The Rise of Fentanyl in Ohio: What Families Should Know

Ohio is once again at the epicenter of America’s opioid crisis. While opioid-related deaths have begun to decline nationally for the first time since 2018, fentanyl remains the primary driver of fatal overdoses in the state. According to the Ohio Attorney General’s Office, 3,579 fentanyl-related overdose deaths were recorded in 2023, representing nearly 98% of all opioid fatalities statewide (Ohio Attorney General). This staggering figure highlights just how deeply fentanyl has infiltrated communities across the Buckeye State.

What makes fentanyl particularly devastating is its potency. It is up to 50 times stronger than heroin and 100 times stronger than morphine. Even a trace amount can be deadly, making it unlike any drug crisis Ohio has faced before. Families across the state—from urban neighborhoods to small towns—are grappling with the reality that fentanyl has reshaped the landscape of substance use and public health.

Urban Centers in Crisis: Cleveland and Columbus

Cleveland has been hit especially hard. In 2022, the city recorded a drug-related death rate of 93.2 per 100,000 residents, one of the highest rates in the country (Cuyahoga County Board of Health). Columbus also faces a severe challenge, with 68.5 deaths per 100,000 during the same period. In both cities, fentanyl is involved in the overwhelming majority of overdoses, often mixed into counterfeit pills or street drugs without the user’s knowledge.

Yet, there are small signs of progress. Cuyahoga County reported fewer than 500 overdoses in 2024, a drop linked partly to reduced fentanyl availability and expanded harm-reduction programs. Still, families in Ohio’s two largest cities remain on constant alert as fentanyl continues to appear in every corner of the illicit drug supply.

Rural Realities: Fentanyl’s Reach Beyond the City

While urban overdose rates grab headlines, rural Ohio is far from immune. In fact, the CDC has found that Ohio’s rural and urban overdose rates are more similar than in most other states (CDC). Rural counties face unique challenges, such as limited access to addiction treatment, fewer harm-reduction programs, and longer emergency response times.

This lack of resources means overdoses in rural communities can be more deadly. Families in smaller towns often face stigma when discussing substance use, making it harder for individuals to seek help before a crisis occurs. The fentanyl epidemic in Ohio has therefore blurred the traditional lines between rural and urban health disparities.

How Fentanyl’s Danger Has Escalated

Fentanyl began as a prescription medication used for pain management in cancer patients. But the fentanyl driving today’s crisis is illicitly manufactured, often imported or produced in clandestine labs (NIDA). Over the past decade, overdose fatalities involving fentanyl skyrocketed in Ohio—from just a few dozen deaths in 2010 to thousands by 2016 (Journal of Addiction Medicine).

By 2023, fentanyl or its analogs were involved in 78% of all unintentional overdose deaths in Ohio (Governor’s Office Annual Report). This makes it not just the dominant opioid threat in the state, but one of the most urgent public health concerns Ohio families have ever faced.

Families at Risk: Recognizing the Signs

One of the greatest dangers of fentanyl is how quickly an overdose can occur. Families should know the warning signs: sudden loss of consciousness, shallow or gurgling breathing, pinpoint pupils, and unresponsiveness to external stimuli. Because fentanyl is so potent, symptoms appear within minutes—sometimes seconds.

Recognizing these signs can save a life. Immediate medical attention and the use of naloxone (Narcan) are critical. Families who educate themselves on overdose symptoms are better equipped to act quickly, which can make the difference between survival and tragedy.

Narcan and Harm Reduction: Saving Lives Daily

Ohio has made significant investments in harm reduction, particularly through Project DAWN (Deaths Avoided With Naloxone). The program provides free naloxone kits, fentanyl test strips, and overdose education across the state (Ohio Department of Health).

Grassroots organizations such as the SOAR Initiative are filling gaps, especially in rural areas. They distribute test strips, naloxone, and run bad-batch alert systems to notify communities when dangerous supplies hit the streets. These interventions are saving lives daily, offering families a tangible tool against the fentanyl crisis.

Emerging Threat: Carfentanil Joins the Mix

As if fentanyl weren’t enough, Ohio has also seen a rise in carfentanil, an even more potent analog. The CDC recently reported a 720% increase in carfentanil-related deaths nationwide between the first halves of 2023 and 2024 (Health.com). Cases have already been confirmed in Ohio.

Carfentanil is estimated to be 100 times stronger than fentanyl and 10,000 times stronger than morphine. Even the tiniest particle—equivalent to a few grains of salt—can be lethal. This emerging threat has added a new level of urgency for families and first responders alike.

Safety Strategies for Families

Families can take several proactive steps to protect themselves. Keeping Narcan on hand and learning how to administer it is perhaps the most important. Because fentanyl overdoses often require multiple doses, having more than one kit is recommended.

Fentanyl test strips can detect the drug in pills or powders, offering another layer of protection. Families are also advised to stress the dangers of counterfeit pills to teens and young adults, as many overdoses occur when individuals unknowingly ingest fentanyl-laced substances. Most importantly, no one should use drugs alone—having someone nearby increases the chances of survival in the event of an overdose.

A Shared Responsibility: How Communities Can Act

The fentanyl crisis cannot be solved by individual families alone. Communities have a critical role to play. Ohio’s RecoveryOhio Overdose Early Warning Dashboard provides real-time data and predictive maps to identify high-risk areas, helping local organizations respond more effectively.

Community education programs, naloxone distribution events, and recovery support networks create an environment where families feel less isolated. By combining statewide initiatives with local action, Ohio communities can help turn the tide of the crisis.

Hope Amid Crisis: Trends and Future Outlook

Despite the grim statistics, there are reasons for cautious optimism. Ohio saw a 12% drop in fentanyl-involved overdose deaths from 2022 to 2023 (Governor’s Office Annual Report). Nationally, opioid deaths also declined in 2023—the first time in five years (CDC).

These positive shifts suggest that harm reduction efforts, public awareness campaigns, and increased access to Narcan are beginning to make a difference. Still, the road ahead is long. Families and communities must remain vigilant, informed, and prepared to act.

Protecting Ohio Families

The rise of fentanyl has reshaped Ohio’s public health landscape, creating challenges that touch nearly every family. Yet knowledge is power. By understanding the risks, recognizing the signs of overdose, and keeping life-saving tools like Narcan close at hand, families can protect their loved ones.

The fentanyl crisis demands both vigilance and compassion. Whether in Cleveland, Columbus, or rural townships, Ohioans are finding ways to support one another and push back against an epidemic that has taken too many lives. The future will depend on this collective effort—families, communities, and policymakers working together to bring hope amid heartbreak.