CINCINNATI -- It's no secret that synthetic opioids like fentanyl have driven an increase in overdose deaths.
Dr. Jennifer Mooney, with the Cincinnati Health Department, made clear Monday just how bad the problem has become: In the past five years, there's been a 1,000 percent increase in deaths from synthetic opioids in Hamilton County.
Fatal overdoses from those drugs now surpass heroin.
Half of opioid-related overdose deaths in 2016 were due to fentanyl, a synthetic opioid 50 to 100 times more powerful than heroin. Another, carfentanil, is 10,000 times more potent than heroin -- so strong it's used to tranquilize elephants. Synthetic opioids are being mixed into other street drugs, such as cocaine. The theory, Mooney said, is that drugs are being cut so many times before they hit the market that nobody really knows what's in them.
"So it's kind of terrifying," she said.
More drug users also are being diagnosed with deadly illnesses, such as hepatitis C and HIV. Mooney said that doesn't take into account the effects on drug users' families, and the first responders called to help them.
But she also sees reason for hope in efforts to turn the tide against an epidemic that's gripped the Tri-State for years now. Data suggests first responders are saving lives when they treat a person with naloxone, the opioid-reversal drug. That person might not quit abusing opioids right away -- police and firefighters have plenty of repeat cases. Mooney thinks it's important to take a longer view.
"They're buying people time," she said, "because we don't know and we can't decide for people when they're ready for treatment."
Hamilton County had 570 total overdose deaths last year. From 2016 to 2017, HIV cases increased 250 percent among people who inject drugs, and 42 percent overall. Cases of hepatitis B and C also increased sharply.
That's why Mooney says needle exchange programs are so critical. Through the Needle Exchange, people who inject drugs are given a clean syringe for each used syringe they bring in. The program had 5,213 visits in the first six months this year, exchanging 200,000 needles that otherwise could've been dumped on the streets.
People also are offered testing for HIV and hepatitis C; the Exchange has given hundreds of those tests so far this year.
Preventing a single case of HIV or four cases of hepatitis C offsets the costs of the entire program for the year, Mooney said.
The Health Department also sees hope in medication-assisted treatment. Those patients have lower relapse rates and fewer fatalities, fewer arrests, and more employment and family stability, Mooney said.
She also recognizes there are a lot of unknowns. Are public dollars being spent the best way to serve the most people? What are the long-term effects of mass addiction on future generations?
Concerned about repeat overdoses, Councilman Jeff Pastor said he recognizes many have an underlying mental health issue. He told Mooney he wanted to be sure the city's efforts got to the core of the problem.
"I don't want to be treating the symptom," he said.