Cuyahoga County Appeals for Assistance with Heroin/Fentanyl Crisis

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Christopher Harris: (216) 443-7157 or

Federal help sought in wake of 45 Heroin/Fentanyl Fatalities Occurring in May 2016

CLEVELAND - Cuyahoga County Executive Armond Budish, along with Cuyahoga County Medical Examiner Dr. Thomas Gilson, today announced that Cuyahoga County has requested additional funding and support to fight the heroin/fentanyl crisis.

"While our ongoing efforts to collaborate and cover all relevant aspects of our opioid problem have been worthy, it’s obvious that new and more aggressive strategies are needed," said Cuyahoga County Executive Budish. "It’s critical that we continue to address the heroin and fentanyl crisis we are facing in our community, which is why I have reached out to the U.S. Department of Health and Human Services requesting additional funding and support to address this growing – and evolving - problem."

Estimates extrapolated from federal drug survey results (SAMHSA) indicate Cuyahoga County may have up to 80,000 people misusing or abusing prescription opiate/opioids. As many as 20,000 may switch over to heroin and fentanyl use every year. According to SAMHSA and other federal statistics, at least 20 million Americans were classified as needing substance abuse treatment. Only 5% acknowledged the need for treatment, and only 1/3 of those acknowledging they needed treatment, actually sought out treatment. Estimates are that between 1,000 and 1,200 people sought treatment in Cuyahoga County last year, leaving tens of thousands without treatment.

In the request made to the U.S. Department of Health and Human Services, Cuyahoga County seeks assistance on 11 specific points (see attached letter). In general these are divided into the following areas:

Stopping the flow of new users is a critical step in slowing the rate of fatalities. The overprescribing of prescription opiates/opioids in the 90’s and 2000’s provided a ready-made client base for the Mexican cartels, who ramped up their heroin production five-fold in 2006, and dumped cheap heroin onto American cities. Now, those same cartels are producing fentanyl, which is much cheaper and more potent.

The request made to the Federal government includes changes to Medicaid reimbursement regulations which currently restrict facilities to 16 beds and require pain management satisfaction surveys as part of doctor evaluations, impacting reimbursement for treatment and promotion of over prescribing opiate/opioid pain medication.

Increased access to naloxone, the opioid antidote, is also being sought. The antidote is a crucial element in saving the lives of addicts who overdose. At the Atlanta Heroin Summit (March 2016) President Obama proposed a change to the current Medically Assisted Treatment (MAT) rules, allowing the number of patients that can be treated to increase from 100 to 200. Additional grants for treatment as an alternative to incarceration and in-jail treatment are also being sought.

Fatalities in the Cuyahoga County Medical Examiner’s Office jurisdiction increased over 10% in 2015 and are now increasing by similar amounts in 2016. Heroin/fentanyl overdose deaths are now on pace to double from 2015. The impact on medical, scientific and forensic staff and equipment is immense and slows response. Similarly, local law enforcement is seeing serious increases to their caseloads.

A coordinated and sustained effort by a long standing cooperative partnership of local, state and federal officials and agencies in Cuyahoga County still requires constant refreshing and support. The most current evolution of this long public health emergency threatens to overwhelm local resources and requires a serious State and Federal response, not just for Cuyahoga County, but Ohio as a whole and wide stretches of the entire United States.

Local Federal officials and agencies have been supportive and proactive partners and have sought additional resources to respond to the crisis. Still, the crisis continues. More resources, including increased funding and personnel are still needed and are a part of the County’s request.

"As our most recent numbers bear out, we are in the midst of a worsening problem with deaths from heroin and fentanyl, which continue to rise at a rapid rate. Our county response has been thorough and, in general, we have been a model for other jurisdictions," said Dr. Gilson. "In spite of so many local partners collaborating to address this emergency, we are being stretched to maximum capacity and having difficulty meeting increasing caseloads, both in Cuyahoga County and the adjacent jurisdictions we support. I appreciate Executive Budish's call for assistance at this critical time."

The ability to track and analyze data, in real time or as close to real time as possible is crucial in preparing not only response but also long term policy and intervention and education strategies.

A public awareness campaign is another important step to reduce those entering the opiate/opioid dependent population.

Heroin and fentanyl deaths continue to soar in 2016, as May would see a total of 45 deaths due to heroin, fentanyl, or a combination of the two. Within a six-day span (May 25th – May 31st), 15 fatal overdoses had occurred. May residential demographics are as follow:

19 – City of Cleveland Residents
26 – Suburban Residents
Brecksville, Brook Park, Chagrin Falls, Cleveland Heights, East Cleveland, Lakewood (2), Maple Heights, Mayfield, Mayfield Heights, Oakwood, Olmsted Township, Parma (5), Parma Heights, Strongsville, and 5 out of county residents (Aurora, Chesterland, Elyria, Newbury, North Ridgeville)

With Cuyahoga County’s heroin and fentanyl deaths reaching record-breaking numbers, state and national leaders have weighed in on the crisis:

Congresswoman Marcia L. Fudge (OH-11):
"Forty-four deaths in the month of May is nothing short of tragic. There is no time to waste. I urge my colleagues at all levels to use every available resource to combat this deadly epidemic. We must get excess prescription and illegal drugs off our streets, increase access to treatment, reform the way we treat drug abuse in our criminal justice system, and continue efforts to educate both the public and physicians about the risks of opioid use. We cannot lose another life."

U.S. Senator Sherrod Brown:
"The opioid epidemic has shattered families across Ohio and has hit northeastern Ohio particularly hard. With over 40 opioid-related deaths in Cuyahoga County in the last month alone, it is clear we aren’t doing enough to curb addiction and treat those who need help. Our communities need real investment to tackle this problem."

Congresswoman Marcy Kaptur (OH-9):
"These latest numbers are startling, and upsetting. They are a cruel reminder of the families whose lives are being torn apart by the heroin and opioid epidemic."

U.S. Senator Rob Portman:
"After years of listening to those in recovery, advocates, local governments and law enforcement – and working in Congress to pass legislation to make resources available to our communities to assist with education, treatment and recovery – these latest numbers make me more determined than ever to get federal legislation signed into law so it can begin to make a real difference in the lives of those who are suffering from addiction in Cuyahoga County and across our state and nation."

David Fowler, MD (National Association of Medical Examiners):
"The increased caseload of over 10% for many offices for the last 2 years in a row is devastating. In order to maintain accreditation many offices will need to add pathologists in the face of a significant shortage."

David P. Corey (Ohio State Coroners Association):
"As it stands, death investigation systems are being stretched beyond capacity. It is becoming increasingly clear that a comprehensive response that includes adequate funding is required."

At least 197 deaths have occurred due to heroin, fentanyl, or a combination of the two in 2016. For more information on the Cuyahoga County Heroin Initiative, please visit: