Heroin & Fentanyl Related Deaths in Cuyahoga County

Transcription

1 Thomas P. Gilson, M.D Cedar Avenue, Cleveland, Ohio A National Association of Medical Examiner s (N.A.M.E.) accredited office CUYAHOGA COUNTY MEDICAL EXAMINER S OFFICE Heroin & Fentanyl Related Deaths in Cuyahoga County MARCH 31, 2016

2 Heroin Risk Continuum Risk of Fatality Not using heroin Being in an Auto accident Previous legal prescription for opioids Using heroin Using IV heroin Using alone Mixing with alcohol or other drugs Using after period of abstinance (jail or treatment) Using without DAWN naloxone kit Using Heroin tainted with or replaced by fentanyl Persons in Cuyahoga County Annually Misusing or Abusing Persons in Cuyahoga County who Annually Switch to Heroin Opioid Prescriptions (Based on estimates from SAHMSA Drug Survey results and known local data) Examiner s Office revised

3 Persons in Cuyahoga County Dying Annually From Heroin-related Overdoses Persons in Cuyahoga County Dying Annually From Fentanyl-related Overdoses Persons in Cuyahoga County Anticipated to Die in 2016 from Heroin Examiner s Office revised Persons in Cuyahoga County Anticipated to Die in 2016 from Fentanyl

4 CURRENT PUBLIC HEALTH EMERGENCY No. of Fatal Cases due to heroin/fentanyl in March City of Cleveland Residents 31 - Suburban Residents- Brecksville, Brook Park (3), Chardon, Cleveland Heights (2), Columbia Station (2), Euclid (2), Lakewood (4), Middleburgh Heights, North Olmsted, North Royalton, Olmsted Township, Parma (4), Parma Heights, Peninsula, South Euclid (2), Strongsville, Westlake (2), One out of State resident - PA VICTIMS Victims ages range from Male victims; 15 Female victims 6 African American victims; 4 Hispanic victims; 40 Caucasian victims EXPONENTIAL RATE OF INCREASE In 2015, one person died every day in Cuyahoga County from a drug overdose. In 2016, during January and February, one person died every day in Cuyahoga County from a heroin or fentanyl overdose. January was a record for fentanyl deaths, broken again in February. In March 2016, two people have died every day in Cuyahoga County from a heroin or fentanyl overdose. March will set a new record for fentanyl deaths. At least 107 victims already for 2016.

5 2.25 Cuyahoga County Deaths per Day due to Heroin and Fentanyl 2 Represents a projected 712 heroin/fentanyl deaths Represents a projected 438 heroin/fentanyl deaths dead from heroin and fentanyl out of 365 total drug Represents OD deaths 228 heroin/fentanyl deaths out of 370 total OD deaths Represents a projected 346 heroin/fentanyl deaths Jan-Feb /1 to 3/9/16 3/10 to 3/31/16

6 40 CCMEO 2016 Fentanyl & Heroin Related Deaths, By Month (For monthly total, combined cases are subtracted from the sum of other columns ) JAN FEB MAR Heroin Fentanyl Combined

7

8 Fentanyl Residence Locations

9 Fentanyl Incidence Locations

10

11

12 250 Cuyahoga County Overdose Deaths Most Common Drugs cases cases cases cases cases cases cases cases cases cases Heroin Cocaine Oxycodone Fentanyl All Opioids (Inc. Oxycodone & but not Fentanyl)

13 CCMEO Heroin Related Deaths, Comparisions * st Q 1st Tri MidYear 2nd Tri 3rd Q FINAL

14 450 Cuyahoga County Heroin Related Overdose Deaths Projected with DAWN Saves and Fentanyl as Heroin OD Deaths plus Fentanyl 2013 w/o DAWN plus fentanyl 2014 w/o DAWN 2015 proj 2015 proj 2015 proj w/fentanyl w/o DAWN

15 CCMEO Fentanyl Related Deaths, Comparisions * st Quarter 1st Trimester 1st Half 2nd Trimester 3rd Quarter Thru Nov Final

16 Cuyahoga County, Heroin and Fentanyl Deaths Heroin + Fentanyl Fentanyl (no Heroin) Heroin (no Fentanyl)

17 35 CCMEO Monthly Fentanyl Deaths October 2014 to March 2016 (January - March 2016 cases based upon preliminary toxicology) NOV DEC JAN FEB MAR APR MAY JUNE JULY AUG SEP OCT NOV DEC JAN FEB MAR

18 100% 5 Cuyahoga County Fentanyl Deaths % % 93 70% 60% 50% 97 40% % 20% % 0% Months Deaths 2006-Sept Oct Oct.31, 2015 Nov. 1, Mar. 30, 2016

19 Figure 1: Gender of Fentanyl-related Overdose Decedents in Cuyahoga County, (126 cases) 30.16% 100% 90% 80% 70% 60% 50% 85% 73.40% 75% 81.30% 76.60% 75.80% 73.71% 79.08% 74.86% HEROIN DEATHS BY GENDER Male 69.84% 40% 30% 20% 10% 26.60% 15% 25% 18.70% 26.29% 23.40% 24.20% 20.92% 25.14% Female Male Female 0% Figure 2: Race of Fentanyl-Related Overdose Decedents in Cuyahoga County, (126 cases) 23.02% 0.79% 76.19% White Black Asian 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 75% 90.60% 82.80% 82.40% 82.20% 86.30% 85.57% 86.22% 83.06% 25% 17.20% 17.60% 17.80% 9.40% 13.70% 14.43% 13.78% 15.85% 7.70% 0% 3.10% 3.10% 3.70% 4.40% 4.64% 6.12% 5.46% 0% 1.09% 0% 0% 0% 0% 0% 1.24% 0.51% HEROIN DEATHS BY RACE White Black Hispanic Other Examiner s Office revised

20 Figure 3: Age of Fentanyl-related Overdose Decedents in Cuyahoga County, (126 cases) 29.37% 4.76% 38.89% 26.19% 60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00% 50.00% 46.94% 45.31% 40.19% 40.44% 40.63% 39.13% 40.21% 37.50% 35.16% 36.68% 37.50% 32.65% 31.68% 31.44% 29.67% 28.04% 32.66% 26.56% 26.56% 28.57% 25.23% 25.47% 24.23% 20.41% 23.62% 26.78% 24.59% 17.19% 7.50% 7.04% 8.20% 6.59% 6.54% 4.69% 5.00% 1.56% 3.73% 4.12% 0.00% HEROIN DEATHS BY AGE Age Age Age Age Fentanyl Deaths by Residence (126 cases) % 50.00% 43.72% 36.87% 12.02% 13.13% 13.49% % 44.10% 38.66% 41.61% 11.34% 14.29% 44.44% % 43.96% 50.47% 42.86% 5.61% 13.19% % 40.63% 9.38% 42.06% % 43.75% 14.06% % 45.00% 12.50% % 40.82% 4.08% Residence Cleveland Suburbs Out of County Examiner s Office revised % 20% 40% 60% 80% 100% City of Cleveland Suburb Out of County HEROIN DEATHS BY RESIDENCE

21 Fentanyl Deaths by Incidence Location (126 cases) % 36.36% 31.82% 44.26% 2.53% 1.64% 12.02% 28.28% % 32.99% 5.15% 16.49% % 35.40% 2.48% 21.12% 27.78% 32.54% % 45.05% 38.32% 38.46% 0.00% 14.95% 3.30% 13.19% % 31.25% 3.13% 18.75% 3.17% % 55.00% 37.50% 37.50% 1.56% 12.50% 0.00% 7.50% % 32.65% 0.00% 6.12% 36.51% Cleveland Suburbs Out of County Unknown 0% 20% 40% 60% 80% 100% City of Cleveland Suburb Out of County Un-known HEROIN DEATHS BY INCIDENCE Examiner s Office revised

22 Examiner s Office revised

23 Examiner s Office revised *82 in City of Cleveland, 39 Unknown

24 Bay Beachwood Bedford Bedford Hts. Berea Brecksville Broadview Hts. Brooklyn Brook Park Chagrin Falls Cleveland Hts. Cuyahoga Hts East Cleveland Euclid Fairview Park Garfield Hts. Gates Mills Highland Hts. Independence Lakewood Lyndhurst Maple Hts Mayfield Mayfield Hts Middleburgh Hts Newburgh Hts North Olmsted North Royalton Oakwood Olmsted Falls Olmsted Twp Orange Parma Parma Hts. Pepper Pike Richmond Hts Rocky River Seven Hills Shaker Hts South Euclid Solon Strongsville Valley View Warrensville Hts Walton Hills Westlake Woodmere Bentleyville Bratenahl Brooklyn Hts. Glenwillow Highland Hills Hunting Valley Linndale Moreland Hills North Randall University Hts Akron Ashtabula Avon Avon Lake Bainbridge Brunswick Camden Twp Chesterland Twp. Columbia Station Cortland Creston Delaware Eastlake Elyria Freedom Twp Litchfield Lorain Medina Mentor North Ridgeville Northfield Painesville Russell Twp Saybrook Twp Twinsburg Valley City Warren Wickliffe Windham Willoughby 80 TOTAL SUBURBAN HEROIN DEATHS (By community of residence) TOTAL Examiner s Office revised

25 Bay Beachwood Bedford Bedford Hts. Berea Brecksville Broadview Hts. Brooklyn Brook Park Chagrin Falls Cleveland Hts. Cuyahoga Hts East Cleveland Euclid Fairview Park Garfield Hts. Gates Mills Highland Hts. Independence Lakewood Lyndhurst Maple Hts Mayfield Mayfield Hts Middleburgh Hts Newburgh Hts North Olmsted North Royalton Oakwood Olmsted Falls Olmsted Twp Orange Parma Parma Hts. Pepper Pike Richmond Hts Rocky River Seven Hills Shaker Hts Solon South Euclid Strongsville Valley View Warrensville Hts Westlake Bentleyville Bratenahl Brooklyn Hts. Glenwillow Highland Hills Hunting Valley Linndale Moreland Hills North Randall University Hts Walton Hills Woodmere Ashtabula Avon Avon Lake Brunswick Chesterland Twp. Columbia Station Eastlake Elyria Lorain Medina Mentor North Ridgeville Painesville Wickliffe Willoughby Other TOTAL SUBURBAN HEROIN DEATHS (By community of incidence*) * City of Cleveland 507; Unknown location Total Examiner s Office revised