Isolation during the COVID-19 pandemic and drugs laced with a potent opioid pushed overdose deaths to new heights, public health officials say.

In 2020, 5,018 Ohioans died from drug overdoses — the first time the figure exceeded 5,000, according to a report by the OHIO Alliance for Population Health using data from the Ohio Department of Health. Overdose deaths have increased 13-fold since 1999.

The U.S. Centers for Disease Control estimates that overdose deaths across the United States surpassed 100,000 between May 2020 and April 2021. The data is still being compiled and death investigations are pending, but experts see a clear pattern.

Street drugs such as methamphetamine and cocaine are being laced with fentanyl, a highly addictive and extremely potent opioid, according to Dr. Joe Gay, author of the report and Alliance member.

“Even if a person doesn’t know theyre using fentanyl, they may get it,” said Gay. “And so that further increases the death rate.”

Dealers cut their drugs with fentanyl in order to make them stronger, explained Gay. While the drug does make highs more powerful, it also increases the danger factor. According to the Alliance report, a lethal dose of the drug is 2 milligrams, equivalent to a few grains of salt. The report also states that fentanyl is fast-acting and can result in death within minutes.

Compared to other drugs, the Alliance found that fentanyl is seven times as deadly as cocaine and heroin and has an overdose rate 37 times higher than methamphetamine and 86 times higher than benzodiazepines.

The isolation caused by the COVID-19 pandemic has also been blamed for the increase in overdoses. With substance users more isolated, the potential for being found and brought back from an overdose decreases. Since the pandemic began in Ohio — with the first case reported in the state in early March 2020 — overdose deaths have surpassed those of previous years month by month. May 2020 brought the biggest disparity with 575 overdose deaths.

The trend has continued into 2021 with numbers in January and February climbing even higher than those recorded in 2020.

Data from the CDC shows a 26.6% increase in overdose deaths in Ohio from April 2020 to April 2021. West Virginia and Kentucky saw even greater loss with 62.2 and 54.5 percent increases.

The jury is still out as to whether the increase can be blamed solely on the pandemic or the increase in the drug supply. Gay tends to believe that the latter, but does say the virus obscured the situation.

In regards to the increase in supply, Gay said, “I don’t expect that to stop anytime soon. The authorities are making an effort to stop it but the supply is overwhelming.”

Athens County has fared better than others with an overdose death rate of 15.8 deaths per 100,000 between 201 and 2020. While it isn’t the county with the lowest rate recorded — that is Holmes County with a 6.4 death rate — Athens was one of the affected in the region. Other Ohio Appalachian counties varied from Monroe County with its rate of 14.1 deaths, to the highest rate in the state, 83.2 in Scioto County.

Gay touts progressive programs such as the needle exchange program in Athens County as contributing factors to its low rate. He also hailed County Prosecutor Keller Blackburn’s Ohio Fresh Start, a program designed to help those addicted to illicit drugs while also maintaining public safety. The program is multi-faceted, incorporating sentencing reform and rehabilitation efforts to combat the issue of addiction.

The Alliance recommends that those with substance use disorder carry naloxone — a drug they call “the best defense against overdose deaths.” Also known as Narcan, it can be purchased prescription free at pharmacies and can be ordered online through Harm Reduction Ohio.

Knowing the signs of a drug overdose is also crucial. These include:

  • Small, constricted ‘pinpoint pupils’
  • Falling asleep or loss of consciousness
  • Slow, shallow breathing
  • Choking or gurgling sounds
  • Limp body
  • Pale, blue, or cold skin

Gay says support for alternative programs that treat substance use disorder, law enforcement and harm reduction programs as well as regulation on appropriate opioid prescribing practices can be important steps toward reducing overdose deaths.

“If the strategies I described are used, it can make a difference,” said Gay.

As for the average person, carrying Naloxone can save a life, according to Gay.

“I think supporting treatment and — for those who are at risk or have a loved one at risk — having Naloxone and knowing how to use it are probably the most important things,” said Gay.

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