The death rate for opioid overdoses in Appalachia’s 420 counties nationwide was 72% higher than non-Appalachian counties in 2017, a new study found.
Appalachian counties reported 24 deaths by opioid overdose per 100,000 residents compared to 14 deaths per 100,000 residents in non-Appalachian counties, according to the study by the National Association of Counties (NACo) and the Appalachian Regional Commission (ARC).
The two groups released the report, “Opioids in Appalachia: The Role of Counties in Reversing a Regional Epidemic,” in an effort to combat the opioid epidemic that has plagued Ohio as well as the rest of the country.
“The opioid epidemic is like nothing we’ve seen before, and it has wreaked havoc on communities across the country, especially in Appalachia,” said Matthew Chase, NACo’s executive director, said in a release. “The good news is that county leaders are tackling the crisis head on.”
Ohio had the second-highest number of opioid-involved overdose deaths per capita in 2017 behind only West Virginia, according to a report from the U.S. Centers for Disease Control and Prevention. There were 4,293 overdose deaths involving opioids in 2017, a 19% increase from 2016.
“If you look at the history of the opioid epidemic, Appalachia was an early hot spot and it continues to be,” said Lisa Roberts, a registered nurse with Portsmouth City Health Department in Scioto County.
Appalachian counties have been struggling with the opioid epidemic for about two decades, she said.
“There was a time when pain pills were like currency,” she said.
The report makes five recommendations to Appalachian county leaders. The first suggests having county agencies, community leaders, business leaders and faith-based organizations create opioid task forces. Other recommendations include creating and strengthening preventive and educational initiatives, and expanding access to addiction treatment.
The report also recommends getting county law enforcement to crack down on people selling illegal opioids, and working with physicians and pharmacists to monitor opioid prescriptions and report physicians who are over-prescribing. Finally, the report suggests counties work with businesses to provide economic opportunities for people in recovery.
“As those on the frontlines, local officials understand well the tragic toll this crisis exacts on their communities,” Tim Thomas, co-chair of ARC federal, said in the release. “Collaborative efforts like this help give those leaders the tools and information they need to develop local solutions. My hope is that this effort will be a benefit to local officials as they work to address this pervasive challenge.”
The report detailed seven case studies, including one from Ross County, which has Ohio’s third highest overdose mortality rate with 112 fatal overdoses between 2014 and 2016.
Every court in Ross County has an embedded drug court, and almost every first responder is equipped with the overdose-reversing naloxone medication and is trained on administering it, according to the report. Opioid overdose deaths in Ross County decreased from 44 to 33 in 2017, the first year-to-year decline since 2013, according to the report.
Making naloxone readily available and expanding access to addiction treatment are ways Appalachian counties can fight the opioid epidemic, Roberts said.
Ross County’s Alcohol Drug Addiction and Mental Health Services Board is starting a program funded by the state that will reimburse employers for drug testing, train supervisors on how to manage individuals in recovery and establish a forum for information exchange among employers willing to hire individuals in recovery, the report says.
Ross County also works alongside South Central Ohio Jobs and Family Services (SCOJFS), which provides public assistance, employment programs and child protective services to Ross, Hocking and Vinton counties. SCOJFS leaders suggest Appalachian counties take a unified, combined approach in fighting the opioid epidemic.
A problem with these programs, however, is the lack of unrestricted grant funding, according to the report. Stringent grant requirements, the report found, can make it difficult to identify target populations and limit the flexibility of the county to spend money as challenges arise.