Ohio is arguably one of the hardest-hit states in the country when it comes to the opioid crisis, and Butler County is one of the hardest-hit in Ohio.
The state is second only to West Virginia when it comes to drug overdose rates, and Butler County has the fifth-most number of unintentional overdose deaths in the state, according to the Ohio Department of Health.
“You have to understand the core of the problem, and the reason we’re number one in the nation for overdose deaths is because we have a pain-killer problem,” said Ohio Rep. Robert Sprague, R-Findlay. “We prescribe, and have prescribed, in the state of Ohio a progressively higher number of prescription painkillers. That is the origin for us being ground-zero for the heroin epidemic in Ohio.”
Lawmakers have reacted to the opioid crisis in Ohio by introducing and passing various pieces of legislation over the past several years. But some in Columbus say much more is needed to address the rising number of overdose deaths still occurring in the state.
“Addiction is prevalent, addiction is real and we need to make sure we keep our eye on this and as a legislature we need to make certain politics is out of it and that we’re serving the people that need it the most,” said Ohio Rep. Thomas West, a social worker and Democrat from Canton. “The legislature has stepped up in the past few years in trying to address a public health emergency … and we need all hands on deck. And they came up with some options, some treatment options, some prevention options that would address this crisis, but more needs to be done. You need many spokes to this wheel.”
Unintentional drug overdoses caused 7,100 deaths in 2015 and 2016, according to the Ohio Department of Health. The Center for Disease Control reported earlier this year more than 5,200 people died from a drug overdose from July 2016 to June 2017.
In Butler County, more than 1,000 people have died from a drug overdose between 2012 and July this year, according to the county coroner’s office. Nearly 72 percent of those who overdosed did so on an opioid, either heroin, prescription pills or a synthetic like fentanyl or carfentanil.
WHAT’S BEEN DONE
The skyrocketing number of overdose deaths, and in particular due to opioids, started essentially in 2007, according to the Ohio Department of Health. The state's first response to this epidemic happened in 2011 when lawmakers passed House Bill 93, which eliminated the so-called pill mills — large-volume prescribing practices that essentially consisted of a doctor, a prescription pad and cash.
“They were basically pain clinics where a person could go get a large quantity of opioids,” said Ohio Rep. Dan Ramos, D-Lorain. “The thinking at the time was, ‘These centers are what causing people to get them addicted, let’s shut them down.’ Unfortunately, we didn’t do anything … about the people who were already addicted. We had a large group of people who had already become addicted to opioids, though the pill mills or taking their doctor’s orders.
The next significant piece of legislation, House Bill 341, took effect in September 2014 when lawmakers eliminated doctor shopping, Sprague said.
“We had all this doctor shopping going on where people would basically fool the doctors into giving them these narcotic prescriptions, so we passed a law where every single prescriber in the state … they would have to go into OARRS (Ohio Automated Rx Reporting System),” he said. “Now all the prescribers are required to look at this database that tells you what other narcotics you’re getting from other physicians.”
Lawmakers passed dozens of bills, amendments and resolution — and introduced countless more pieces of legislation — over the past seven years to address the epidemic. Among the laws that have passed, include:
• required maternity units, newborn care nurseries and maternity homes to report to the Ohio Department of the Health the number of opioid-dependent newborn babies;
• allowed pharmacists to provide patients, or their family members, naloxone, commonly known as the brand name Narcan, without a prescription;
• allocated $11 million to create and expand the medication-assisted treatment drug court program;
• approved a Good Samaritan Law that provides immunity for minor drug possession offenses when they call 911 if someone they’re with overdoses;
• require, in most cases, parental consent to be obtained before a physician prescribing opioids to a minor; and
• created drug take-back programs administered by the Attorney General to provide a way to dispose of leftover drugs in Ohioans’ medicine cabinets.
Ohio Sen. Joe Schiavoni, D-Boardman, said what needs to happen next is a “proactive, robust addiction program,” which includes addiction services, mental health, children services, job re-training, education.
“I don’t think you can do this piecemeal,” he said. “Overdoses are on the rise in the state of Ohio, and that’s not a good sign.”
Schiavoni, who is term-limited at the end of the year, said while it’s important to help the addicts recover from their addiction, Ohio needs to invest in a path to success by educating the youth.
“Our youngest are the most vulnerable,” he said. “We need to show them a path to succeed, and show them that there are people out there that love them and care about them, and want to show them that path — not just during school but after school with mentor programs and things like that — that’s where I think we really need to invest.”
Ohio Rep. Jim Butler, R-Oakwood, agreed, saying the reactive pieces of legislation were appropriate, but a proactive approach is needed.
“It’s such a huge problem I really think we need a comprehensive solution — a bold, comprehensive solution that’s really going to address all the different issues that have resulted in this problem,” he said. “It’s more than just about heroin or even opiates, it’s addiction. We have an addiction problem.”
Butler said he’s working on a bill with Ohio Rep. Kristin Boggs, D-Columbus, that addresses many aspects of the epidemic, from addiction recovery services to prevention and education.
Ohio Rep. Richard Brown, D-Canal Winchester, believes establishing an office of drug policy as a cabinet-level position in the Ohio governor's office, which he introduced on Aug. 30.
“This office of drug policy would be tasked with coordinating efforts across the state of Ohio,” he said.
Along with Brown’s proposed bill would promote the sharing information and data statewide, not only from the demographics of who died, but the community approaches and addiction services treatments that have worked, and where the problems and issues lay.
“It’s data, but also medical information, like research and new treatments and new treatment options,” he said. “What we envision is an overarching data information sharing what we think can be beneficial to both the addicts and first responders.”
But Ohio Rep. Wes Retherford, R-Hamilton, said there likely isn’t much more legislatively that can be done.
“I think this is a community issue. Each community is different,” he said. “I think it needs to be all hands on deck.”
Many groups are addressing the opioid issue, from drug task forces and prevention coalition to mental health boards, and they all are sharing information.
“I don’t think sharing the information is the problem a lot of times, at least of what I’ve witnessed. I think a lot of times, of what I witnessed, is people’s willingness to listen,” Retherford said.
Michael D. Pitman has been a reporter in southwest Ohio since 1999. He's covered local governments in Warren and Butler counties, as well as state and national issues. He currently covers the cities of Fairfield and Hamilton.