Reviewed by: Kamilah Mathieu, Clinical Supervisor
Published: August 10, 2026
Updated: August 11, 2026
BrightView Health Clinical Supervisor spoke with WDTN about Montgomery County’s progress in reducing overdose deaths, the growing role of stimulants, and why some people at risk may not recognize the danger.
DAYTON, Ohio — Overdose deaths in Montgomery County continue to fall, marking significant progress for a community that was once among the hardest hit by the opioid epidemic.
But declining deaths do not mean addiction has disappeared.
In an interview with WDTN, Kamilah Mathieu, clinical supervisor with BrightView Health, explained that the substances involved in overdoses are changing, risks are increasingly overlapping, and some people may not realize they are vulnerable to an overdose.
“Montgomery County’s decline in overdose deaths is real progress and should be recognized,” Mathieu said. “But it doesn’t mean that addiction has disappeared. It just means that the substances that are involved are changing, the risks are overlapping, and some people who are in danger might not recognize that they’re part of the overdose crisis.”
The Montgomery County Coroner’s Office recorded 155 accidental drug overdose deaths in 2025. That is about 12% lower than the 176 suspected overdose deaths reported in 2024 and approximately 73% below the county’s 2017 peak of 566 deaths. Still, 155 deaths equate to nearly three lives lost every week.
Mathieu said that progress should be viewed as evidence that prevention, treatment, naloxone access, and other community efforts are working, rather than a reason to pull back.
Kamilah Mathieu, clinical supervisor with BrightView Health, joined WDTN to discuss what changing overdose trends mean for people and families throughout the Dayton region, watch the full interview above.
The Overdose Crisis Is No Longer Only About Opioids
One of the most important changes in Montgomery County is the increasing role stimulants are playing in overdose deaths.
County data from 2024 show that 69% of confirmed overdose deaths involved fentanyl, 39% involved cocaine, and 39% involved methamphetamine. Because multiple substances can be present in the same death, those percentages overlap.
Perhaps more telling, one in five overdose deaths in 2024 involved a stimulant but no opioid at all. In 2017, that figure was just 4%.
That shift creates two distinct risks.
Someone can experience a serious or fatal medical emergency from cocaine, methamphetamine, or another stimulant. At the same time, people using illicit stimulants can be unknowingly exposed to fentanyl. The Centers for Disease Control and Prevention notes that illegally manufactured fentanyl can be mixed with drugs such as cocaine and methamphetamine, sometimes without the person using the drug knowing it is present.
That can be particularly dangerous for someone who does not consider themselves an opioid user.
“Someone who uses cocaine occasionally probably doesn’t carry naloxone, know the signs of an opioid overdose, or see themselves as someone who could overdose,” Mathieu explained. “That gap in perception is one of the big challenges that providers face now.”
Stimulant Emergencies Can Look Different
Families and communities have become increasingly familiar with some of the warning signs of an opioid overdose, including very slow or stopped breathing and difficulty waking someone.
A stimulant-related emergency can look very different.
“Stimulants don’t just affect energy levels,” Mathieu said. “They can damage the heart, trigger anxiety and psychosis, and dramatically affect how the brain functions.”
According to the CDC, signs of a serious stimulant-related emergency may include rapid or irregular heartbeat, chest pain, severe anxiety, confusion, overheating, hallucinations, or psychosis. Seizures and signs of a stroke or heart attack require immediate medical attention.
Mathieu said families should be aware of symptoms such as:
- Severe agitation, confusion, or paranoia
- A rapid or irregular heartbeat
- Overheating or excessive sweating
- Seizures
- Chest pain
- Stroke-like symptoms, such as sudden numbness, severe headache, blurred vision, or loss of coordination
Because stimulant overdose can present differently from opioid overdose, families may not immediately associate those symptoms with substance use. The CDC advises calling 911 when someone shows signs of a serious medical emergency.
Naloxone Still Matters, Even When Stimulants May Be Involved
The changing drug supply also makes access to naloxone especially important.
Naloxone reverses an opioid overdose. It does not reverse the effects of cocaine or methamphetamine. However, if fentanyl or another opioid may be involved, administering naloxone can save a life. The CDC says naloxone will not harm someone if opioids are not involved.
“Because fentanyl may be involved without anyone knowing it, naloxone should always be given whenever an overdose is suspected,” Mathieu said. “But naloxone only reverses the opioid component. It does not treat cocaine- or methamphetamine-driven medical emergencies.”
If an overdose is suspected, call 911 and administer naloxone if it is available. Emergency medical care may still be needed even if the person responds to naloxone.
Families Can Help Before a Crisis Happens
Mathieu stressed that families do not have to wait until substance use results in an overdose or another major crisis before encouraging someone to seek treatment.
“The best thing families can do is stay connected, lead with compassion instead of judgment, address them with love, and encourage treatment early,” she said.
And one message is especially important for people who may believe their substance use is not yet “serious enough” to warrant treatment.
“People don’t have to hit rock bottom to get help,” Mathieu said. “Recovery is possible with the right support.”
Montgomery County’s decline in overdose deaths demonstrates how much progress is possible. But as the substances involved and the risks surrounding them continue to change, recognizing those risks and connecting people with care remains critical.
BrightView Health provides outpatient addiction treatment, including medical care, counseling, and social support, in Dayton, Centerville, and communities across Ohio.
If you or someone you love is struggling with substance use, you do not have to wait for a crisis to seek help. Find a BrightView location near you or schedule an appointment.
Sources
- Montgomery County Coroner’s Office, Annual Report 2025. The report lists 155 accidental drug overdose deaths in Montgomery County in 2025.
- Community Overdose Action Team, 2024 Data Unit Annual Report. The report documents 176 suspected overdose deaths in 2024, the 2017 peak of 566 deaths, drug involvement, and changing stimulant trends.
- Centers for Disease Control and Prevention, Fentanyl Facts.
- Centers for Disease Control and Prevention, Stimulant Guide and Stimulants.
- Centers for Disease Control and Prevention, 5 Things to Know About Naloxone.
