Heroin/Fentanyl/Cocaine Related Deaths in Cuyahoga County

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1 Thomas P. Gilson, M.D. 111 Cedar Avenue, Cleveland, Ohio 4416 A National Association of Medical Examiner s (N.A.M.E.) accredited office CUYAHOGA COUNTY MEDICAL EXAMINER S OFFICE Heroin/Fentanyl/Cocaine Related Deaths in Cuyahoga County 219 FEBRUARY UPDATE March 6, 219

2 Examiner s Office revised -6-19

3 CURRENT PUBLIC HEALTH EMERGENCY At least 17 fatalities since Mar. 1 Fatal Cases due to heroin/fentanyl/analogs in FEBRUARY at least 44 ( pending testing) 24 - City of Cleveland Residents 19 - Suburban Residents- Bay Village, Brooklyn, East Cleveland, Euclid, Fairview Park Highland Hts., Lakewood (2), Lyndhurst, Mayfield Hts., Oakwood, Richmond Hts., Solon, South Euclid, Valley View and Westlake (2) and, - Out of County- Barberton (Summit),Valley City (Medina) VICTIMS Victims ages range from 25-7 Male victims; 21 Female victims 1 African American victims; 1 Asian American victim; Caucasian victims ( hispanic victims) TRENDS At least 97 victims have died from heroin/fentanyl/analog or in combination through February 219. This compares to 69 in 218 and 112 in is at least 17 fatalities when including cocaine as well. Carfentanil: 191 FATAL CASES in 217; 24 confirmed in 218; 6 confirmed in 219 as of 2/1/19 Rate of African American deaths involving fentanyl is 26.% of all victims so far in 219, a rate above 216 (14.5%), and higher than the 2.% in 217 and in 218. As many as 24 cocaine related deaths occurred in February 219 with as many as 18 being mixed with Fentanyl, Heroin or both. Examiner s Office revised -6-19

4 5 219 CCMEO Overdose Deaths, Most Common Drugs Involved Combined is heroin and fentanyl or cocaine and fentanyl in some combination 1 (Fentanyl analogues will be counted under Fentanyl Columns) JAN - 57 Heroin Heroin/Fentanyl Combined Cocaine/Fentanyl Combined 7 4 FEB- 51 Fentanyl Cocaine alone Opioid ODs (awaiting confirmation tests) Examiner s Office revised -1-19

5 218 CCMEO Overdose Deaths, Most Common Drugs Involved Combined is heroin and fentanyl in some combination (Fentanyl analogues will be counted under Fentanyl Columns) JAN FEB MAR APR- 1 MAY JUNE JULY AUG SEP OCT NOV DEC- 5 Heroin Fentanyl Heroin/Fentanyl Combined Cocaine alone Cocaine/Fentanyl Combined Examiner s Office revised

6 14 Cuyahoga County Heroin/Fentanyl Related Overdose Deaths * Projected deaths with DAWN Saves as overdose Deaths 149 (* 218 based on preliminary data thru February 1, 219) plus Fentanyl 21 w/o DAWN plus fentanyl 214 w/o DAWN proj w/fentanyl w/o DAWN proj w/fentanyl w/o DAWN w/o w/fentanyl DAWN 218 proj 218 proj w/fent 218 proj w/o DAWN Examiner s Office revised DAWN includes all documented naloxone saves through DAWN including police reversals. Does not include EMS administrations: (1,9 doses in 215, 5,156 in 216 and 7,745 in 217 and,789 dose administrations in 218).

7 1% 9% 8% 7% Cuyahoga County Fentanyl Deaths % 5% 4% Cuyahoga County has seen 121 more fentanyl related deaths in the past 8 months than the entire decade prior. % 2% 1% % Months 26-Sept., 214 Oct. 1, 214-Nov.21, 215 Nov. 21, Apr. 7, 216 Apr. 8 - July 2, 216 July 21 - Sept, 216 Oct. 1 - Dec 1, 216 Jan 1 - Feb 15, 217 Feb 16 - May 15, 217 May 15- June, 217 July 1 - Oct 15, 217 Oct. 16- Dec. 1, 217 Jan 1 - Apr 4, 218 April 5 - July 1, 218 July 14-Sep 1, 218 Sep 1 - Nov 28 Nov 29 -Feb 28, Deaths Examiner s Office revised -1-19

8 Opioid related overdose deaths as Percentage* of All Drug related Deaths *( %; %) 64.42% 67.77% 72.26% 77.6% 72.24% 75.14% 8.6% 76.48% 78.57% 1.% 75.% % 57.25% % 47.79% 5.% 2 25.% *-56.% TOTAL DRUG OD DEATHS All Opiate/opioid % opioid deaths to all drug deaths Examiner s Office revised

9 16 CCMEO Fentanyl-related fatalities among African Americans * *(Red - Projected for remainder of year, as of March 1, 219) Fentanyl (YTD) Fentanyl (Projected) Examiner s Office revised -1-19

10 CCMEO, Proliferation of Fentanyl and Cocaine/Fentanyl mixtures in fatalities * (* thru February) Cocaine + Fentanyl Heroin + Fentanyl Fentanyl Examiner s Office revised -1-19

11 CCMEO Cocaine related Overdose Deaths * Demographic Shift in Cocaine Deaths (Includes cocaine/fentanyl mixed ) *218 from rd Qtr data and projected from remainder of 218 as of 12/1/ % 59.84% % % 56.1% 51.2% 52.25% 46.96% 46.77% 42.61% % 76 7.% 6.% 5.% 4.% %.% 29.92% 2.% 2 1.% *.% African American Cocaine Deaths African American Cocaine Deaths as Percentage of Total Examiner s Office revised

12 5 4 EPIDEMICS OF UNINTENTIONAL DRUG OVERDOSE DEATHS IN OHIO Sources: WONDER (NCHS Compressed Mortality File, & ) ODH Office of Vital Statistics, Change from ICD-9 to ICD-1 coding in 1999 (caution in comparing before and after 1998 and Fentanyl Analogs & Cocaine 2 1 Heroin Crack Cocaine Examiner s Office revised