A coroner in Ohio keeps running out of room for dead bodies as more and more people die in the opioid epidemic.
According to CBS News, the coroner’s office in Montgomery County ran out of space for the second time this year after it received 13 bodies on Monday, 12 of which were for overdoses. And that came after the office expanded its cooler to hold 42 bodies, up from 36, after facing similar issues last year.
“If this pace continues, I'm not really sure what we’re going to do,” Kent Harshbarger, the coroner, told the Tribune-Review. “It’s full every night.”
According to Harshbarger, he’s looking at 2,900 autopsies this year, 2,000 of which are for drug overdoses. Last year, he reportedly handled fewer than 2,000 autopsies total. His office handles autopsies for Montgomery County and the surrounding rural areas in southwest Ohio.
To deal with the spikes in death, Harshbarger has reportedly rented space at a funeral home and refrigerated trailers. But that, apparently, may not be enough at the current pace.
Harshbarger’s struggles drive home just how deadly the opioid epidemic has become: Even the people equipped to deal with death can’t keep up with the pace.
In 2015, the opioid epidemic led to more than 33,000 opioid overdose deaths and more than 52,000 total drug overdose deaths nationwide. In Ohio, overdose deaths climbed by 21.5 percent from 2014 to 2015, according to the Centers for Disease Control and Prevention.
Since that data was collected, there are signs that the epidemic has gotten worse with the introduction of the potent fentanyl and its analogs to the illicit opioid market. The deadliest drug overdose crisis in US history, then, is likely getting deadlier.
The opioid epidemic, explained
In 2015, more Americans died of drug overdoses than any other year on record — more than 52,000 deaths in just one year. That’s higher than the more than 38,000 who died in car crashes, the more than 36,000 who died from gun violence, and the more than 43,000 who died due to HIV/AIDS during that epidemic’s peak in 1995.
This latest drug epidemic, however, is not solely about illegal drugs. It began, in fact, with a legal drug.
Back in the 1990s, doctors were persuaded to treat pain as a serious medical issue. There’s a good reason for that: About one in three Americans suffer from chronic pain, according to a 2011 report from the Institute of Medicine.
Pharmaceutical companies took advantage of this concern. Through a big marketing campaign, they got doctors to prescribe products like OxyContin and Percocet in droves — even though the evidence for opioids treating long-term, chronic pain is very weak (despite their effectiveness for short-term, acute pain), while the evidence that opioids cause harm in the long term is very strong.
So painkillers proliferated, landing in the hands of not just patients but also teens rummaging through their parents’ medicine cabinets, other family members and friends of patients, and the black market.
As a result, opioid overdose deaths trended upward — sometimes involving opioids alone, other times involving drugs like alcohol and benzodiazepines (typically prescribed to relieve anxiety). By 2015, opioid overdose deaths totaled more than 33,000 — close to two-thirds of all drug overdose deaths.
Seeing the rise in opioid misuse and deaths, officials have cracked down on prescriptions painkillers. Law enforcement, for instance, threatened doctors with incarceration and the loss of their medical licenses if they prescribed the drugs unscrupulously.
Ideally, doctors should still be able to get painkillers to patients who truly need them — after, for example, evaluating whether the patient has a history of drug addiction. But doctors, who weren’t conducting even such basic checks, are now being told to give more thought to their prescriptions.
Yet many people who lost access to painkillers are still addicted. So some who could no longer obtain prescribed painkillers turned to cheaper, more potent opioids: heroin and fentanyl, a synthetic opioid that’s often manufactured illegally for nonmedical uses.
Not all painkiller users went this way, and not all opioid users started with painkillers. But statistics suggest many did: A 2014 study in JAMA Psychiatry found many painkiller users were moving on to heroin, and a 2015 analysis by the Centers for Disease Control and Prevention found that people who are addicted to prescription painkillers are 40 times more likely to be addicted to heroin.
So other types of opioid overdoses, excluding painkillers, also rose.
That doesn’t mean cracking down on painkillers was a mistake. It appeared to slow the rise in painkiller deaths, and it may have prevented doctors from prescribing the drugs to new generations of people with drug use disorders.
But the likely solution is to get opioid users into treatment. According to 2014 federal data, at least 89 percent of people who met the definition for a drug use disorder didn’t get treatment. Patients with drug use disorders also often complain of weeks- or months-long waiting periods for care.
So federal and state officials have pushed for more treatment funding, including medication-assisted treatment like methadone and buprenorphine.
Some states, like Louisiana and Indiana, have taken a "tough on crime" approach that focuses on incarcerating drug traffickers. But the incarceration approach has been around for decades — and it hasn’t stopped massive drug epidemics like the current crisis.