Montgomery County Poisoning Death Review, 2016: Quarter I Updated June 20, 2016

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1 Montgomery County Poisoning Death Review, 2016: Quarter I Updated June 20, 2016 Prepared by: Robert G. Carlson, Ph.D., Professor and Director, Project Director Linna Li, M.S., Data Manager Raminta Daniulaityte, Ph.D., Associate Professor and Associate Director, Co-Project Director Center for Interventions, Treatment, and Addictions Research Boonshoft School of Medicine Wright State University Public Health - Dayton & Montgomery County Montgomery County Coroner s Office June 20, 2016 The Poisoning Death Review (PDR) is conducted by the WSU Boonshoft School of Medicine Center for Interventions, Treatment & Addictions Research (CITAR), in collaboration with the Montgomery County Coroner s Office, under contract with Public Health - Dayton & Montgomery County. The PDR was part of the Preventing Unintentional Drug Poisoning Project, which was funded by Public Health Dayton & Montgomery County and the Ohio Department of Health, with injury prevention block grant funds from the U.S. Centers for Disease Control. CITAR Wright State University Boonshoft School of Medicine, 3171 Research Park Blvd., Suite 124. Kettering, OH Office:

2 Highlights of Quarter I Findings Introduction: This 2016 Quarter I Report presents the Poison Death Review data on unintentional drug overdose deaths based on reports provided by the Montgomery County Coroner s office. The vast majority of deaths occurred January through March, Of the 89 deaths discussed in this Report, two occurred in April and two in May, Methods: The attached tables provide data on: 1) Demographics; 2) Health; 3) History of Substance Abuse; 4) Location of Death; and 5) Toxicology. The toxicology tables indicate mentions of drugs found in decedents bodies as identified by the Coroner s office. Drug Mentions: A drug mention means that a specific drug was found in a bodily system or fluid of a decedent, not that the drug was necessarily the sole cause of death. The presence of more than one drug can result in more than one mention from a single decedent. Limitations: The highlights below describe comparisons of Quarter I 2016 findings with findings from all of. The comparison of percentages are very preliminary indicators of trends in Highlights Dramatic increase in the number of unintentional drug overdose deaths. Eight-nine deaths were reported, largely reflecting January through March, By comparison, 37 deaths were reported January through March,. The number of deaths more than doubled when comparing January through March,, to the same time period in Montgomery County Residents: Of the 89 drug overdose deaths, 80 were Montgomery County residents. Comparison of all overdose death data in Montgomery County (n=89) and all overdose death data among Montgomery County residents (n=80) suggest no substantial differences. Mentions of illicit fentanyl (non-prescription fentanyl) increased from 41 in to 66 in Quarter I, Mentions of heroin indicate a decreasing trend from 45 in, compared to 29 in Quarter I, Any prescription opioiod mentions indicate a decreasing trend from 31 in, compared to 22 in Quarter I, Any benzodiadepine mentions indicate a decreasing trend from 43 in, compared to 30 in Quarter I, Increasing trend in deaths with Illicit fentanyl but no other central nervous system depressant mentions (13 in, compared to 21 in Quarter I, 2016). This indicates the very powerful effects of illicit fentanyl on the central nervous system and its increasing use. 2

3 Increasing trend in deaths with illicit fentanyl plus no heroin mentions (31 ; 49 Q I, 2016). This suggests increases in the availability of illicit fentanyl that has not been mixed with heroin. Overall, the findings indicate a tremendous increase in the impact of illicit fentanyl on the community. The findings indicate that increases in naloxone distribution (including increased provision to opioid users), and linkage of opioid dependent drug users with medicated assisted treatment are urgently needed. 3

4 POISONING DEATH REVIEW SUMMARY REPORT, Quarter 1, All Cases. DEMOGRAPHICS Total Cases Jan 1- March 31 (estimate) 89 Cases : Characteristic Category Freq Average Age Age Group <15 years years years years years years years years Gender Male Female Race White Black Other Education <High School HS graduate College graduate Post-graduate Unknown Marital Status Single Married Divorced Separated Widowed Unknown Military Ever in Military Residence Montgomery Co HEALTH Characteristic Freq Physical Disability/Illness Heart Disease

5 HISTORY OF SUBSTANCE ABUSE Total Cases 89 Cases : Substance Abuse Freq Any history DEATH INVESTIGATION Characteristic Category Freq Location of death Home Relative's home Friend's home Hospital Drug Trt facility 0 0 < Public area Other

6 TOXICOLOGY REPORT This section of the summary includes all substances found in the decedent's body or bodily fluids. There may be multiple drug mentions for each case. Total Cases Characteristic Category Freq Freq Freq Freq Freq Freq Freq Alcohol Cocaine Methamphetam ine Heroin Illicit Fentanyl Prescription Opioids Any Oxycodone Hydrocodone Methadone Fentanyl Tramadol Hydromorphone Morphine Anti-Depressants Any Sedatives (Including Benzos) Any Benzodiazepines Any Any Rx Opioid + Any Benzo Two or more CNS Depressants Heroin with No Other CNS Depressant Illicit Fentanyl with No Other CNS Depressant Heroin + Any Rx Opioid Any Opiate (Heroin/Rx Opioid/Illicit Fentanyl) Any Rx Opiate + No Heroin

7 Illicit Fentanyl + Heroin Illicit Fentanyl + No Heroin Methamphetamine + (Heroin or Illicit Fentanyl) Cocaine + (Heroin or Illicit Fentanyl) Heroin + No Illicit Fentanyl Any Benzo + Heroin Any Benzo + Illicit Fentanyl Any Benzo + Any Opioid Cocaine + Heroin Cocaine + Illicit Fentanyl Other Prescription Any Over-The-Counter Any