Fewer Crawford County residents died from an unintentional drug overdose in 2021 than in any year since 2013, according to Crawford County Drug Overdose Fatality Review’s annual report.
But at the same time, 153 Crawford County residents went to an emergency room or urgent care center for overdose treatment — the most since 157 were reported in 2018, according to Crawford County Public Health’s annual report. In 2020, 140 overdoses were recorded.
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“We are fortunate that all of our first responders in Crawford County carry naloxone, and I do believe that plays a big part in that,” said Kate Siefert, county health commissioner, who prepared both reports. “And we have more distribution of naloxone, so while we might have more overdoses, we’re having less deaths. That’s a good start for our community, but we still have a long ways to go.”
In five of the seven overdose fatalities, fentanyl was listed in the toxicology, she said.
“I still would like to explore with our community the option of distributing fentanyl test strips,” she said.
It’s not about making it easier for people to use illegal drugs, she explained.
“A lot of time people just struggle with understanding the concept of that you have to do a lot of harm reduction as you step them toward treatment and then recovery. You really have to surround them with the tools to keep them safe and not dying until you can get them to the point of being ready for treatment.”
Getting off opioids isn’t the same as giving up pop for Lent, Siefert said.
“It’s not the same as cutting out cigarettes or anything like that,” she said. “When you’ve been exposed to opioids, your brain has been physically changed and the giving is just so much harder. It’s different — very different — behavior modification.”
She hopes to foster more talk in the community about the need for harm reduction tools, such distributing naloxone, using fentanyl test strips and keeping drug users safe until they’re ready for treatment. “And then of course we need more treatment options here locally as well.”
The Drug Overdose Fatality Review —which includes representatives of the county coroner’s, prosecutor’s and sheriff’s offices; Crawford County Public Health; Crawford-Marion ADAMH Board; Marion-Crawford Prevention Programs; and a local funeral home — meets quarterly to review and share information in an effort to better understand the circumstances surrounding these deaths, then develop local
recommendations to prevent drug overdose deaths, according to the report.
Of the seven people who died in 2021, five were women, according to the report. Three lived in the 44820 (Bucyrus) ZIP code; three in 44833 (Galion) and one in 44887 (Tiro area). The average age was 41, with a range from 34 to 66.
Five of the people died at home, the others at a friend’s home. None were married at the time of death, though two were divorced and two were widowed, according to the report. At least seven children younger than 18 years lost a parent to drug overdose in 2021.
None were in the military or a veteran, the report also notes. Two had some college credit, but no degree; three had a high school diploma or GED; and two attended through 12th grade but did not have a diploma. Four had been in trouble with law enforcement in the past, and three had lengthy juvenile and adult records.
The review found indications that two individuals had been previously referred to treatment.
Not all of the 153 accidental overdoses involved illicit drugs, Siefert pointed out.
“It could have been a prescription drug overdose, it could have been an opioid; it’s a mix,” she said. “And I think what a lot of people forget is you can still have an overdose with over-the-counter medications.
“The storage and how you secure them in your home — especially if you live with toddlers — is very important.”
Eight children age 3 or younger were taken to an ER for a possible drug overdose in 2021, according to the health department’s annual report.
These were children who got into prescription medication belonging to a parent, sibling or grandparent, she said. In every case, a parent said, “I just turned my back for a second,” Siefert said.
“How scary of a moment for those families to realize their toddler may have taken something,” she said. “And one was blood-pressure medications — an adult’s blood-pressure medications — which for a small toddler, that could have been a bad moment.”
Fortunately, none of the cases were fatal, but it’s a reminder to be sure medications are stored safely, she said.
For more than a year, Siefert has been able to access the state’s EpiCenter database, which allows her to see triage notes from emergency rooms and urgent care centers. It has given her much better understanding of what’s behind the numbers, and cleared up some mistaken assumptions.
“When we saw there was a toddler with an overdose, we often would just make that assumption that a toddler got into their parents’ illicit drugs accidentally,” she said.
Now health officials know they need to help people understand the importance of safe storage of over-the-counter and prescription drugs.
“Reading the triage notes, we can now use that with the prevention coalition to fine-tune that messaging and to say look, eight children last year,” Siefert said. “Eight children in this tiny little county almost had a really bad day, and those families almost lost a loved one. And this could happen to any of us because we all have Tylenol, we all have cold medicines. All these things we store in the home, but how careful are we when a toddler’s around?”
Among adults, particularly the elderly, confusion about medications can be a factor, she said. In the case of a 102-year-old resident, it was a new pill box.
“Instead of taking seven different medications by going across the pillbox, they went down and they took seven times the one medication,” Siefert said. In another case, a new caregiver reorganized the person’s medications, “thinking it was helpful.”
“It’s important to remind ourselves, when we’re caring for seniors, how important these routines are,” she said.