Ohio’s opioid agony
As college football season looms, hope springs eternal here in Columbus that our premier land-grant institution of higher learning will be atop the pile at the end of a glorious, or even a workmanlike season.
Unfortunately, Ohio currently is instead leading the pack in the metrics for two national crises: at-risk student loans and drug overdose fatalities. My Buckeye state experienced nearly 17,000 deaths from drug overdoses from 2010 to 2016, and led the nation last year with more than 4,050. The Ohio Department of Health is still compiling the data, so the total could even go higher still.
I have attended four national conferences of state legislators this summer, and these lawmakers are well-aware that the street drug problem has gotten much worse in the last couple of years, with the addition of fentanyl to many of the traditional offerings. As a synthetic opioid, it can be manufactured and transported anywhere. It can reportedly even be bought online, if one knows where to look. It’s easy to understand the dangers posed by a substance 50 times as powerful as heroin, which currently is being mixed with other street drugs—cocaine, heroin and even marijuana—to hook users.
To illustrate how “powerful” fentanyl is, the story of Patrolman Chris Green—an East Liverpool, Ohio officer—made national news in May when he overdosed from wiping just a small amount of fentanyl off his shirt. He had worn gloves and a mask which searching a stopped vehicle, but got it on his skin later when he brushed off. He had to be administered multiple doses of naloxone before he recovered.
The worst stories, in terms of the major public policy problems that surround opioids, are stories of people who have had to be administered lifesaving antidotes up to three separate times in the same 24-hour period. What can be done about those so determined to injure themselves is certainly beyond the scope of this piece, and is going to require a level of resources that is difficult to imagine.
There are 41 drug-related task forces in Ohio, and law enforcement is overwhelmed by the task of trying to “serve and protect” our citizens whose lives are dictated by access to opioids. John Born, director of the Ohio Department of Public Safety, was quoted in the Columbus Dispatch recently claiming that 20 kilos of fentanyl were taken off the streets in Ohio last week. Gov. John Kasich issued a plan in March limiting prescriptions of opioid analgesics to seven days for adults and five days for children. Ohio’s lawmakers are tackling the problem in every way they can imagine, as President Donald Trump mulls whether to declare a “national emergency.”
An extra $20 million was added to the Ohio biennial budget to be used for innovation in opioid product development, an area where there had been some progress recently. At the epicenter of the problem, scientists are working as hard as policymakers to mitigate the challenges.
The use of opioid analgesics for chronic and acute pain management—including neuropathic pain and post-surgical pain—has become commonplace and, while effective, can have unwanted side effects. The most extreme of these side effects is addiction, which people can transition to following recreational use or misuse and abuse of these drugs.
Reported separately in the Sunday edition of the Columbus Dispatch was a hopeful report on a novel delivery system. The company formed to manufacture this new product was initially funded by Ohio’s Third Frontier program, a ballot issue approved by Ohioans several years ago to facilitate generation of innovative products to the marketplace.
A pellet about half the size of a grain of rice delivers an analgesic that is designed to be nonaddictive. In a trial of 55 people, this analgesic has been injected into the intrathecal space of the lumbar spinal cord to mitigate pain from sciatica for up to a year with no major side effects. If it passes all the tests for efficacy and safety, this could offer at least one solution to one part of the problem we face as a nation.
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