For several years now we’ve been hearing about the ever-worsening opioid crisis. While it’s a national issue, Ohio seems to have the unfortunate distinction of being at the heart of the problem. Not exactly what we had in mind with that old tourism slogan: Ohio – The Heart of It All.
How did our land of rolling meadows, cornfields, small towns and mid-size cities become ground zero for a drug epidemic that seems more the province of large coastal metropolises?
That question is answered in a terrifically informative book called Dreamland, written by Sam Quinones. Published in 2015, Dreamland recounts what Quinones learned during years of investigating the drug trade in both the United States and Mexico.
The full explanation for the rise of opioids is long and involved. The short answer is this: In the 1990s, there was an unfortunate convergence of two main factors – first, the emergence of the infamous pill mills that provided easy-to-obtain prescription painkillers, and second, the arrival of cheap, potent black-tar heroin from Mexico that, for a variety of reasons, flew under the radar of law enforcement.
The problem didn’t arrive here in full bloom, but the numbers now – the death toll, the addicts, the volume of pills and heroin moving through the state – are staggering. Like a cancer that starts doing its dirty work before doctors detect it, the opioid scourge began coursing through Ohio’s veins well before officials realized how bad it was.
Perhaps one of the first big clues showed up in 2005 when Ed Socie, an epidemiologist with Ohio’s department of health, noticed that poisoning deaths in Ohio were climbing. Historically, that number remained fairly constant. Why was it increasing?
The data on poisoning deaths came from the federal Center for Disease Control (CDC), which got its numbers from Ohio coroners. Socie discovered that deaths that were being recorded as accidental poisonings were actually due to drug overdoses.
As recounted in Dreamland, Socie recognized that this was a new phenomenon. “Cocaine and methamphetamine – the popular drugs through the 1980s and 1990s – are damaging drugs, but people don’t often fatally overdose on them. Heroin, which people do overdose on, hadn’t been a sustained problem since the 1970s. Drug overdoses in Ohio had remained pretty constant for decades.”
When Socie ran the numbers he saw that, after remaining stable for decades, the death toll from overdoses “suddenly took off like an airplane, almost tripling in six years.”
Although Socie found the numbers alarming, his warnings initially “fell on deaf ears.” But in 2007, Socie presented his findings to a new supervisor, Christy Beeghly, who was “astonished” with the data. When they dissected the numbers further, they realized that “drug overdose deaths were about to surpass fatal auto crashes as Ohio’s top cause of injury death. This was a stunning moment in the history of U.S. public health.”
Quinones explained the significance. “Since the rise of the automobile in America, vehicle accidents sat unassailed atop the list of causes of injury death in every state, and in the United States as a whole. Now Ed Socie’s numbers showed that would soon no longer be true in Ohio. And by the end of 2007, it wasn’t.”
The next year, overdose deaths surpassed auto fatalities as the leading cause of accidental death for the entire country. Socie and Beeghly wrote a report that presented the numbers in a stark manner.
The number of Ohioans dead from drug overdoses between 2003 and 2008 was 50 percent higher than the number of U.S. soldiers who died in the entire Iraq War.
Three times as many people died of prescription pill overdoses between 1999 and 2008 as died in the eight peak years of the crack cocaine epidemic.
In 2005, Ohio’s overdose deaths exceeded those at the height of the state’s HIV/AIDS epidemic in the mid-1990s.
Since then, the situation has only deteriorated. In 2015, Ohio accounted for 1 in every 9 overdose deaths in the United States. In 2016, we had an estimated 200,000 opiate addicts living in the state.
Unfortunately, those numbers reveal only a portion of the calamity. The tentacles of this beast are far-reaching and generational. This is a drug problem, yes, but it also presents legal and public policy issues we haven’t really seen before, impacting such things as foster care, adoption and welfare in Ohio. We’ll examine some of those issues in future blogs.