Medina County, Ohio, Cuts Overdose Deaths by Nearly 80% Through Community Coalition

In 2017, Medina County, Ohio, lost 42 residents to drug overdoses. By 2025, that number had fallen to eight — a decline of nearly 80% that local leaders attribute to a decade of coordinated, county-wide work rather than any single policy shift. The turnaround arrives as Ohio itself reports one of the steepest statewide reductions in overdose mortality in the nation, with the rate dropping from roughly 70 deaths per 100,000 residents in 2021 to 27 in 2025.

A coalition built after the peak

The county’s effort began at its worst moment. In 2017, Medina County formed an Addiction and Recovery Coalition that brought together law enforcement, school districts, faith communities, recovery centers, and the local health department. Holly Phillips, a public health nurse at the Medina County Health Department, said the group focused on expanding mental health services, training peer-support workers, and running stigma-reduction campaigns.

"We wanted to see a decrease in stigma because stigma keeps people from seeking help," Phillips told Ideastream Public Media. The coalition’s work was deliberately broad: it funded counseling slots, trained first responders, and pressed local employers to hire people in recovery.

Naloxone access scaled from 15 kits to 1,500

One of the coalition’s earliest priorities was distributing naloxone, the medication that reverses opioid overdoses. In 2015, Medina County gave out just 15 kits. This year, Phillips said, the county is on track to distribute more than 1,500.

That local expansion mirrors a statewide program called Project DAWN, which now operates in more than 150 of Ohio’s 88 counties. According to Hailey Akah of the Health Policy Institute of Ohio, Project DAWN has distributed nearly 300,000 naloxone kits across the state and documented more than 20,000 overdose reversals in 2023, the most recent year for which data is available. Naloxone has been available over the counter in Ohio since 2015, and Medicaid covers it without prior authorization.

People seeking help for opioid use disorder can find medication-assisted treatment programs that combine FDA-approved medications with counseling.

Workforce training as a recovery tool

Medina County also tried something less common: it tied employment to recovery. The county ran a Culinary Training Institute that taught kitchen skills to people in early recovery and placed graduates at a local restaurant, Sérénité, which hired exclusively from the program. The restaurant has since closed, but the training institute continues, and Akah said the model points to a broader lesson.

"Employment provides income and economic stability," she said. "It provides daily structure, a sense of accomplishment, social connections, and the opportunity to develop skills that reduce instability — things that make recovery a lot harder when they are missing."

Research on recovery economics consistently shows that stable employment is one of the strongest predictors of long-term abstinence, yet workforce programs remain rare in rural and suburban counties.

Ohio’s statewide drop

Medina’s success is not an isolated outlier. Ohio’s 2024 Unintentional Drug Overdose Report, compiled by the state health department, showed overdose deaths falling across much of the state after years as a national epicenter of the crisis. The decline has been attributed to a combination of expanded naloxone access, Medicaid-funded treatment, and an evolving drug supply.

Still, Phillips cautioned that the county’s lower overdose numbers do not mean substance use has disappeared. "Even though we've seen a decrease in opioid overdoses, we still have other concerns," she said. "We've seen an increase in methamphetamines and cocaine and alcohol use disorder. So we want to address that as a community as well."

Lessons for other counties

Medina County had a lower baseline rate of substance use disorder than some of Ohio’s harder-hit urban counties, which means its exact numbers may not be replicable everywhere. But public health researchers say the underlying strategy — a single coalition with representatives from every sector, sustained funding for peer support, and concrete workforce pipelines — is transferable.

The county’s experience also underscores a tension in the national data. Overdose deaths are falling in many parts of the country, but the drugs causing them are changing. Stimulants such as methamphetamine and cocaine are increasingly present in toxicology reports, and alcohol-related mortality continues to rise. Programs built to combat the opioid wave of the late 2010s may need to broaden their scope to keep pace.