The recent history of overdoses in Ohio
Joe Finley

Heroin-related deaths accounted for 1,424 unintentional drug overdose deaths in 2015, an increase from 1,196 in 2014. Heroin was involved in 46.7 percent of all overdose deaths. The Cuyahoga County Medical Examiner’s Office reported that 51 percent of the 198 drug overdose deaths it processed during the past six months involved heroin; 24.8 percent of these heroin cases also involved fentanyl.

In March of 2016, 14 people in Lorain County overdosed on heroin mixed with Fentanyl during a two-week period. Of six of those 14 died and five individuals were later arrested for selling the drug. The Cuyahoga County Medical Examiner’s Office released a statement following a rash of overdose deaths, which revealed a total of 29 individuals who died from heroin, Fentanyl or a combination of both from March 10‒27, 2016.

Heroin and opioid-related deaths have not been limited to the Cleveland area. A report provided by the Summit County Medical Examiner’s Office showed 93 deaths in 2016, which were directly linked to opioid toxicity. The youngest casualties were only 18, the oldest was 70, but the range in between seems almost indiscriminate.

As of March 2017, five opioid overdose deaths have been reported in Summit County and that number is expected to climb drastically.

Heroin is an opioid drug that is synthesized from Morphine, a naturally occurring substance extracted from the seedpod of the Asian opium poppy plant.  Fentanyl is an incredibly potent synthetic opioid, up to 100 times stronger than Morphine. Fentanyl has become a relatively cheap and frequently used cutting agent for heroin dealers, but due to its high levels of potency, has resulted in a staggering number of overdose deaths.

Typically, opiate overdoses result in death because the drug slows respirations, causing hypoxia—or the lack of adequate breathing and oxygenation of vital organs, such as the brain and heart.  Those experiencing an overdose are often a bluish hue, sweaty, cool to the touch, and have constricted pupils. If the person overdosing remains hypoxic for more than a few minutes, breathing will cease altogether, resulting in death.

In an attempt to combat the prevalence of opioid overdoses in the area, the pharmaceutical Naloxone, more commonly known as Narcan, has been made widely available. Narcan works to block opioid uptake receptors in the brain, temporarily reversing the effects of opiates.  Narcan is fast-acting and helps to restore spontaneous respirations in users during an overdose.

Originally used primarily in hospitals and by first responders, Narcan is now available to police officers, business owners and the general public through programs such as Project DAWN. Narcan can be purchased over-the-counter at most pharmacies.

Due to its limited contraindications, ease of distribution with inter-nasal atomization, and remarkable acting time, Narcan has saved the lives of many opioid users worldwide. Equipped with a small, plastic cap, the medication is sprayed—or atomized—into the person’s nostrils, where it is quickly absorbed into the bloodstream.

The obstacle healthcare providers and first responders have encountered is the overall strength of Fentanyl. The typical 2mg vial of Narcan is often not enough to reverse the effects of Fentanyl. Some providers have noted doses of up to 10-12mg of Narcan being administered before an overdose can be reversed.