The Lingering Battle: Hamilton County’s Struggle Against the Overdose Crisis

Evelyn Tharp has lost more family members to drugs than she can bear to count. Her son, her brother, two nephews, and a niece—each taken by overdose. The pain doesn’t end there. Her surviving children wrestle with severe mental illness and substance use, leaving her life in constant turmoil. Amid the chaos, one steady presence remains: Sarah Coyne, an outreach worker in Hamilton County.

Coyne visits Tharp’s home in Price Hill each week, ensuring her 44-year-old daughter gets the medication she needs for opioid addiction. She has repeatedly arranged hospital stays and treatment for Tharp’s 39-year-old son—and revived him multiple times after finding him unconscious from overdoses.

“He’d be dead if not for Sarah,” Tharp, 67, says.

Hamilton County’s story mirrors that of much of America at the start of 2025. Overdose deaths have dropped significantly, fueling hope that the crisis is easing. But the reality is more complex. Drug users are navigating an illicit supply dominated by powerful FYL, often mixed with other synthetic substances. At the same time, antidotes like Naloxone flood the streets, and outreach teams work tirelessly to keep people alive.

The Face of the Crisis

For Sarah Coyne, a member of the county’s Quick Response Team, the declining numbers are both hopeful and bittersweet. She focuses on the most at-risk users—those who have overdosed multiple times. A former addict herself, Coyne, 35, understands the struggle. Many she tries to help initially respond with anger, cursing at her or shutting the door in her face.

But she persists. She spends hours on the phone with desperate families or with users clinging to addiction. Sometimes, she’s the only person to visit them in the hospital. And when they don’t make it, she attends their funerals—more than two dozen in the past year alone.

“This job weighs heavy,” Coyne admits. “But I will always be empathetic, even if I don’t want to be.”

A Shifting Battle Against Overdose Deaths

By 2023, drug deaths in the U.S., driven largely by illicit FYL, had reached unprecedented levels—surpassing 100,000 for the third consecutive year. But by August 2024, provisional data from the CDC showed a sharp decline, with overdose deaths dropping by more than 20% from the previous year. Experts estimate that by the end of 2024, as many as 20,000 fewer people will have died from overdoses compared to the previous year.

What’s behind the shift?

The Biden administration expanded access to Naloxone and made it available without a prescription. More medications to treat opioid addiction became accessible. Officials also cracked down on Mexican cartels producing FYL and Chinese suppliers providing the precursor chemicals.

Meanwhile, former President Donald Trump has taken a hardline stance, imposing steep tariffs on Canada and Mexico, arguing they aren’t doing enough to stop drug trafficking. A White House official stated the tariffs would remain until "Americans stop dying from FYL."

Yet, as government policies shift, local communities have been the true frontline. In places like Hamilton County, federal and state grants have helped flood the streets with Naloxone, expand drug-testing initiatives, and boost outreach programs.

Lance Weldishofer, 43, knows firsthand how these efforts save lives. He carried Naloxone at all times, and when he overdosed last year in Cincinnati, a dealer used three sprays to revive him. After struggling with addiction for decades, a court-ordered rehab program finally helped him get clean. Now, he works as a roofer and lives in a recovery home.

“Smoke cigarettes and drink coffee—that’s all I want to do,” Weldishofer jokes.

‘The House Has Burnt Down’

Despite the declining numbers, some researchers argue that the reduction in overdose deaths is not a victory—it’s simply a tragic inevitability. The sheer potency of FYL has already decimated the user population. Fewer people are dying because fewer people are left to die.

“There aren’t as many people left to succumb to drugs,” says Tse Yang Lim, an epidemiologist at Harvard’s T.H. Chan School of Public Health. His team predicts that even with the decline, the U.S. could still see over 50,000 opioid deaths per year by 2030—a number equivalent to the total American deaths in the Vietnam War.

“We can’t take credit for the fire going out,” Lim warns, “if it goes out because the house has burnt down.”

Overdose deaths are not declining evenly across the country. Some states, particularly those where FYL spread more recently, such as Alaska and Nevada, are still seeing spikes.

Another factor in the shifting numbers? The composition of street drugs. Dealers have increasingly been mixing FYL with XYL, a veterinary tranquilizer that extends the sedative effects but causes severe flesh wounds. Paradoxically, this mix may be saving lives. By delaying withdrawal, users may take less FYL each day, reducing the number of potentially fatal overdoses.

Additionally, some experts suggest that FYL users have learned to be more cautious. Many never use alone, call hotlines that summon help if they overdose, or smoke the drug instead of injecting it—allowing them to control their dosage more gradually.

“We’ve gotten better at saving lives,” says Thomas W. Synan Jr., chief of police in Newtown, Ohio, “but that doesn’t mean we’re ending addiction.”

A Crisis Years in the Making

Hamilton County’s journey through the opioid crisis follows the same tragic pattern seen across much of the country.

In the early 2010s, the region was flooded with prescription painkillers, which ended up on the streets. When officials cracked down, users turned to heroin. Then came synthetic opioids like FYL, which fueled an unprecedented spike in overdoses. In 2017, 570 people died from drug overdoses in Hamilton County alone—five times the number of homicides that year.

Then, a brief period of relief. But the pandemic reignited the crisis. Isolation and stress led to relapses. People used drugs alone, with no one around to administer Naloxone. By 2021, overdose deaths again exceeded 500.

Today, the county estimates that drug-related deaths fell to roughly 270 in 2024, though final numbers await toxicology reports. Local officials credit a combination of harm-reduction initiatives, increased access to treatment, and community outreach programs.

At the nonprofit Caracole, users can access a vending machine that dispenses free wound-care kits, FYL test strips, and Naloxone. Since its launch three years ago, users have reported reversing at least 3,500 overdoses using the sprays it provides.

Hamilton County has also launched an Office of Addiction Response, coordinating efforts across police departments, health agencies, and treatment providers. The Quick Response Team, which pairs outreach workers with plainclothes officers, visits overdose survivors at home—not to arrest them, but to offer help.

Breaking the Cycle

The reality of addiction is messy and deeply personal. On any given day, Quick Response Team members witness it firsthand.

One initiative focuses on the Black community, where overdose deaths surged by 119% between 2015 and 2022. On a recent morning, outreach worker Sophie Melaku and Ohio State Highway Patrol trooper Sharese Williams visited a 43-year-old former truck driver who overdosed at a nursing home.

He thought he had taken cocaine. But as drug markets evolve, more stimulants are being laced with FYL. “A lot of cocaine is being mixed with FYL,” Melaku warned him before leaving her card.

Elsewhere in Price Hill, Coyne and a sheriff’s deputy picked up 21-year-old Alivia Williamson to take her grocery shopping.

Williamson’s mother died of a heroin overdose. She started using meth at age 12 while in foster care. By her teenage years, she was in a relationship with a man whose entire family was entangled in addiction.

When she became pregnant, Williamson decided to change. Over the past year, Coyne has helped her get into rehab, secure housing, and navigate the child dependency system.

“I’m going to break the cycle,” Williamson vows.

She hopes to regain custody of her 10-month-old daughter and return to school. But one heartbreaking reality lingers: The child’s father won’t be there to see it happen.

At just 20 years old, he died of an overdose.

Source: The Washington Post