Ohio has been among the states hardest hit by the opioid epidemic for years, but data released Wednesday from the state’s Department of Health makes clear that the problem is only worsening: between 2015 and 2016, overdose deaths rose by 33 percent.
The epidemic’s ripple effects are manifold, straining morgues, emergency services, and foster care systems. Largely because of prevalent drug use and overdose, the state’s foster population grew by 10 percent between 2015 and 2016, to 15,000 children.
Driving the increase in deaths is fentanyl, a synthetic opioid up to 100 times more potent than morphine, and dozens of fentanyl analogs, or slight molecular variations on the original fentanyl molecule. As the chart below shows, the state’s opioid epidemic has evolved over the years, from opioid painkillers to heroin and then to fentanyl and its analogs.
Those three stages are a national trend too: As Dan Ciccarone, a professor University of California-San Francisco School of Medicine, recently wrote in the International Journal of Drug Policy:
This is a triple epidemic with rising waves of deaths due to separate types of opioids each building on top of the prior wave. The first wave of prescription opioid mortality began in the 1990s. The second wave, due to heroin, began around 2010 with heroin-related overdose deaths tripling since then. Now synthetic opioid-related overdoses, including those due to illicitly manufactured fentanyl and fentanyl analogues, are causing the third wave with these overdose deaths doubling between 2013 and 2014 .
The state data takes us through 2016, but a report published Thursday by the Centers for Disease Control and Prevention suggests that the trend towards fentanyl and fentanyl analogs—and away from heroin and painkillers—has only become more extreme this year. The researchers looked at overdose deaths in 24 of Ohio’s 88 counties, most in the southern part of the state in and around Dayton, in January and February of this year. About 90 percent of them involved fentanyl or fentanyl analogs, whereas heroin was only identified in 6 percent of cases.
One reason fentanyl and its analogs are so widespread is that they have become so easy to order online. The drugs, predominantly manufactured in China, can be found on cryptomarkets on the “dark” web, or marketplaces that grant anonymity to both seller and buyer and rely on cryptocurrencies like bitcoin. The result, as the CDC study puts it: “Ohio is experiencing an unprecedented loss of life.”