The Departments of Public Health for both Columbus and Franklin County, Ohio issued an advisory Wednesday, June 19, 2019 in response to increased cases of drug overdose and called on residents to engage in harm reduction practices. This advisory is evidence of an important shift taking place in cities, counties, and states across the country as officials have begun to perceive addiction, and the opioid crisis specifically, as a public health epidemic as opposed to a crime epidemic. In the wake of the opioid crisis, jurisdictions across the United States are moving away from criminalizing and stigmatizing addiction and moving toward treating it and reducing its potential for harm. Treatment is important, but a person must first be living to access and benefit from it.
The opioid crisis has affected countless Ohioans. The most recent data from 2017 shows that Ohio had the second highest drug overdose death rate in the country, with a rate of 39.2 deaths per 100,00 people, nearly three times the national average. The mixing of fentanyl with many illicit drugs bears responsibility for the most significant increase in overdose deaths. Between 2012 and 2017, the number of deaths involving synthetic opioids increased by nearly twenty-fivefold. In its advisory, the Columbus Public Health Department added that “Fentanyl is being mixed with all street drugs, including meth and cocaine.” In Franklin County specifically, overdose deaths involving fentanyl increased from 144 in 2016 to 346 in 2017.
Both departments urged recreational drug users and all those affected by a substance use disorder to access naloxone, a drug that can save a person’s life in the event of an overdose if received soon enough; use strips that test drugs for the presence of fentanyl; and call 911 immediately in the event of a suspected overdose. Columbus Public Health provided free naloxone and fentanyl test strips for four hours Wednesday at a harm reduction clinic in the city and informed residents of where they can access harm reduction products at other times.
Last year the Surgeon General issued a rare public health advisory—the last one was issued in 2005 and related to alcohol consumption during pregnancy—urging Americans to carry naloxone and familiarize themselves with how to use it, as they would an EpiPen. Columbus Fire and EMS units have been carrying and administering naloxone for over forty years, and Columbus Police began carrying it in 2016. An assistant fire chief in the city estimated last year that his units use the often life saving drug on an average of 10 patients per day. While its use by first responders has saved countless lives, emergency personnel cannot always arrive in time to use it. For this reason, the Surgeon General’s advisory and Columbus’ efforts to make naloxone more accessible to all represents a significant step toward saving more lives.
Recent statewide legislation in Ohio has also evinced this trend toward harm reduction. In 2017 Ohio expanded its Good Samaritan law to provide criminal immunity for possession of small amounts of controlled substances for those who contact emergency personnel in the event of an overdose experienced by themselves or someone else. An extension of this law that would also provide immunity for the possession of drug paraphernalia, such as a syringe, in such situations is currently being reviewed by the House Criminal Justice Committee. Ohio also recently passed a law that made naloxone available in pharmacies without a prescription, and a Senate bill has been introduced to expand pharmacist education in its dispensing.
While the need to issue the advisory in Ohio shows the extent to which opioid misuse continues to ravage communities across the country, the emphasis on harm reduction in the departments’ response is what will likely curb some of its toll.
The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.