OSAM Ohio Substance Abuse Monitoring Network Surveillance of Drug Abuse Trends in the State of Ohio June 2014 - January 2015 Legend Akron-Canton region Columbus region Athens region Dayton region Cincinnati region Toledo region Ohio Department of Mental Health and Addiction Services Cleveland region Youngstown region Office of Quality, Planning and Research Ohio Substance Abuse Monitoring Network Surveillance of Drug Abuse Trends in the State of Ohio June 2014 - January 2015 Prepared by: Ohio Department of Mental Health and Addiction Services Office of Quality, Planning and Research Sanford Starr, Deputy Director — MSW, LISW-S R. Thomas Sherba, OSAM Principal Investigator — PhD, MPH, LPCC Beth E. Gersper, OSAM Coordinator — MPA Table of Contents OSAM-O-Gram ...........................................................................................................................................................3 Executive Summary ...................................................................................................................................................5 Drug Abuse Trends by Region Akron-Canton Region ............................................................................................................................................ 21 Athens Region .......................................................................................................................................................... 39 Cincinnati Region .................................................................................................................................................... 58 Cleveland Region .................................................................................................................................................... 73 Columbus Region .................................................................................................................................................... 93 Dayton Region ........................................................................................................................................................113 Toledo Region .........................................................................................................................................................131 Youngstown Region .............................................................................................................................................147 Tracy J. Plouck, Director • John R. Kasich, Governor Contact information: R. Thomas Sherba Office of Quality, Planning and Research 30 E. Broad St., 8th Floor Columbus, OH 43215 P: 614.466-9020 F: 614.488.4789 Recommended citation for this report: Ohio Department of Mental Health and Addiction Services [OhioMHAS] (2015). Ohio Substance Abuse Monitoring Network: Surveillance of Drug Abuse Trends in the State of Ohio: June 2014-January 2015. A-- ram Ohio Substance Abuse Monitoring Network Surveillance of Drug Abuse Trends in the StateOSAM-O-Gram of Ohio OhioOhio Substance Substance Abuse Abuse Monitoring Monitoring Network: Network SurveillanceDrug Abuse of Drug Trends Abuse in Trends the State in the of State Ohio of Ohio June 2012OSAM - January 2013 John R. Kasich, Governor June 2014Orman - January Hall, Directo 2015r Toledo Region Cleveland Region • Toledo Region • Cleveland Increased av Regionailability of heroin; likely increased availability of Ecstasy, likely decreased availability of Ecstasy • Ecstasy, heroin & methamphetamine availability h high-gr• Heroinade availabilitymarijuana and h methamphetamine; likely decreased availability of • DEA and BCI reported increase in number of bath salts cases; bath salts bath salts • More clients in treatment began drug use with heroin instead • Heroin often cut with fentanyl chemically altered and re-branded • In Cleveland, heroin is now commonly available through anonymous of progressing from prescription opioids • Pink & blue heroin reported • Despite decreased availability of Ecstasy, Ecstasy-like substances (2CE and 2CB) available• Fentanyl & cocaine popularly used to cut heroin • • Heroin users in area typically suburban • DEA repor• Metht highly availableeveral mobile in rural methamphet areas whereamine typical labs, user has • Prescription monitoring h cause limited prescription opioid availability manufacturlowere thr oughsocio-economic “one-pot” and status, “shak e-and-bakis white &e” 18-25 methods years of age • • PurMarijuanaest form concentratesof Ecstasy (aka availability “Molly”) becoming h in past mo sixre months available as knowledge • Bath salts, prescription opioids & synthetic marijuana availability i of• drugBath g salts,rows ecstasy, prescription opioids availability i • Decreased availability of prescription opioids attributed to Dayton Regiondoctor, pharmacy & law enforcement interventions • Decreased availability of Ecstasy; Akron-CantonAkron-Canton Region Region •• Heroin Increased availability availability h of likely incrDaytoneased av Regionailability of heroin and Suboxone®; likely decreased • Heroin most used drug in region • Heroin dealers supply cocaine due availability of crack cocaine •opioids Fentanyl and &Sub prescriptionoxone®; likely opioids to users who like to “speedball” increased availability of crack cocaine • commonly used to cut heroin heroin with cocaine and heroin heroin has reached “epidemic” • Heroin use by teens & young • Dealers selling baby laxatives as • Methamphetamine thought to adults with no prior drug expe- not used fakepersonally powdered reported cocaine friends have increased due to more people and family who have withrience knowledge on the rise of “one-pot” or • In one weekend, 8 die in Montgom- • Free “testers” of heroin remain •“ Methamphetamineshake-and-bake” method h of ery Cty. from fentanyl-cut heroin available in Dayton which makes it •manuf Policeactu seere increase in meth from • No needle exchange in the region for users to avoid the drug •Mexico • Bath salts & synthetic marijuana i • Bath perc saltsent &of prescription all drug-related opioids deaths i • Snorting Neurontin® (anti-epilep- according to coroner’ • Increasedtic agent)availability gaining of her popularityoin and Suboxone®; likely increased YoungstownYoungstown Region Region Cincinnati Region availability of bath salts, • Heroin• leading drug of abuse in region • Heroin & Suboxone® availability h • Availabilityopioids; lik ofely heroin, increased methamphet availability -of marijuana;• Users likely seek decr whiteeased powderedavailability amine,heroin, sedative-hypnotics methamphetamine & Suboxone® and h of powderheroined cocaine cut with fentanyl, Suboxone®; likely decreased availability • Heroin made more potent when cut • though fentanyl-cut heroin with cocaine, fentanyl and Xanax® increases overdose danger • Opana®, Roxicet®, Ultram® and with those as young as 12 years • Mahoning Cty. Coroner reported • Common to share needles to beginning use heroinopioids reason now forpresent over in half 77.8 of pe allrc drug-ent of all inject heroin • Current availability of relateddrug- deathsrelated deathsin the pastaccor sixding months to the • More clinics prescribe Suboxone®, coroner’ methamphetamine is high in rural • Increased availability of Suboxone® making it easier to obtain • Throughout the region, professionals due to increase in opiate use • Bath salts use i reported heroin to be the primary drug • Heroinproblem users say difficult to purchase new injection needles as more stores Columbus Region Athens Region Columbus Region require a prescription • Increased availability of bath salts; likely increased availability of heroin, •Athens Increased Region availability of heroin and Suboxone®; likely increased • Heroin, marijuana & powdered cocaine availability h av• Heroinailability & ofmethamphetamine bath salts and methamphet availabilityamine; h likely decreased • • Heroin often cut with pharmaceutical drugs • Use of marijuana extracts & concentrates (aka “dabs”) h easily obt• Crimeained at labs the seesame cases stores of that heroin-fentanyl previously sold mixture, them bef evenore the straight law •• Crystal forms of methamphetamine (aka “ice”) now in the region banning them took e ect fentanyl thought to be heroin seeking• “Shake-and-bake” treatment for (powdered heroin use meth made in mobile labs) most • • Common practice of sharing needles for heroin injection • prevalent meth type • Law enforcement identifies vaporizing as a new way to consume marijuana bath salts popularity • Bath salts & meth often sold as “molly” (powdered MDMA) • Bath salts & ecstasy availability i •• Bath BCI r eportedsalts, ecstasy an incr availabilityease in bath i salts cases; as soon as one substance is banned, another chemical analogue takes its place Ohio Department of Mental Health and Addiction Services • Office of Quality, Planning and Research • Ohio Department of Alcohol and Drug Addiction Services • Division of Planning, Outcomes & Research • • 30 W. Spring St., 6th Floor, Columbus, Ohio 43215 • 1-800-788-7254 • www.ada.ohio.gov • Surveillance of Drug Abuse Trends in the State of Ohio Page 4 OSAM Drug Trend Report January 2015 Surveillance of Drug Abuse Trends in the State of Ohio Surveillance of Drug Abuse Trends in the State of Ohio OSAM Ohio Substance Abuse Monitoring Network Surveillance of Drug Abuse Trends in the State of Ohio January-June 2014 Executive Summary Powdered Cocaine The Ohio Substance Abuse Monitoring (OSAM) Network consists of eight regional epidemiologists (REPIs) located in the following regions of