Empowering Communities to Reduce Fatal Opioid Overdoses in Rural Ohio


Between 2014 and 2017, Ohio has ranked in the top four states for the highest number of opioid deaths, synthetic opioid deaths, and heroin deaths. In 2017 alone, Ohio ranked among the top three states for synthetic opioid overdose rates with 3,523 deaths. The most recent concern our state is combating is the use of potent fentanyl. According to the Centers for Disease Control and Prevention, fentanyl is a synthetic opioid that is 50 times more potent than heroin and nearly 100 times more potent than morphine. Fentanyl can be mixed with other drugs such as heroin or methamphetamine (CDC, 2018). In a study conducted from July 2016 through June 2017, Ohio had the highest number of reported deaths with fentanyl analogs detected (O’Donnell, Gladden, Mattson, & Kariisa, 2018). Statistics from the Ohio Department of Health shows that in Ohio, rural counties experience disproportionately higher rates of overdose deaths compared to urban counties (ODH, 2018).


Why the Empowering Communities Initiative?

These three objectives are vital to the success of this intervention. The intervention counties have been selected based on criteria that include having more than 19.9% poverty level and data that indicates high nonfatal or fatal opioid overdose rates. This calamitous epidemic has further complicated the situation in Ohio by overwhelming the public and social service systems such as the child welfare system. Parental opiate use has negatively impacted families as 1 in 4 affected children are placed in out-of-home care such as kinship or foster care (PCSAO, 2017).

Another complexity of this intervention is that Appalachian counties involved in the program have limited treatment service accessibility. Current research suggests that rural regions have significant risk factors based on their geographic location and socioeconomic status such as availability, accessibility, and acceptability of formalized healthcare to include behavioral health services (Shelby-Nelson et al.,2018).


The U.S Department of Health and Human Services, Office of Minority Health has funded the Empowering Communities Initiative based on their mission which states that they are “dedicated to improving the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities” (OMH, 2018).


Over the next three years, we will build upon current efforts to work with individuals and families who have been impacted by opioid-use disorders. We will collaborate with county Public Children Services Associations (PCSAs) executive directors, CompDrug, and Integrated Services for Behavioral Health.



Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. (2018). Statistically significant
changes in drug overdose death rates involving synthetic opioids by select states: United States, 2016 to 2017. Retrieved from: https://www.cdc.gov/drugoverdose/data/

O’Donnell J, Gladden RM, Mattson CL, Kariisa M. Notes from the Field: Overdose Deaths with Carfentanil and Other Fentanyl Analogs Detected — 10 States, July 2016–June 2017. MMWR Morb Mortal Wkly Rep 2018;67:767–768. DOI: http://dx.doi.org/10.15585/mmwr.mm6727a4.

Ohio Department of Health, Violence and Injury Section. (2018). 2017 Ohio Drug Overdose Report. Retrieved from: https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/violence-injury-prevention-program/media/2017_ohiodrugoverdosereport

Public Children Services Association of Ohio, Opiate Epidemic. (2017). Retrieved from: http://www.pcsao.org/programs/opiate-epidemic

Selby-Nelson, E. M., Bradley, J. M., Schiefer, R. A., & Hoover-Thompson, A. (January 01, 2018). Primary care integration in rural areas: A community-focused approach. Families, Systems & Health : the Journal of Collaborative Family Healthcare, 36, 4, 528-534.

U.S. Department of Health and Human Services, About the Office of Minority Health. Retrieved from:  https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=1&lvlid=1