Authorities say the heroin epidemic won’t stop until more addiction treatment is available

According to officials, solutions will have to go beyond emergency response and include expanding currently strained treatment options.

Oct 5, 2016 at 10:50 am

Officials have ramped up law enforcement efforts against heroin dealers but say more treatment options are vital. - Photo: Thinkstock
Photo: Thinkstock
Officials have ramped up law enforcement efforts against heroin dealers but say more treatment options are vital.
Ohio is fighting a killer with unprecedented power and reach.

Overdoses involving heroin and stronger, deadlier additives like fentanyl and carfentanil continue to occur at crisis levels, especially in Greater Cincinnati, and local and state leaders are scrambling to find strategies to stop them.

That has led to a number of anti-overdose efforts here in the city, including short-term saves like increasing the availability of anti-overdose drug Narcan, which blocks dopamine receptors in the brain triggered by opiates and can bring an overdosing person back from the brink of death. 

But solutions will have to go beyond emergency response, many officials say, and must include expanding currently strained treatment options. 

At least 1,400 people have overdosed on heroin in Cincinnati this year, according to city data. Back in mid-August, the city saw 174 such overdoses in just a week. 

Though overdose levels have decreased slightly since that spike, Hamilton County Coroner Lakshmi Sammarco says she still sees an average of two drug overdose deaths a day. Many of those are taking place in specific regions of the city. 

West Price Hill has had the highest number of overdoses in 2016, with 143, followed by Westwood with 104 and East Price Hill with 93. Downtown and Over-the-Rhine have also seen significant numbers of emergency responses to overdoses, with 76 and 71, respectively. 

“If we didn’t have Narcan readily available to first responders, we would have a lot more deaths on my hands,” Sammarco said at a Sept. 28 heroin meeting of local leaders in downtown Cincinnati called by Ohio Attorney General Mike DeWine. “We’d be inundated.” 

But authorities say reviving overdose victims can’t be the only response to the crisis.

“We’re bleeding profusely and we need a tourniquet,” Newtown Police Chief Tom Synan, who heads the Hamilton County Heroin Task Force, said at DeWine’s Sept. 28 meeting. “It’s not going to take a Band-Aid and it’s not going to take someone telling us to put pressure on the wound and it will all be better. We need real action and we need it now.”

Some Cincinnati City Council members are hoping part of that help will come via $700,000 to expand West End’s Center for Chemical Addiction Treatment, the city’s strained detox facility. A motion drawn up by council members Wendell Young and Charlie Winburn and passed out of Council’s Budget and Finance Committee directs city administration to prepare a report about spending that money, plus finding matching funds from state or federal sources. 

Council and city administration are also poised to chip in about $50,000 to increase the availability of Narcan to first responders and to train citizens to help with overdose situations as they hash out what to do with an unexpected $16.6 million surplus later this month. 

State Rep. Denise Driehaus, who is running for Hamilton County Commissioner against interim Commissioner Dennis Deters, has proposed other solutions, including adding a detox and addiction treatment center to the Hamilton County Justice Center, where many inmates currently must detox cold turkey. 

That’s an idea Hamilton County Sheriff Jim Neil also supports. Neil, and other county officials, say they often see the same inmates cycling through the county’s justice system because they can’t kick the drug.  

Meanwhile, the Hamilton County Heroin Coalition, led by commissioner Deters, has been working on the problem from the other end, putting together quick response teams that include Hamilton County Sheriffs deputies, emergency medical personnel and addiction treatment specialists. 

The idea is to respond to the immediate emergency of an overdose while presenting users with long-term options to fight their addictions.

The roots of the current heroin crisis are deep and stubborn and lie mostly with recent additives like fentanyl and carfentanil. 

Over the past year, authorities have become increasingly concerned about fentanyl, a factor in the prescription opiate boom that sparked the ongoing drug crisis over the last decade. As that crisis has transitioned into the heroin addiction epidemic, fentanyl has made a comeback as a powerful additive.

“Fentanyl is often mixed with heroin, which is cheap, potent and available,” said Deters, who is head of the Hamilton County Heroin Coalition, last year. “Users are unaware that their drugs may have been cut with fentanyl or other adulterants, which places them at even greater risk of overdose or even death.”

From 2007 to 2013, according to Hamilton County Public Health, fentanyl contributed to just seven of the county’s overdose deaths. But in 2014, it played a role in 81 fatal overdoses, or 30 percent of the county’s 251 total overdose deaths. 

The crisis has gripped the entire state. By Ohio Attorney General DeWine’s count, eight people a day are dying in Ohio from overdoses, many caused by the additives. 

“If we were losing eight people a day to a terrorist attack, not only would that be national news, we’d declare this a horrible emergency,” DeWine said at the Sept. 28 meeting in downtown Cincinnati.

Some state lawmakers, including Driehaus, have asked Ohio Gov. John Kasich to do just that. Driehaus, a Democrat, has joined others in her party in asking Kasich to release some $300 million from the state’s $2 billion rainy day fund to help fight the addiction crisis. 

“They need resources,” Driehaus said of social service and law enforcement agencies across the state. “They need the state to behave in a real way and say we have an epidemic statewide.”

Kasich has demurred, saying he doesn’t have that kind of power and that the legislature will have to pass a spending measure to release that money.

Currently, federal law enforcement agents are working with local authorities to try and trace the source of heroin laced with additives higher up the chain of dealers. 

Hamilton County Prosecutor Joe Deters has explored offering legal immunity to any dealer who provides information about the source of the drugs.

Two local dealers, Phillip Watkins and Jeanetta Crawford, were indicted Sept. 21 in the first federal carfentanil trafficking case in the country. They were arrested Sept. 15 for selling heroin laced with the tranquilizer in Elmwood Place to users who later overdosed. 

“This is significant,” Synan of the Heroin Task Force said of the arrests. “It’s going to send a strong message that if you’re putting this poison on the street, you’ll spend significant time in federal prison.”

But some, including the lawyers of the low-level dealers, question the strategy.

“Charging the offense in federal court with a 20-year mandatory minimum certainly sends a message,” Scott Rubenstein, Watkins’ attorney, told CNN recently. “That far exceeds the exposure that Watkins would have had in state court. Is going after a low-level dealer in this manner going to have an effect on the problem? That remains to be seen.”

Even federal authorities acknowledge arrests alone won’t be enough to stem the tide of overdoses.

“If we are going to combat the opioid problem in Ohio, it requires prevention, enforcement and treatment,” said Benjamin C. Glassman, U.S. attorney for the Southern District of Ohio, at the Sept. 21 news conference announcing the indictment of the dealers. ©