The Lake County General Health District has released the county’s 2017 unintentional overdose death statistics as part of its most comprehensive report to date.
The health district examined the 329 drug overdose deaths in Lake County over a five-year period from 2013 to 2017. Using vital statistics requested from the Ohio Department of Health, the health district recorded demographic information like occupation, marital status, education level and setting (home, hospital, hotel etc.).
Health district staff hope to use the information to provide a more proactive approach to combating the opioid epidemic that is gripping the county, state and country.
The United States, Ohio and Lake County all saw record levels of overdose deaths in 2017. There were 93 unintentional overdose deaths in the county up from 92 in 2016 -- that figure has been bumped up; a previous health district report listed 86 overdose deaths in 2016.
Data shows fentanyl (and fentanyl analogs) was again the most common drug involved in the county’s overdose deaths in 2017. Fentanyl was involved in 65 of the 93 overdose deaths. That’s actually a decrease from 71 in 2016.
Deaths involving cocaine or a combination of cocaine with another drug or drugs jumped from three in 2016 to 11 last year. The deaths represents 50 percent of the cocaine-related overdose deaths in the past five years.
Heroin deaths continue to fall. Heroin-related deaths peaked in 2014 at 27 and have fallen every year since then as fentanyl became the primary driver of overdose deaths in 2015. There were five heroin-related overdose deaths in Lake County in 2017, falling from seven the previous year.
The health district’s report does not identify the specific types of fentanyl analog involved in overdose deaths. They’re grouped in with fentanyl.
However data provided from the Lake County Crime Lab shows an increasingly diversified number of analogs were tested in 2017. The lab tests drugs seized by Lake County law enforcement agencies.
Fentanyl tests fell from 403 in 2016 to 258 last year. At least nine fentanyl analogs were found for the first time in the county last year, however. Carfentanil cases jumped significantly last year as well. In 2016 there were 40 positive tests for the large animal sedative 100 times more powerful than fentanyl (which itself is 50 times more powerful than heroin). Carfentanil cases increased to 153 last year.
The shift in recent years to highly potent opioids like fentanyl and carfentanil poses a problem when it comes the administering of the opioid-reversal medication naloxone. The health district’s policy, research and planning coordinator Matt Nichols said at its current two milligram formulation, a single dose of naloxone is not enough revive a person who is overdosing on those drugs.
Nichols said that 70 percent of overdoses are requiring multiple doses of naloxone to reverse the effects.
“It’s like trying to put out a fire with a garden hose rather than a fire hose,” Lake County Health Commissioner Ron Graham said of the current formulation.
Graham said there are currently no existing recommendations to give out more doses of naloxone at sites like Project DAWN (Deaths Avoided with Naloxone) clinics. He said research like this helps prompt those changes.
Nichols said the dosage becomes critical because 65 percent of overdose deaths are occurring in the home, and there’s a limited amount of time to revive a person, usually only a few minutes. He said that in addition to a reformulation, an increased focus on third-party naloxone distribution for family and friends of opioid users is needed.
Over the past five years, Lake County overdose victims have been primarily male (72 percent) and non-Hispanic Caucasian (98 percent). The county’s roughly 230,117 residents as a whole are 52 percent female and 92 percent non-Hispanic Caucasian. Seventy-six percent of overdose death victims were between the ages of 25 and 54.
The 25-34 age group accounted for 33.1 percent of the deaths. The second-most common age group was 45-54, accounting for 23.7 percent of overdose deaths. Six people 65 or older died of drug overdoses. None were under the age of 18.
Most victims (61.4 percent) are single/never been married. Twenty-four percent were divorced.
Half of Lake County’s drug overdoses are concentrated in two zip codes. The highest (27 percent) is in the 44077 region comprised of Painesville, Fairport Harbor and Concord Township. Second is the 44060 region comprised of Mentor, Mentor-on-the-Lake and Kirtland Hills. Overdose deaths in the 44060 zip code more than doubled from 2015 (11) to 2016 (25). The 26 overdose deaths in 2017 were the county’s highest by zip code.
Most victims (64.8 percent) are high school graduates (or have the GED equivalent). The next most common group were those with some college education but no degree (12.5 percent) followed closely by those who went to high school but do not have a diploma (11 percent).
Nearly half (46.8 percent) of Lake County’s overdose death victims over the five-year period in the report worked in the labor, maintenance and trade field.
“Obviously Lake County has long history of manufacturing presence,” Nichols said. “But these are folks who are also probably disproportionately at risk for being underinsured or being uninsured and with that may not have access to services or may not be aware of services they do have access to, things like Medicaid.
Given the disproportionate number of overdose deaths in that field, the report states that initiatives could “foreseeably be directed and delivered through relevant Lake County employers, such as those involved with manufacturing, construction and building trades, landscaping and general maintenance.” Initiatives could include drug-free workplace and employee education programs as well as targeted naloxone education and distribution via Project DAWN.
The report comes from the Lake County General Health District’s recently created Office of Health Policy and Performance Improvement.
Nichols will be presenting the health district’s conceptual addiction modeling methodology in conjunction with the CDC and the University of Pittsburgh in November at a conference in Cleveland.
Nichols said to the health district’s knowledge, the modeling hasn’t been done before.
Statistics and demographic information from the Lake County General Health District on unintentional overdose deaths from 2013-2017.