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Drug Overdose

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The ODH Violence and Injury Prevention Section (VIPS) collects and utilizes surveillance data to inform prevention programs with the goal of reducing overdose-related fatalities. 

  • In 2007, unintentional drug poisoning became the leading cause of injury death in Ohio, surpassing motor vehicle crashes for the first time on record. This trend has continued through 2020.
  • 2020 surpassed 2017 as the highest year for unintentional drug overdose deaths in Ohio, with 5,017 deaths. This was a 3% increase over 2017 and a 25% increase over 2019. 
  • In 2020:
    • The unintentional drug overdose death rate for Black non-Hispanics (55.2 deaths per 100,000 population) surpassed the rate for white non-Hispanics (46.8 deaths per 100,000 population).
    • Black non-Hispanic males had the highest drug overdose death rate in Ohio compared with other sex and race/ethnicity groups.
    • Fentanyl was involved in 81% of overdose deaths in 2020, often in combination with other drugs. That percentage was up from 76% in 2019, 73% in 2018, and 71% in 2017.
    • Fentanyl was involved in 83% of all heroin-related overdose deaths, 80% of all cocaine-related overdose deaths, and 79% of all psychostimulant/methamphetamine-related overdose deaths. Carfentanil was involved in 161 fentanyl-related overdose deaths in 2020 compared with 508 and in 2019.

Ohio Drug Overdose Reports are available. Latest Drug Overdose Report. Past Drug Overdose Reports 

What is the Ohio Department of Health (ODH) doing to address the issue?


The Violence and Injury Prevention Section (VIPS) works closely with state and local partners to align efforts, identify best practices, and share information. The VIPS supports Governor Mike DeWine’s RecoveryOhio initiative while utilizing the Ohio Overdose Prevention Network to coordinate efforts with local partners.

In January, Governor DeWine signed an executive order creating the RecoveryOhio Advisory Council. The council was tasked with providing actionable recommendations to improve mental health and substance use prevention, treatment, and recovery support services in Ohio. Those recommendations are included in a report released in March 2019. 

The Ohio Overdose Prevention Network (Ohio OPN), coordinated by VIPS, is a multi-disciplinary action group devoted to reducing drug abuse and overdose. The Ohio OPN is implementing their strategic plan with the following focus areas: supports for responsible prescribing; promotion of harm reduction practices and policies; uptake and enforcement of evidence-based policy; improved utilization of data; and infrastructure. The Ohio OPN welcomes new members. Learn more about Ohio Ohio Overdose Prevention Network (OPN)

Take Charge Ohio 

ODH VIPS facilitated the development of Take Charge Ohio, a multi-agency website allowing Ohio patients, prescribers, and communities to access valuable tools and information. 


Local Community Projects

Ohio supports local, comprehensive overdose prevention efforts by providing funding and technical assistance to community partners. ODH VIPS allocates 2.6 million in funding annually to 22 projects to implement:

  • Community Coalitions
  • Local Strategic Plans
  • Overdose Fatality Reviews
  • Immediate Community Response Plans
  • Community/Clinical Linkages
  • Comprehensive and Sustainable Systems

VIPS also supports the development of local immediate community response plans to address sudden increases in overdoses. View the Community Response Plan template for local jurisdictions.

Naloxone Distribution 

VIPS allocates state funds for life-saving naloxone to local overdose education and naloxone distribution programs, click Project DAWN (Deaths Avoided With Naloxone) for information about Ohio’s primary program. Since 2014 nearly 90,000 naloxone kits have been distributed with approximately 11,000 overdose reversals reported through this program.

Utilizing funds from the Ohio Mental Health and Addiction Services (Ohio MHAS), VIPS implements the Integrated Naloxone Access and Infrastructure local grant program, with 37 agencies currently implementing 118 distribution strategies. This program is designed to reach Ohio’s highest-risk people by implementing distribution programs in community agencies, jails, recovery housing, emergency departments, homeless outreach, mail, drug courts, syringe access programs, and FQHCs.

Overdose Fatality Reviews

The purpose of an Overdose Fatality Review (OFR) is to effectively identify system gaps and innovative community-specific overdose prevention and intervention strategies. OFRs involve a series of confidential individual case reviews by a multidisciplinary team. A case review examines a decedent's life cycle in terms of drug use history, comorbidity, major health events, social-emotional trauma, encounters with law enforcement and the criminal justice system, treatment history, and other factors, including local conditions to facilitate a deeper understanding of the missed opportunities for prevention and intervention that may have prevented an overdose death. 

By conducting a series of OFRs, jurisdictions begin to see patterns of need and opportunity, not only with specific agencies, but across systems. OFR teams develop program and policy recommendations to improve coordination and collaboration between agencies and community conditions to prevent future overdose deaths. 

Effective Sept. 30th, 2021, OFRs were formalized in Ohio Revised Code (ORC) Section 307.631-307.639.

Overdose Fatality Review Manual

The Ohio Department of Health an local partners from across the state worked together to create robust guidance than can be used to ensure that important key factors are being considered when establishing and facilitating local OFRs in Ohio. View the Overdose Fatality Review Manual

Overdose Fatality Review Annual Reporting Guidance 

OFR Committees shall establish systems for collecting and maintaining information and data points necessary for the review of drug overdose or opioid-involved deaths. OFR committees shall prepare and submit an annual report to the Ohio Department of Health that includes data points and summary information from the previous calendar year. For guidance on annual report components and access to a REDCap submission link, view the OFR Annual Reporting Guidance

Resource: 'An Introduction: Suicide and Overdose Fatality Reviews'

The following video will provide local partners across Ohio with an overview of the components of suicide and overdose fatality reviews, details on structure and establishment, legislation, processes, partners, and available resources and supports. 

Overdose Surveillance

ODH VIPS utilizes several different data sources to identify circumstances surrounding overdose fatalities to inform prevention and response strategies. Critical surveillance activities include:

  • Ohio VDRS – Data system to collect and identify detailed circumstances of overdose deaths
  • Syndromic Surveillance – Utilizing chief complaint data in emergency departments to identify rapid spikes in ODs
  • Injury Surveillance & External Data Sources –Analysis of available data to inform interventions

Visit the Injury Surveillance and Data page for recent reports and additional information

Public Awareness

ODH VIPS utilizes data to identify emerging issues or populations that may benefit from increased awareness on different topics related to drug overdose.

The comprehensive awareness campaign, Take Charge Ohio, is designed to help Ohioans manage pain safely and create safer pain medication practices. Stop Overdose provides information on the signs and symptoms of an overdose and how to access naloxone.

Messages are currently under development to promote prescribing of medication assisted treatment and inform Ohioans of the risks of fentanyl.