A record number of Ohioans died from drug overdoses last year thanks in part to abuse of a synthetic painkiller far more powerful than heroin, the Department of Health said Thursday.
The state said 2,482 people died from accidental overdoses in 2014, an 18 percent increase over the previous year and a reminder of the severity of a problem haunting the state for more than a decade.
Abuse of the painkiller fentanyl, which is often combined with heroin or sometimes mistaken for it by addicts, is a significant contributor to the increase, the department said.
Fentanyl was involved in 502 drug overdose deaths last year, up from 84 the previous year. Fentanyl is a controlled substance prescribed for people with severe pain. But the version being abused in Ohio is entering the state as a synthetically manufactured illegal drug, authorities said. It is 30 to 50 times more powerful than heroin, according to the Health Department.
Addicts may not know when fentanyl has been combined with other commonly abused drugs such as heroin, increasing the chance of death, said Andrea Boxill, deputy director of Gov. John Kasich's Cabinet Opiate Action Team.
Hamilton, Montgomery and Summit counties led the state in the number of fentanyl-related deaths.
Last year's overdose deaths also included a record 1,177 related to heroin, up from 986 in 2013.
Fatal drug overdoses remain the leading cause of accidental death in Ohio, above car crashes, a trend that began in 2007.
State officials ticked off efforts underway to combat the problem, from prescription drop-off programs to tighter prescribing rules to successful law enforcement efforts.
But the most effective response is keeping people from becoming addicted in the first place, said Tracy Plouck, director of the Department of Mental Health and Addiction Services.
"Ultimately that is going to be the only thing that ultimately stems the tide of this epidemic for our state," she said.
An important step is reducing the "family and friends fund" of drugs, typically leftover medication, sometimes years old, that poses a risk to people's children and their friends, said Dr. Mark Hurst, medical director of the state addiction services agency.
"If you want to know what you can do for this, it's clean out your medicine cabinet," Hurst said Thursday.
The addiction crisis has its roots in the development of a new generation of painkillers, such as oxycodone in the late 1990s, which were both highly effective and addictive.
Those addictions fueled a rise in pill mills, or pills-on-demand clinics where huge numbers of painkillers were prescribed to people paying in cash after only a cursory examination.
A 2011 law resulted in the elimination of most, if not all, of such clinics, which tended to cluster in southern Ohio. But the closing of those mills coincided with an increase in the supply of heroin, which was more readily available and much cheaper than illegal pills.
Even as authorities cracked down on heroin, a new problem emerged in the form of fentanyl. In addition to its impact on adults, the drug has been blamed for the deaths of two babies in Columbus in May who somehow ingested fentanyl-laced heroin. Their parents face involuntary manslaughter and child endangering charges.
Lawmakers have tackled several bills to reduce drug overdose deaths in recent years, including a law expanding the availability of a drug overdose antidote.