The numbers reported by the state represent only those people who were verified as residents of the county, explained Public Health spokesman Dan Suffoletto, while the county’s number includes everyone who died in the county.

Whatever the true number, Montgomery County’s age-adjusted overdose death rate for the year topped the state at 106.7 people per 100,000 population.

Clark County’s rate of 81.1 per 100,000 was third highest in Ohio. Clark County had 96 deaths last year, according to the state health department numbers.

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Both counties are on a pace for far fewer deaths in 2018.

Through Aug. 9 of this year, Montgomery County has tentatively recorded 159 accidental overdose deaths. Clark County reported 23 overdose deaths as of Aug. 13.

At its current pace, Montgomery County will likely see less than half the number of overdose deaths as last year, possibly the fewest deaths since 2013.

County leaders attribute the decline to the work done by the more than 100 organizations participating in the Community Overdose Action Team.

“We believe that kind of this public health-driven model to really impact the opioid crisis is the right model and we think that we’re going to, over time, we believe that we’re going to consistently see our numbers in 2018 (continue to decline),” said County Commissioner Dan Foley. “Certainly we’re still having too many deaths in Montgomery County and we can’t sugarcoat that.”

The emergency management model used by the COAT has won awards and was recently recognized by the Trump administration during a visit by U.S. Housing and Urban Development Deputy Secretary Pamela Patenaude.

“We’re trying build the structure to fight the opiate crisis not just in 2018,” Foley said, but into the future as well. “We do believe we’re heading in the right direction.”

Suffoletto noted the huge difference between the first half of 2017 and the first half of 2018. By July 1 of last year, the county had surpassed 2016’s total overdose deaths with more than 375 deaths recorded. This year, the July 1 total was 132.

“The numbers aren’t surprising,” said Paula Cosby, newly appointed director of external affairs for Montgomery County Alcohol, Drug Addiction and Mental Health Services. “We’re expecting that those numbers will turn around significantly for 2018.”

The reasons for the high local death numbers are still a little unclear. Some have speculated that the intersection of Interstates 70 and 75 boosts the availability of drugs in the area, but Foley said there may be other reasons as well.

“We are still kind of suffering from the over-prescribing that happened in places like Portsmouth, in places like Cincinnati, Dayton, and Columbus,” he said.

Here are the rest of the county numbers according to ODH: