In 2009, heroin and other opiates, both legal and illegal, were named on the death certificates of more unintentional fatal overdose victims than they were absent from, according to data released by the state Tuesday.
Overall, non-suicide drug overdose deaths were down from 2008 to 2009, 1,473 to 1,393. Data for 2010 remains incomplete because of the lag time for toxicology tests and returns from residents who died outside of Ohio.
The Ohio Department of Health, which released the data to fulfill a public records request, cautioned people not to interpret the decrease as a break in the pattern of rising overdose deaths because the data might not be complete, for the same reasons that 2010 figures are not complete.
One trend is clearly unchallenged: The share of casualties attributed, at least in part, to heroin and other opiates continued upward.
Heroin and other opiates, a category that includes legal pain relievers such as OxyContin and Vicodin, contributed to 54.4 percent of all unintentional overdose deaths in 2009, up almost 8 percent from the year before, according to an analysis done by the health department's Injury Prevention Program.
Data for the first decade of the century shows heroin's ascendance closely tracks the year-over-year increases in the mentions of other opiates on the death certificates of Ohio overdose victims. This comingling of the two -- closely related in chemistry -- by users was detailed in The News-Messenger's 2009 series "Prescription to Addiction."
Orman Hall, director of the Ohio Department of Alcohol and Drug Addiction Services, said the data reinforces the widespread belief that heroin and prescription opiate addictions are coupled.
"Nobody starts on heroin, everybody starts on prescription opiates," said Hall, former director of the Fairfield County Alcohol, Drug Addiction and Mental Health board. "The big thing now is making sure everybody is connecting the dots."
Hall, who is leading the state's pushback against opiate addiction, said if the state can limit the abuse of legal opiates, it will see reductions in deaths ascribed to those medications. He also thinks heroin deaths would plummet, because fewer people will turn to that drug as a way of satisfying the opiate addiction created by misuse of legal pain relievers.
The grouping other opiates is first in cause of death mentions for the second consecutive year in 2009. Heroin was second and cocaine was third.
The 2009 figures show the continued decrease of cocaine, which was the top killer from 2002 to 2007.
Benzodiazepines, a family of depressants including brands such as Xanax or Klonopin, jumped from 154 mentions in 2008 to 212 in 2009, which was the biggest increase for any drug grouping.
Hall, who had not personally reviewed the data as of Tuesday, said he was encouraged by the apparent decrease.
"That's certainly a sign that people are starting to pay attention," he said. "I would have been encouraged by a smaller increase this year."