Stats don’t explain Ohio’s surge in heroin deaths

Ohio, Texas and California are similar in several important respects, but the Buckeye State differs in one tragic way, a report released Tuesday says.

Each is a large and urban state and, before the heroin epidemic in 2010, the amount of opioids prescribed per person was relatively close to the national average.

Yet, unlike the other two states, the rate of heroin deaths in Ohio spiked between 2010 and 2015, becoming the highest in the country. For the rate of opioid deaths overall, Ohio ranked third behind neighboring West Virginia and Kentucky, respectively.

The differences between the big states could hardly be more stark.

In Ohio in 2015, more than 12 people per 100,000 died of heroin overdoses. For Texas and California — both states on the border with Mexico, where much of the heroin supply is said to originate — that figure was less than two.

The report, Heroin Highways: Fueling the Opioid Epidemic, is an analysis of federal data by Seattle-based LiveStories, which crunches numbers for cities and other public entities. It asks — but does not answer — why illicit drug sales took such a strong hold in Ohio.

“The question of ‘Why Ohio?’ could well be posed to illegal drug traffickers,” the report says. “What did they see in Ohio that made it seem like a lucrative investment for market expansion?”

One reason might have to do with the Buckeye State’s location, said Cheri Walter, CEO of the Ohio Association of County Behavioral Health Authorities, whose members treat Ohioans caught in the grip of the epidemic.

“We are part of the superhighway,” she said Monday. “A whole lot of drugs pass through going north and south and east and west.”

The LiveStories report points out that Ohio cities are some of the nearest urban centers to residents of West Virginia and Kentucky, where far more opioids were being prescribed per capita in 2008, at the peak of over-prescription, than the national average. Kentuckians were getting 163 percent of the national average, West Virginians were getting 150 percent and Ohioans received 115 percent, according to U.S. Department of Health and Human Services figures.

“Before 2010, West Virginia was already ground zero of the opioid crisis, even before heroin entered the picture,” the report says. “Kentucky, Ohio’s other southern neighbor, was trending well above the national average for years.”

Also, the federal data used in the LiveStories report might not capture the extent of the prescription opioid epidemic in Ohio prior to 2010, Walter said.

“The epicenter was the pill mills and the pill mills were in southeastern Ohio — Scioto County,” she said. “And pill mills weren’t reporting their prescriptions. It was cash and carry.”

The flood of heroin into Ohio after 2010 wasn’t a complete surprise, Walter said. Once public attention was focused on the pill mills, state and federal authorities cracked down, creating a vacuum for opioid users.

“We saw it coming,” Walter said. “They closed the pill mills, which was a good thing.”