YOUNGSTOWN — Mahoning County had 161 drug overdose deaths in 2021, according to preliminary data released by the Mahoning County Drug Overdose Prevention Coalition — marking the highest-ever total in the county.

It is an increase of 20.5 percent over the 131 overdose deaths in 2020, which was a 26 percent increase over the 101 overdose deaths in 2019.

It’s not coincidental that those two big spike years correspond with the two worst years of the COVID-19 pandemic, according to Duane Piccirilli and Brenda Heidinger of the Mahoning County Mental Health and Recovery Board.

Likewise, now that COVID-19 is waning, Piccirilli, Heidinger and Adam Lonardo of Broadway Recovery Services, which provides recovery housing, say they expect to see lower numbers for 2022.

But first, recovery experts will address the springtime tax-refund-check phenomenon.

“We see spikes (in overdoses and overdose deaths) every March, April, May with income tax returns,” said Heidinger, associate director of the MCMHRB. The idea is that when people battling substance abuse see an infusion of cash, it leads to more illicit drug use, Heidinger said.

“That was something we discovered in our recovery houses. We had to work hard when those influxes of cash were happening,” Heidinger said. The MCMHRB works closely with the recovery houses — businesses that provide a place for addicts to live and attend group sessions to support them in their sobriety.

“We’ve been working very hard with our recovery houses to make sure they are supporting those guys and gals, giving some budgeting help, giving some incentives on how to budget and save some of your money, doing more things you should have learned at home as a teenager but may not have,” she said.

PEER RECOVERY

As high as the overdose death numbers have been the last two years, they could have been higher if not for the greatly increased use of peer recovery specialists, Heidiger said.

These are people with “lived experience” as recovering addicts themselves, who have taken close to 60 hours of training through the Ohio Department of Mental Health and Addiction Services to help others in recovery.

Peer recovery specialists are paid employees in Mercy Health emergency room facilities in Mahoning County. They also work in recovery houses. The concept grew in 2017 during the last big spike in overdose deaths.

Heidinger and Piccirilli said the advantage of having a recovering addict speak to someone in addiction and recovery is that someone who has gone through recovery has credibility.

“The person can dispel any myths about what going into treatment looks like,” Heidinger said. Addicts hear tales from others about specific treatment facilities, “but a peer recovery specialist can dispel those myths,” Heidinger said. A peer recovery specialist also can serve as an “example that you can recover,” she said.

In 2017, a federal Comprehensive Addiction and Recovery Act grant to the Mahoning County Health Department and funding from the Mercy Health Foundation allowed Mercy Health and the MCMHRB to put 10 peer recovery specialists in Mercy Health emergency departments and into treatment agencies.

The number of peer recovery specialists has now grown to about 25, Heidinger said. “The peer recovery model has really taken off,” she said, noting that agencies such as Mahoning County Children Services also uses family peer-recovery specialists for programs that help parents with substance-use addictions.

“People in recovery knew that peers were important long before the professionals started to recognize its potential because groups like Alcoholics Anonymous have used sponsors for a long time,” Piccirilli said. “People in recovery knew for years because they had sponsors for years.” Mahoning County started using peer recovery specialists starting around 2013.

“It was the walking-in your-shoes concept,” Piccirilli said. “Now the peers are right there with the counselors.”

“A peer is somebody who has been there, done that,” Heidinger added. “It’s not a professional telling you what you should do. It’s somebody who can say, ‘I’ve done that. You’re not going to BS me. Stop it.'”

COVID-19

It’s been pretty well documented that the COVID-19 pandemic has increased overdose deaths. Society was shut down in early 2020 after the pandemic started. The ongoing fear of spreading the virus kept most people from gathering with others.

“Isolation is the greatest enemy of recovery,” Heidinger said. “We say (the pandemic) is the perfect storm,” Piccirilli said. “Everything you do to survive a pandemic you don’t do when you are in recovery. You isolate. You stay away from others. And we found people, especially those new in recovery, need the fellowship, and you really didn’t have the fellowship.”

Piccirilli said last summer he saw hopeful signs during a lull in the pandemic, but the numbers spiked again late last year.

“During the summer of 2021, I would walk downtown and would see people at picnic tables, so people would gather again outside. Then the pandemic kicked up again. I think the lack of fellowship really hurt,” Piccirilli said.

Heidiger said 12-step programs that help people recover were being provided online during 2020 and 2021, “But the saying is, ‘You missed the meeting after the meeting,'” Heidinger said. She was referring to “the old-timer who said, ‘Let’s grab a cup of coffee. You look like you’re struggling,'” Heidinger said.

“In 2020, our recovery houses were seeing a spate of relapses. So we worked with people who have long-time recovery under their belt. We asked if they would be willing to go into the recovery houses.

“And so they went into a couple of our recovery houses, just to have ‘the meeting after the meeting’ with the people living there, just to give them some support. And we reduced some of those relapse numbers,” Heidinger said.

“But the pandemic truly was the perfect storm. You didn’t have meetings. You didn’t have treatment. You weren’t seeing your counselor and you were getting money — just showing up. Every time a stimulus check came in, we saw a spike in overdose cases.” Heidinger said. The federal government issued federal stimulus checks to Americans in April 2020, December 2020 and March 2021.

STATS

Mahoning County’s 26 percent increase in overdose deaths in 2020 over 2019 was a little higher than the state increase that year of 25 percent, according to the Ohio Department of Health. The state does not have final numbers for overdose deaths for 2021, but the Mahoning County Drug Overdose Prevention Coalition says there were 161, Heidinger said.

The coalition was created in 2017 with a Mahoning County Public Health grant. Its role is to bring together professionals from the county coroner’s office, MCMHRB, and local treatment providers to review all overdose deaths in the county. It publishes a monthly Overdose Surveillance Report, which contains information such as the types of drugs being used the most and the ages and sex of those who have died.

Its purpose is to find the most impactful prevention efforts, according to its reports. The coalition’s work has to be focused on Mahoning County residents because that is what the funding is for, Heidinger said.

According to the Ohio Department of Health, the number of overdose deaths in Mahoning County has consistently risen since 2013 — from 41 in 2013 to 48 in 2014, to 60 in 2015, to 83 in 2016, then the big jump in 2017 to 112.

The Mental Health and Recovery Board responded in 2017 with peer counselors and other measures, and the number dropped to 98 in 2018, Heidinger said.

“Pre-pandemic we had them down to 98. We were really working to reduce that number. Then the pandemic hits, and we start climbing back up,” Heidinger said. The number was 101 in 2019, 131 in 2020 and 161 in 2021.

Mahoning County Drug Overdose Prevention Coalition reports different numbers of overdose deaths in Mahoning County than the Ohio Department of Health because it has numbers only for Mahoning County residents.

For 2020, for example, the coalition found that 117 Mahoning County residents died of drug overdose, but the total of death certificates for drug overdoses issued in Mahoning County in 2020 was 131, Heidinger said. The Ohio Department of Health’s overdose death numbers are taken straight from Mahoning County death certificates, Heidinger said.

Heidinger and Piccirilli hope to see a smaller number of overdose deaths at the end of 2022.

The Ohio Department of Health reports that Mahoning County had a rate of overdose deaths from 2015 to 2020 of 47.4 per 100,000 residents compared to the state average of 37.4. Mahoning County’s rate ranked it 18th highest in Ohio over that period.

Trumbull County had a rate of 61.4 deaths per 100,000 residents, meaning it had the fourth highest total in the state. Trumbull County had 117 overdose deaths in 2021, one more than in 2020, according to the Trumbull County Coroner’s Office.

RECOVERY HOUSES

Canfield native Adam Lonardo, co-founder and executive director of Broadway Recovery Services, which runs seven substance-abuse recovery homes in Mahoning County, said he thinks the “isolation that was required during the pandemic absolutely led to an unparalleled increase of drug and alcohol deaths.”

He also cited reporting from the New York Times and other media that alcohol-related deaths rose 25 percent nationally during the pandemic.

“Our guys and our residents are extremely excited to be back out in the community, whether it’s attending 12-step meetings, whether it’s getting back to participating in their treatment programs face to face, like counseling,” he said. His program also requires volunteer work every week, “So our guys are getting back into St. Vincent DePaul and Dorothy Day House,” he said of places where his clients volunteer.

Lonardo said getting clients back into those organizations “has been extremely helpful.” Broadway’s big focus is recovery and reconnection, he said.

Now that COVID-19 has “died down, we are adamant that reconnecting will have a positive impact on these overdose numbers. I think they will go back down as long as we continue to focus on reconnecting and not disconnecting these guys in recovery from the world and people and community.”

erunyan@vindy.com