Overdose deaths are down nationally, but up in many Western states

Despite an encouraging national dip in the past year, overdose deaths are still on the rise in many Western states as the epicenter of the nation’s continuing crisis shifts toward the Pacific Coast, where deadly fentanyl and also methamphetamine are finding more victims. Overdose deaths remain sharply higher since 2019. Many states are working on “harm reduction” strategies that stress cooperation with people who use drugs; in some cases, states are getting tougher on prosecutions, with murder charges for dealers. Alaska, Nevada, Washington and Oregon have moved into the top 10 for rate of overdose deaths since 2019, according to a Stateline analysis of federal Centers for Disease Control and Prevention data. Meanwhile the biggest one-year improvements were in Nebraska (down 30%), North Carolina (down 23%), and Vermont, Ohio and Pennsylvania (all down 19%). The spread of fentanyl, a synthetic opioid that can cause overdose and death even in tiny amounts, explains much of the east-to-west movement in the number of deaths, said Daliah Heller, vice president of overdose prevention program at Vital Strategies, an international advocacy group that works on strengthening public health. “Fentanyl really came in through the traditional drug markets in the Northeast, but you can see this steady movement westward,” Heller said. “So now we’re seeing overdoses going up on the West Coast while they’re going down dramatically on the East Coast.” The provisional CDC data estimates drug overdose deaths in the year ending with April 2024, and nationally they decreased by 10%, with more than 11,000 fewer deaths than the year before. But they’re still rising in 10 states and the District of Columbia, including 42% in Alaska, 22% in Oregon, 18% in Nevada and 14% in Washington state. Deaths climbed by almost 1,300 in those states and others with more modest increases: Colorado, Utah and Hawaii. Experts are still debating why some Eastern states hit early in the overdose crisis are seeing improvements. “There’s some kind of improvement spreading from east to west and we don’t know exactly what it is yet. Everybody sees their little piece of the elephant,” said Nabarun Dasgupta, a scientist specializing in opioid disorder and overdose at the University of North Carolina’s Injury Prevention Research Center. In North Carolina and other states with recent improvements, “it feels like we finally got a lid on the pot, but the pot is still boiling over. Things aren’t really cooling down,” Dasgupta said. It could be a result of better acceptance of harm reduction policies to help those who use drugs, including no-questions-asked testing of street drugs and providing naloxone to counteract overdoses. Or users may simply be getting more wary of fentanyl and its dangers and unpleasant side effects, Dasgupta said. “Fentanyl is very potent, but potency isn’t the only thing. Otherwise we’d all be drinking the highest proof IPAs (India pale ales),” Dasgupta said. Alaska now has the nation’s second-highest rate of drug overdose deaths, about 53 per 100,000 population, behind only West Virginia (73 per 100,000). Other Western states that are now in the top 10: Nevada (47 per 100,000), Washington state (46 per 100,000) and Oregon (45 per 100,000). The CDC data shows Alaska had the largest increase from 2023 — up 42%, to 390 deaths. Republican Gov. Mike Dunleavy in August 2023 proposed legislation making fentanyl dealers subject to murder charges in overdose death cases, writing: “Drugs and drug overdoses have had a devastating effect on our state.” The legislation was signed into law this year. In May, the state kicked off “One Pill Can Kill,” a national awareness campaign warning about the dangers of fentanyl. Fentanyl, mostly in the form of counterfeit 30 mg oxycodone pills, has become tremendously profitable for smugglers in Alaska who make use of airline passengers and air shipments of other products to get drugs into the state, said state Department of Public Safety spokesperson Austin McDaniel. Pills that sell for less than $1 near the U.S. southern border with Mexico can fetch $20 in Alaska, McDaniel said. “We want to make the dealers think twice about targeting Alaska,” said Alaska state Rep. Craig Johnson, an Anchorage Republican, who supported the bill signed into law July 12. Johnson’s 23-year-old nephew died of a fentanyl overdose two years ago. “This is personal. I don’t want other Alaska families to go through what we went through. I hope we never have to use it, because that will mean nobody else died.” Other state and federal authorities are also trying a more punitive approach to the fentanyl crisis: Under a state program in Wisconsin meant to ferret out suppliers, three people were arrested in September and charged with first-degree reckless homicide in the fentanyl overdose death of a 27-year-old man. In Michigan, two men pleaded guilty this month to federal charges in a mass fentanyl poisoning that led to at least six deaths. Such punitive approaches can backfire, experts say, if they drive people toward more dangerous solitary drug use — where no one can see an overdose and try to help — and away from programs such as free testing to unearth fentanyl hidden in other drugs. “It’s sort of nonsensical, like saying you can beat something out of people. People are still going to use drugs,” said Heller, of Vital Strategies. “This should be a call to action to wake up and really invest in a response to drug use as a health issue.” In Nevada, health authorities in the Las Vegas area are stressing more cooperation with residents who use drugs, increasing naloxone distribution and encouraging people to submit their drug purchases for testing so they’re not surprised by counterfeit heroin, methamphetamine or other drugs that are increasingly cut with cheaper fentanyl, said Jessica Johnson, health education supervisor for the Southern Nevada Health District. A state office coordinates goals for county naloxone distribution based on factors such as hospital reports of overdoses. More overdoses trigger more naloxone distribution to community centers, clinics, entertainment venues and even vending machines. One puzzle in Nevada and in other states is that increasingly, overdoses involve a combination of opioids, such as fentanyl, along with stimulants such as methamphetamine. Almost a third of overdoses in Nevada are caused by both being used together, according to a state report based on 2022 data. It could be that some people seek the “roller coaster of effects using a stimulant like methamphetamine and a depressant like fentanyl or heroin,” Jessica Johnson said, but mostly she hears that unsuspecting users get cocaine or methamphetamine that’s been cut with cheaper fentanyl. “We get people saying, ‘Oh I don’t need naloxone because I don’t use fentanyl,’ and our team is able to say, ‘Well, our surveillance data actually suggests there might be fentanyl in your methamphetamine’ or whatever it is.” Nationally, both drugs are increasingly a factor in fatal overdoses: Synthetic opioids such as fentanyl contributed to 68% of overdose deaths in this year’s CDC data, up from 48% in 2019. Stimulants such as methamphetamine were factors in 35% of deaths, up from 20% in 2019. Heroin and other partly natural opioids, such as oxycodone, have diminished as factors, together accounting for 13% of deaths in the latest data compared with 40% in 2019. Some experts theorize that the high potency of fentanyl makes those who use drugs want to tweak or balance the effect with methamphetamine. Fentanyl itself is often cut with xylazine, a non-opioid animal tranquilizer — often known as “tranq” — that can cause unpleasant side effects, including extreme sedation and skin lesions, Dasgupta said. “During the pandemic, there were a lot of reasons why people were using substances more. Now that things are different, people are tired of the adulteration, the sedation, the skin wounds,” Dasgupta said. “People may take lower doses, and that in itself can help lower overdoses.” Ohio Capital Journal is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Ohio Capital Journal maintains editorial independence. Contact Editor David Dewitt for questions: info@ohiocapitaljournal.com. Follow Ohio Capital Journal on Facebook and X.

Overdose deaths are down nationally, but up in many Western states

Sherrod Brown leads the charge on border security and fentanyl crackdown

U.S. Sen. Sherrod Brown (D-Ohio) has long been known for his advocacy on behalf of working families and his ability to work across party lines. Brown’s recent efforts have focused on two critical areas for Ohioans: border security and the fight against fentanyl trafficking. Through bipartisan cooperation, Brown has pushed forward significant legislation designed to secure the U.S. southern border and combat the deadly opioid epidemic that has ravaged communities across Ohio and the nation. Toughest Border Security Bill in Decades Brown played a pivotal role in advancing a bipartisan border security bill widely regarded as the most stringent immigration reform in modern history. The legislation, described by CBS News as “one of the toughest border and immigration laws in modern history,” aimed to bolster security at the U.S.-Mexico border by providing much-needed resources and tools for enforcement agencies. The bill would have funded the hiring of 1,500 new border agents, increased the use of technology to monitor illegal crossings, and empowered the government to swiftly deport violent criminals. In addition, the legislation tightened the asylum process by front-loading criminal history checks for migrants seeking refuge in the U.S. “This proposed legislation would provide the strongest set of tools we have had in decades to effectively manage migration and enhance our nation’s border security,” said Troy Miller, acting commissioner of U.S. Customs and Border Protection, in a leaked internal memo. Miller highlighted the bill’s systemic reforms and its role in expanding Border Patrol authority. Despite strong support from law enforcement agencies, including endorsements from the Border Patrol Council and CBP leadership, the legislation faced pushback from some Republicans, including House Speaker Mike Johnson, who declared the bill "dead on arrival" in the House. Cracking Down on Fentanyl Trafficking In a state that has been hit particularly hard by the opioid epidemic, Brown’s work to address the flow of fentanyl into Ohio has been central to his legislative agenda. In 2024, Brown’s FEND Off Fentanyl Act was signed into law, marking a significant step in combating the rise of fentanyl-related overdoses, which have devastated families and communities. The law imposes sanctions on Mexican cartels and Chinese chemical suppliers responsible for producing and trafficking fentanyl into the U.S. It also equips law enforcement with the tools needed to dismantle fentanyl supply chains and prevent money laundering tied to the illegal drug trade. The bipartisan bill, which Brown co-sponsored with Sen. Tim Scott (R-S.C.), was hailed by law enforcement agencies across the country for its comprehensive approach. "Senators Tim Scott and Sherrod Brown have developed a comprehensive approach that codifies an existing executive order giving the president broad authority to attack fentanyl trafficking by using all the resources of the United States,” said Patrick Yoes, national president of the Fraternal Order of Police. Brown’s leadership on the issue was praised by both local and national officials. Mahoning County Sheriff Jerry Greene welcomed the legislation, noting, “Fentanyl is what truly is killing our loved ones and our people out in the community. I applaud the hard work of Senator Brown to get the FEND Off Fentanyl Act signed into law." Leadership in Ohio’s Fight Against the Opioid Crisis Ohio ranks among the states with the highest rates of fentanyl overdoses. The crisis has transcended partisan politics, with leaders from both parties acknowledging the urgent need for action. Brown has positioned himself as a bipartisan leader on this front, working closely with Republican colleagues to advance the FEND Off Fentanyl Act. “The FEND Off Fentanyl Act will crack down on criminals in countries like China and Mexico who try to produce fentanyl or illegally import fentanyl into our communities,” said Hamilton County Sheriff Charmaine McGuffey. “This meaningful legislation will cut off the flow of fentanyl at the source and sanction chemical suppliers, criminal organizations, and drug cartels who traffic the drug.” Brown’s work on border security and fentanyl trafficking is expected to play a significant role in his tough re-election campaign. The Ohio senator, who has been a fixture in state and national politics for decades, continues to emphasize his willingness to reach across the aisle to secure victories for his constituents.

Sherrod Brown leads the charge on border security and fentanyl crackdown

Ohio U.S. Sen. Sherrod Brown’s FEND Off Fentanyl Act signed into law

Aid for Ukraine may be the most consequential part of the foreign aid measures Congress recently approved, and President Joe Biden signed into law, but U.S. Sen. Sherrod Brown is highlighting a different policy change wrapped into the effort. The Ohio Democrat’s FEND Off Fentanyl Act was part of a wide-ranging bill including provisions to use frozen Russian assets and potentially force the sale of TikTok. “Our legislation would impose new, more powerful sanctions targeting the entire fentanyl supply chain,” Brown said in a recent conference call, “from the chemical suppliers in China to the Mexican cartels that traffic the drugs into our country.” Passage of Brown’s measure comes nearly a year to the day after he and U.S. Sen. Tim Scott, R-SC, introduced the idea. The proposal declares fentanyl trafficking a national emergency and places new sanctions on the leaders of trafficking organizations. The measure also gives the U.S. Treasury Department more latitude to combat money laundering tied to trafficking and gives officials the authority to make use of forfeited property for law enforcement efforts. “Law enforcement in Ohio and around the country made it clear that we needed more tools to stop fentanyl at its source,” Brown said in a statement shortly after President Biden signed the bill into law. “Because of our work together, those tools are now law and can begin to be put to use going after the cartels,” he added. “Today is an important step in our fight to stop the illicit fentanyl that is flooding Ohio communities.” The opioid crisis In 2021, the most recent national data, more than 80,400 Americans died of an opioid overdose. Those figures, from the National Institute on Drug Abuse, portray a sharp increase in overdose deaths — the number of fatalities effectively doubled in just five years. In a Centers for Disease Control and Prevention state-by-state comparison of mortality from any drug, Ohio lands near the top. In terms of raw number of overdose deaths, the state had the fifth most in 2021, and in terms of rate, it landed at seventh. Fentanyl has been particularly deadly. According to preliminary state figures from Ohio, 81% of unintentional overdose deaths in 2022 involved the drug. Ohio’s overdose deaths overall declined by about 5% compared to the peak in 2021. But even then, 2022 saw more than 4,900 Ohioans die from an overdose. More than 3,900 of those were related to fentanyl. The organization Harm Reduction Ohio tracks data from the state’s mortality database, and while it notes official reporting is still months away, 2023 is on track to see another modest decline. Still, addressing opioid abuse is, and has been, a priority for politicians from both parties at the local, state and federal level. Brown and his former Senate colleague Republican Rob Portman teamed up on several measures during their time together. Fighting the opioid crisis also remains a perennial feature in campaign ads and political debates. Brown’s campaign team, for instance, was quick to seize on Republican Bernie Moreno’s statement that he would’ve supported aid to Israel but not the broader package of legislation. Although Moreno, who’s challenging Brown for his Senate seat this November, didn’t weigh in on the FEND Off Fentanyl Act specifically, Ohio Democrats painted Moreno’s dismissal as part of a broader rejection of bipartisanship. In line with former president Donald Trump, Moreno vehemently opposed an earlier Senate bill pairing Ukraine funding with several conservative immigration policy changes. In an interview with the Ohio Press Network, Moreno insisted, “I did read all 357 pages,” and it “highlights every single thing that’s wrong with Washington D.C.” “It’s grotesque, it’s disgusting, and I would do everything in my power to make certain that something like that bill never got passed,” Moreno said. Brown’s FEND Off Fentanyl Act was included on page 225. After this story was published, Moreno spokeswoman Reagan McCarthy offered additional context. “Bernie is happy to see any action to stop the flow of fentanyl into our country and would have supported this as a standalone bill,” McCarthy said before criticizing Brown’s “long record of supporting open border policies that have exacerbated the fentanyl crisis.” In particular she cited a 2022 vote in which Brown opposed funding for U.S. Customs and Border Protection to “better detect fentanyl coming across the border.” It’s an apparent reference to an amendment offered by U.S. Sen. Lindsey Graham, R-SC, during the Senate’s vote-a-rama on the Inflation Reduction Act. That proposal would’ve earmarked $500 million to install vehicle scanners at the southern border, among other provisions dealing with oil and gas leases and building energy codes. However, here again the Senate bill Moreno called ‘grotesque’ carried similar provisions — setting aside $424.5 million for the “acquisition and deployment of non-intrusive inspection technology.” Notably, the acting director of Customs and Border Protection as well as the head of the Border Patrol union both endorsed the measure at the time. The FEND off Fentanyl Act Brown’s package of sanctions and anti-money laundering provisions has the backing of several law enforcement organizations including the Fraternal Order of Police, National Association of Police Officers, the National Sheriff’s Association. Wood County Sheriff Mark Wasylyshyn joined Sen. Brown’s call with reporters earlier this week and praised the measure for targeting the flow of drugs into the country. “Fentanyl is ravaging our communities and killing our citizens, and we must stop the flow at the source immediately,” he said. He referenced a recent Congressional report that shows the Chinese government is directly subsidizing the production of fentanyl precursors so long as they’re sold outside China. Once they cross the ocean, those chemicals are fueling massive trafficking enterprises. “They’re making billions — with the B — a year, and we have to stop that,” Wasylyshyn said. “As long as they’re making that kind of money, they’re going to do whatever it takes to get through this.” Brown described hearing the same concerns from law enforcement over and over again. “In Youngstown or Toledo, Cincinnati or Cleveland, Zanesville, Columbus, Bowling Green,” Brown said, “law enforcement tells us one of the best ways we can support them in this fight is by doing more to keep it from reaching Ohio in the first place.” Ohio Capital Journal is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Ohio Capital Journal maintains editorial independence. Contact Editor David Dewitt for questions: info@ohiocapitaljournal.com. Follow Ohio Capital Journal on Facebook and X.

Ohio U.S. Sen. Sherrod Brown’s FEND Off Fentanyl Act signed into law