A thousand ODs hit Hamilton County in two months

Hamilton County hospital emergency workers handled 1,004 overdose cases since the elephant opioid carfentanil was identified in July in heroin here. That's an average of nearly 15 overdoses a day.

"This is a large number of emergency department visits for drug-related activity in a relatively short period of time," said Hamilton County Health Commissioner Tim Ingram.

"Overall, this is indicating that we've got a massive infusion of heroin in our county," said County Commissioner Dennis Deters, chairman of the Hamilton County Heroin Coalition.

The count, released to The Enquirer on Thursday, includes emergency room information from July 15 through Sept. 21. It includes possible overdoses that entered the hospitals, not diagnosed cases. It includes all overdoses and not just heroin- and opioid-related overdoses, health department officials cautioned.

That's because the Hamilton County Public Health's EpiCenter surveillance system shows only the initial intake of people, whose first record in an emergency room was marked with "overdose" or "OD." The cases could be from anything from aspirin to alcohol, prescribed medications to heroin, the health officials said.

The reported numbers include a deluge of 174 overdoses in a five-day period in a focused area, primarily on the west side of Cincinnati.

Since then, overdose runs per day have dropped significantly but continue on a pace far above what they were before July 15. Before July 15, Hamilton County had from 20 to 25 such cases a week. Now it's 20 to 25 overdose runs in a day, said Newtown Police Chief Tom Synan, who heads the law enforcement task force within the coalition.

The heroin coalition uses the information, combined with overdose indications from first responders in the county, to decide when to put out alerts to mobilize for an influx of overdoses.

During the barrage of overdoses from Aug. 19-24, the alerts went to hospitals, treatment providers, police and fire departments so they could better prepare for and respond to what they were facing.

"We took the EpiCenter reports which showed high numbers of people coming into ERs with the chief complaint of overdose and filtered some numbers to heroin-related calls," Synan said. "Speaking to the 1,004 number, I think it does show we are better off monitoring the situation.

"Never before would law enforcement, the health department, ERs and firefighters have shared this type of information until we had the coalition," Synan said. "It gives us an idea of what is happening on the street, and we then can share information with the public."

Deters said people brought to or dropped off at Hamilton County emergency rooms were from not just the city and the county but also from surrounding areas.

Even so, Deters believes "there is a significant market" for drugs in Hamilton County, adding, "That is, frankly, concerning."

He said he's concerned about "first-responder fatigue" and spoke with the Cincinnati Fire Department firefighters who responded to many cases in District 3, on the city's westside. "Firefighters in the city were out of gas," Deters said. "It's a major problem that we need to consider."

The coalition is discussing improved systems of tracking overdoses so that, in the event of another barrage, first responders can be better deployed to prevent such fatigue.

Ingram, Synan and Deters said the coalition is working to provide more precise data to help the county fight the heroin epidemic.

“This highlights the magnitude of the drug problem we’re facing in Hamilton County," Ingram said. "The disease of addiction is serious and can be deadly.  We need to follow-up on this data with opportunities to get people into medically assisted treatment to end the addiction cycle and reduce the number of overdose incidents we’re seeing.”