Fentanyl, a powerful synthetic opioid, is among the drugs leading to overdoses, deaths and an addiction epidemic hitting Ohio particularly hard. Efforts to help addicts are hindered by federal rules restricting Medicaid residential treatment, say member of Congress. (Cuyahoga County Medical Examiner’s Office via AP)

Five steps Ohio has taken to combat the deadly opioid addiction crisis

RELATED: Ohio Lt. Gov. Mary Taylor opens up about her sons’ opioid addictions.

Here are five key steps Ohio has taken to combat the crisis:

1. Expanded Medicaid under Obamacare. Beginning in 2014, Medicaid extended health care coverage to 715,000 low-income Ohioans, 30 percent of whom have drug abuse issues starting. That influx of mostly federal money dramatically expanded the amount of treatment available to Ohioans. Ohio Medicaid also started covering medication-assisted treatment services, such as methadone and Vivitrol, in 2012.

RELATED: Ohio AG Mike DeWine files lawsuit against drug companies over opioid addictions.

2. Beefed up the Ohio Automated Rx Reporting System. This secure database established in 2006 tracks all out patient prescriptions for controlled substances. State law now requires prescribers and pharmacies to report to the system. The number of prescribed opioid doses dropped from 793 million in 2012 to 631 million in 2016. OARRS is now integrated into electronic health records and pharmacy dispensing systems for 13,700 prescribers and pharmacists.

3. Expanded access to naloxone, a drug that reverses the effects of an overdose. In 2014, state law changed to allow first responders to administer the drug — commonly referred to by the brand name Narcan — and friends and family of opiate addicts can get it with a prescription. In 2015, state law changed to allow it to be dispensed without a prescription and now 75 percent of retail pharmacies offer it without a prescription. Ohio EMS workers administered naloxone 19,782 times in 2015.

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4. Tightened prescribing rules for prescription painkillers. Since 2011, the Kasich administration has recommended or mandated changes in protocol for prescribing pain medication in emergency rooms, acute care facilities, pain management clinics, doctor and dentist offices, and elsewhere.

5. Disciplined bad actors. The State Medical Board of Ohio took disciplinary action against 273 doctors and physician assistants between 2011 and 2017 for improperly prescribing prescription drugs. The state moved to shut down “pill mill” pain clinics. The number of people “doctor shopping” to get multiple painkiller prescriptions dropped from 2,493 in 2010 to 720 in 2015.

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