Middletown was once hailed as an All-American City — a national portrait of the American dream. In recent years it got a different label: the epicenter of the nation’s heroin epidemic.
The numbers didn’t entirely support that national name, but pictures have power — and Middletown’s image felt overtaken by one of a passed-out person on the street getting revived by Narcan.
People are still dying from overdoses in Middletown and throughout Butler County, but not nearly as many as one year ago.
As Ohioans continue to lose a record numbers of lives and billions of dollars in economic activity to the opioid crisis, a multi-pronged approach in cities across Butler County is responsible for fewer overdose deaths, officials say.
“We recognize that this epidemic is too large and too complex to address through any one-size-fits-all approach,” Hamilton Police Chief Craig Bucheit said, adding that outreach, not just law enforcement, has helped to slow heroin’s destructive force.
Lawmakers, social workers, medical professionals and first responders have been working relentlessly to reverse the ever-growing number of deaths due to opioid, and their efforts appear to be starting to work throughout Butler County.
During the first seven months of 2018, Middletown reported a 54 percent drop in emergency runs for drug overdoses compared to 2017.
Overdose deaths are also trending down, according to city records.
There were 532 overdoses in Middletown, including 74 fatalities, in 2016. Those numbers jumped to 966 overdoses and 77 fatalities last year. Through the first six months of 2018, there have been 224 overdoses, 23 of which were fatal.
Middletown Fire Chief Paul Lolli credits what he calls “the whole package” for reducing the number of overdoses in the city, including enforcement from the Middletown Division of Police and the State Highway Patrol, which he said are doing an “awesome job getting the dealers out of here.”
“There is a difference between that dealer and that user,” Lolli said. “We had to identify that and get those people help and get the bad guys out of town.”
There are now five drug task forces, such as the Heroin Summit in Middletown and the Fairfield Opiate Task Force, operating in Butler County and several drug prevention coalitions in the area’s high schools. Several communities have also developed or are in the process of creating quick response teams, which pair a social worker, medic and police officer to help those who overdose.
Hamilton Police Chief Craig Bucheit said his city is also seeing success in fighting the epidemic, with a 30 percent reduction in overdoses and a more than 70 percent increase in drug-related arrests this year.
However, Butler County Sheriff Richard Jones said while all these efforts are making a dent, a big reason for the lowered statistics is because most of the users have died.
More than 800 people have died from opiate overdoses from 2012 through July 2018.
“It appears to some that heroin use is maybe starting to reduce in this county and across the country, but I tell you the serious heroin users — in the past five years we’ve probably had close to 1,000 deaths — the real serious ones, they all died,” Jones said. “It’s supply and demand. If the demand isn’t there the supply will go to something else that people will use. Some people doing the next drug down are scared enough not to do (heroin).”
Jones said of the 1,000 prisoners in the county jail, he’d estimate around 700 have some type of drug addiction.
Some local officials agree that this is not just an opioid problem.
“We have an addiction problem,” said Ohio Rep. Jim Butler, R-Oakwood. “It’s always going to be something, and in order for us to be able to help the people that are suffering from addiction and to stop the drug traffickers that are praying on Ohioans, I think we need that comprehensive solution.”
Ohio is No. 2 behind West Virginia among states with the highest rates of deaths due to drug overdoses. Ohio had 39.1 overdose deaths per 100,000 people in 2016 while West Virginia had 52 deaths per 100,000 residents. Neighboring Kentucky is fifth on that list with 33.5 drug overdose deaths per 100,000. And Butler County is No. 5 in Ohio in unintentional overdose deaths, according to the Ohio Department of Health.
This opioid epidemic is also different than what people think of when it comes to drug addiction or drug abuse of the past, said Scott Rasmus, executive director of the Butler County Mental Health and Addiction Recovery Services Board.
“This epidemic is more related to white, middle-aged, maybe more middle class folks than other drugs of choice or addictions of the past,” he said.
The average user who dies from a drug overdose and are slightly younger than middle age white men and women. In 2016, the average age was 41.3 years old and 93.8 percent were white men and women.
A lot of the addiction came from pain management through doctors and pharmaceutical companies advocating for opiates “and there wasn’t a realization or an understanding of the addiction perspective,” Rasmus said.
People are dying not just from one type of drug, said Tiffany Lombardo, director of Addiction Services at the Butler County Mental Health and Addiction Recovery Services Board.
“More and more it’s poly-substance. They’re addicted to multiple substances at this point. The addiction is taking over,” she said. “You’re not seeing like we did five, seven years ago the people that came in that were addicted to prescription drugs, and that was it. It’s whatever they can get their hands on.”
OPIOID CRISIS: 5 key events that spurred Ohio’s opioid epidemic