certificate The Vindicator obtained listed several types of drugs being in the person’s system — nicotine, cocaine, fentanyl and norfentanyl.

Norfentanyl is the immediate chemical intermediary in a synthesis process currently used by clandestine laboratory operators for the illicit manufacture of fentanyl.

Heidinger said it’s possible the person was someone who used stimulants and “thought they were only using cocaine, but their cocaine had a lot of fentanyl in it.”

“If they didn’t have an opiate tolerance, it can kill a person,” Heidinger said. “Or they think they are only using cocaine, so they don’t have Narcan handy.”

That person’s death certificate listed the death as being an accident from multiple drug toxicity due to fentanyl and cocaine.

DEATH CERTIFICATES

Another death certificate described a woman, 23, being found unresponsive on the floor of a home in Austintown after a night of “partying and using illicit drugs with friends.” Her friends woke up the next morning and found her unresponsive.

A friend told Austintown police she and the woman were drinking alcohol and ingested Xanax and cocaine. The woman who died was last seen breathing at 8:30 a.m. An ambulance was called and arrived at the home around 10 a.m.

Another death certificate was for Kyle Murphy, 32, who was found unresponsive by his cellmate around 10 a.m. in his cell in the private Northeast Ohio Correctional Center on Hubbard Road on Aug. 19.

Murphy was seen “vomiting and stumbling around, appearing to be under the influence of something,” around 8 p.m. the night before, the death certificate states.

His cellmate saw him alive at 2 a.m. The cellmate left the cell at 7 a.m. and thought Murphy was sleeping. When the cellmate returned to the cell at about 10 a.m., Murphy did not respond to his cellmate.

A trooper who investigated the incident found a white rock-like substance and a pen case with a white residue visible in the cell. Murphy’s death was ruled an accidental drug overdose as a result of acute fentanyl intoxication.

Heidinger reviewed Murphy’s death certificate with The Vindicator. It indicated that the drugs found in Murphy’s bloodwork were two listings for norfentanyl and one for fentanyl.

“Those are all metabolites — what the body breaks fentanyl down into,” she said. “Occasionally we will see one that is straight fentanyl,” she said. The death certificate listed the death as being an accidental drug overdose resulting from acute fentanyl intoxication.

This is the first year Heidinger was able to provide a summary of the ages of the people who died of drug overdoses. It showed that the age group of 30 to 39 has the most, followed by 40 to 49. There was one person 19 or under, 22 people aged 20 to 29, 25 people between the ages of 50 and 59, 20 people between 60 and 69 and five people aged 70 and over.

AREAS OF COUNTY

Heidinger also provided data on the areas of the county with the highest incidence of non-fatal drug overdoses as reported to emergency departments at local hospitals. The location listed is where the person lives, by ZIP code.

The highest number of individuals involved in non-fatal overdoses lived in the 44512 ZIP code in Boardman. It had the highest number during the first 11 months of 2023 and the highest total over the past seven years.

The second highest over the past seven years is the 44505 ZIP code in part of Liberty Township in Trumbull County, and the northeast part of Youngstown.

The third highest area is the 44511 ZIP code, which is bordered by the Old Furnace District in Youngstown to the north and Shields Road in Boardman to the south.

COVID-19 CONTRIBUTED TO THE PROBLEM

Heidinger said the COVID-19 pandemic made it difficult for addicts to get help through 12-step programs, but meetings are “back up to pre-COVID levels.”

Because of the pandemic, delivery of services moved more to telehealth services and online meetings, and much of that has continued even after in-person meetings resumed in earnest.

“People who may have trouble with transportation or a babysitting challenge can still do an online meeting,” she said. “They don’t have to skip a meeting because they don’t have a babysitter. It gives them some flexibility.”

The additional funding from the opioid settlements is not yet being distributed. Still, the One Ohio Recovery Foundation will have a meeting on Feb. 14 when it will announce the time line for funding being available.

In March there will be a “listening session for local agencies that want to apply” to use funds for purposes such as prevention or recovery support, Heidinger said.

The funds will be provided to the 19 regions of the state on a per-capita basis. Mahoning and Trumbull counties are part of Region 7. Ohio will see $808 million over 18 years from the settlement funds.

Duane Piccirilli, executive director of the Mahoning County Mental Health and Recovery Board, is the Region 7 representative on the state One Ohio Recovery Foundation board.

erunyan@vindy.com