Ohio Health Policy News

Ohio has launched a new website with data on drug overdoses in all 88 counties (Source: “New state dashboard helps communities better understand factors behind opioid overdoses,” Ideastream, March 9).

The state dashboard shows that nearly 1,500 people died in 2021 across the state from overdoses that included cocaine.

Local Ohio organizations working in drug addiction have often found it challenging to respond without reliable data about overdoses in their communities – especially as fentanyl exploded into the drug supply, said Ohio State University College of Social Work Professor Bridget Freisthler.

The National Institutes of Health-funded dashboard is part of an effort to learn what local tools are most effective in combating opioid misuse.

Funding from the OneOhio National Opioid Settlement could begin to come to local communities this fall, but policy delays could impede funding until 2024 (Source: “Target date set for opioid dollars,” Youngstown Vindicator, Feb. 13).

OneOhio Recovery, a private nonprofit, was created out of the National Opioid Settlement. It is tasked with distributing 55% of the money Ohio will receive from the pharmaceutical industry as a result of its role in the national opioid epidemic.

“This is the chance of a lifetime for Ohio. We have to do a good job,” said interim executive director of the Foundation, Kathryn Whittington.

Much of the structure and processes still are being decided by the 29-member board governing the foundation. The foundation was created in December 2021, but most board appointments were not finalized until May 2022.

According to a timeline provided to the members before their meeting Feb. 8, if a grant policy is approved in April, then funds should be distributed for regional projects and statewide initiatives in October. If the policy does not pass by April, funds may not go out until 2024.

The proportion of drug overdose deaths involving buprenorphine, a drug used to treat opioid use disorders, did not increase after relaxed access to the treatment drug during the COVID-19 pandemic, a new study says (Source: “Overdose deaths didn’t rise after prescription rules relaxed, study says,” Dayton Daily News, Feb. 4).

The study, published recently in the Journal of the American Medical Association, said that of approximately 74,474 opioid-involved overdose deaths, buprenorphine was involved in 2.6% of the deaths during July 2019 to June 2021. Although monthly opioid-involved overdose deaths increased, the proportion involving buprenorphine fluctuated but did not increase.

“Buprenorphine was approved by the FDA for treatment of opioid use disorder in 2002, and it has been shown to improve outcomes and even reduce the risk of death from an opioid overdose,” said Dr. Natalie Lester, chief medical officer of OneFifteen.

Analysis included in HPIO’s policy brief, Health Impacts of Tobacco Use in Ohio, found that while overall smoking rates have declined over the past three decades, this has not been the case for people with low incomes. As a result, low-income communities experience a much greater impact of tobacco use than communities with higher incomes. In 1995, Ohioans with very low incomes (less than $15,000 a year) were 36% more likely than those with higher incomes ($50,000 or more a year) to smoke cigarettes. By 2020, this gap had increased to 107%, as illustrated in the graphic above.

Ohio Gov. Mike DeWine vetoed legislation Thursday that would’ve preempted local bans on flavored tobacco (Source: “Ohio Gov. DeWine vetoes tobacco measure that would prohibit local bans,” Ohio Capital Journal, Jan. 6).

“This measure is not — is not in the public interest,” DeWine said of HB 513.

Because a new General Assembly has begun, DeWine’s office contends lawmakers can’t initiate a veto override.

Speaking Thursday, DeWine acknowledged the merit of uniform statewide policy. “The easiest way to do that, it seems to me, is to have a statewide ban of flavored cigarettes and flavored vaping,” DeWine said.

State health director Dr. Bruce Vanderhoff noted Ohio’s rates of tobacco use are higher than national averages, and tobacco remains the leading preventable cause of death in the state. According to Vanderhoff, deaths attributable to tobacco use top 20,000 a year. And treating tobacco-related illness isn’t cheap. According to the Health Policy Institute of Ohio, he said, health care costs tied to cigarettes are about $6.8 billion a year.

The Biden administration this week unveiled a new website that will track non-fatal opioid overdoses (Source: “The White House unveils a new system to track and better prevent opioid overdoses,” NPR, Dec. 8).

The new website will be updated every two weeks with reports collected at the county level by EMS first responders in all 50 states and the District of Columbia. Officials say the information will help shape the medical response when overdose clusters occur in different parts of the country.

Data on the new website will be managed by the National Highway Traffic Safety Administration, which collects EMS data. 

Officials acknowledge this data collection and reporting system will provide a limited snapshot of drug overdoses.

It focuses entirely on opioids — the leading cause of drug deaths — while excluding cocaine, methamphetamines and other substances. The website also won't include information from hospitals, schools, businesses, non-profits and academic programs that collect non-fatal overdose information.

Deaths due to substance abuse, particularly of alcohol and opioids, rose sharply among older Americans in 2020, the first year of the coronavirus pandemic, as lockdowns disrupted routines and isolation and fear spread, federal health researchers reported on Wednesday (Source: “Deaths From Substance Abuse Rose Sharply Among Older Americans in 2020,” New York Times, Nov. 30).

Deaths from opioids increased among Americans aged 65 and older by 53% in 2020 over the previous year, the National Center for Health Statistics found. Alcohol-related deaths, which had already been rising for a decade in this age group, rose by 18%.

Alcohol and opioid deaths remained far less common among older people than among those middled-aged and younger, and rates had been rising in all groups for years. But the pronounced uptick surprised government researchers.

Physiological changes that occur with aging leave older adults more vulnerable to the ill effects of alcohol and drugs, as metabolism and excretion of substances slow down, increasing the risk of toxicity. Smaller amounts have bigger effects, researchers have found.

The Ohio House passed legislation Wednesday that would legalize the possession of test strips used to identify the presence of fentanyl in illicit drugs (Source: “Ohio House votes to decriminalize fentanyl test strips,” Nov. 30).

The policy is aimed at expanding access to the strips, a harm-reduction approach designed to reduce the near-record level of Ohioans who fatally overdose on opioids year over year.

For the last several years, experts have warned that fentanyl – a powerful synthetic opioid – has entered the drug supply and is driving increasing rates of fatal overdoses. It’s often present in drugs without the user’s knowledge. The test strips are a cheap (they cost roughly $1) means of ensuring people know what they’re taking. Current Ohio law, however, classifies them as “drug paraphernalia.” Possession of them can yield a fourth-degree misdemeanor, punishable by up to 30 days in jail.

The legislation passed in the House with just four votes in opposition. It now heads to the state Senate, which has been considering similar legislation.

Improving access to fentanyl test strips is one aspect of harm reduction, a public health strategy aimed at decreasing risks surrounding drug use as opposed to an abstinence-only approach. Other strategies, outlined in an HPIO policy brief last year, include increasing access to naloxone (an overdose reversal drug); expanding syringe exchange programs, which reduce risk of bloodborne diseases; and improving Good Samaritan laws, which provide legal shields to those who help people overdosing seek access to emergency care.

As Columbus contemplates becoming the first city in Ohio to ban the sale of menthol cigarettes, data is starting to come in from areas that have implemented similar bans.

A new Canadian study has found that a ban on menthol has led to increased rates of quitting the use of tobacco products (Source: “Researchers find bans on menthol cigarettes sales can lead to higher tobacco quit rates,” WOSU Public Media, Nov. 14).

Menthol is a chemical tobacco companies began adding to cigarettes broadly in the 1950s, used to mask the harshness of cigarettes in efforts to expand the base of smokers.

The research found cigarette sales decreased by 11% and Canadians who smoked menthol cigarettes quit smoking at a rate of 22%, compared to 15% of non-menthol smokers. In Canada about 5% of smokers used menthols before the ban. But in the U.S., as many as 40% of smokers use menthols, and most Black smokers use menthol cigarettes, meaning a U.S. ban could lead to even greater increases in quitting.

The Centers for Disease Control and Prevention on Thursday softened its guidelines for U.S. doctors prescribing oxycodone and other opioid painkillers (Source: “US agency softens opioid prescribing guidelines for doctors,” Associated Press, Nov. 14).

The new CDC recommendations are an update to 2016 guidelines that added momentum to a decline in opioid painkiller prescriptions.

The previous guidance succeeded in reducing inappropriate and dangerous prescribing, some experts say. But they also were seen as a barrier to care, with some pharmacists refusing to fill prescriptions as doctors wrote them.

The new guidelines are designed to ensure that patients get compassionate and safe pain care, CDC officials said.

A draft released in February received 5,500 public comments. Some modifications were made, but several main changes stayed in place, including no longer suggesting limiting opioid treatment for acute pain to three days; dropping the specific recommendation that doctors avoid increasing dosage to a level equivalent to 90 milligrams of morphine per day; and urging doctors to not abruptly halt treatment for patients receiving higher doses of opioids unless there are indications of life-threatening danger.