Hamilton County coalition credits decade of harm-reduction work as officials describe recent drug-supply spike and response

Hamilton County commissioners and members of the Hamilton County Addiction Response Coalition on Tuesday highlighted a decade of coordinated opioid- and stimulant-response work and described a rapid, multi-agency response after a recent drug-supply change that coincided with 12 overdose deaths over 72 hours.

At a presentation to the Hamilton County Board of County Commissioners, Megan Guthrie, director of the Office of Addiction Response, and Abby Fritsch, the office’s grants manager, summarized last year’s work across prevention, treatment, harm reduction, interdiction and recovery pillars and credited the coalition’s network with helping reduce overdose deaths countywide. “We have been able to build something truly unique in Hamilton County,” Guthrie said.

The report presented a countywide projection that overdose deaths have fallen about 52% from the crisis peak in 2017, with an estimated 270 overdose deaths projected for this year; presenters also said more than 4,450 lives have been lost to addiction in Hamilton County since 2015. Commissioners and coalition leaders repeatedly stressed that each number represents individuals and grieving families and that the work must continue.

Why it matters: presenters said the county’s combination of prevention (school and community outreach), treatment (expanded engagement centers and medically monitored withdrawal protocols), harm reduction (syringe services, drug-checking and broad Narcan distribution) and recovery (employer designation and peer-led networks) creates a full continuum of care aimed at preventing deaths, reducing stigma and expanding access to treatment.

Presenters gave specific program results: prevention pillar lead Nicole Schisler said medication take-back and disposal efforts collected 980 pounds of medication, and countywide youth programming reached hundreds of students. Lenora Godfrey, president and CEO of the Hamilton County Mental Health and Recovery Services Board, said the treatment pillar’s engagement center served more than 634 clients in 2024, with 70% of those discharged attending their first outpatient appointment; she also said 100% of unsheltered clients who came to the center left sheltered upon discharge. The mental health board reported using about $3,100,000 in state opioid and stimulant funding to support nine behavioral-health agencies and 18 projects.

Public-health and harm-reduction officials described expanded services across the county: Health Commissioner Greg Kesterman said safe-services operations ran at seven locations with more than 16,000 client visits in 2024, and the county distributed more than 24,000 doses of naloxone (Narcan) and about 120,000 fentanyl test strips through a “test before you take” program partnered with businesses and venues.

Coalition leaders said the county is also expanding clinical capacity: presenters said the planned Hamilton County Crisis Center opening will add a 24-bed engagement center, a receiving center and short-term residential programming, plus onsite pharmacy and primary-care access.

Drug-supply alert and response: officials said a sudden change in the drug supply, not solely user behavior, precipitated a short-term spike in fatal overdoses and prompted a formal alert. Chief Simon (law enforcement) and Kesterman described how the coalition’s interdiction and public-health partners track supply trends from international distribution to local street-level samples. “We can pretty confidently determine if it’s user behavior or if it’s actually the drug supply change,” Kesterman said. He and other officials said the most recent alert followed detection of a new substance (identified in local testing as metomidine, a sedative-like compound) and that the county saw 12 overdose deaths in roughly 72 hours, including four people who were homeless.

The alert, officials said, is intended to inform both service providers and people who use drugs so they can take precautions; presenters reported an immediate reduction in overdoses after outreach to affected communities, street-level warnings and targeted distribution of naloxone and testing services. “When we put the alerts out, we had right off the bat see this reduction in overdoses and overdose deaths,” Kesterman said. County leaders said the coalition is formalizing a supply-monitoring group that will include public health, the heroin task force, the coroner’s office, the FBI and the Ohio Narcotics Information Center.

Recovery and workplace efforts: Cassidy Lee Can, vice president of recovery services at Greater Cincinnati Behavioral Health, said the Recovery Friendly Hamilton County program reached 67 workplace designees representing about 17,000 employees and that employers who participated reported higher morale and reduced stigma.

Funding and decision-making: commissioners noted that federal-state and settlement dollars (including ARPA allocations and funding distributed through the 1Ohio Foundation and opioid-distributor settlement programs) have supported local programs. Commissioner Denise Driehaus said elected officials rely on subject-matter experts in the coalition when deciding how to allocate those funds.

Commissioners praised the coalition’s decade of work, called the initiative a local model for coordinated response and thanked frontline providers and peers. “You have saved so many lives,” Commissioner Alicia Reese said.

Votes at a glance: At the meeting’s close, the board voted to adjourn; the motion carried on a unanimous voice vote by the three commissioners present.

The presentation materials and a 10-year anniversary panel and memorial events were scheduled later the same day at Memorial Hall; coalition leaders invited public attendance and emphasized continued vigilance for future changes in the local drug supply.