Thomas P. Gilson, M.D. 11 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 218 JUNE UPDATE July 12, 218
9 Cuyahoga County Overdose Deaths 26-218* Most Common Drugs (*projected based upon estimated as of May 15, 218) 8 7 6 NOTE: Projections have been based on initial ELISA screens and not from ruled. This may cause statistical deviations in overprojecting some drugs (especially cocaine) that do not end up in the official cause of death and underprojecting fentanyls (especially analogs and carfentanil) because the confirmations require additional time. Due to heavy caseloads, this process is 6-75 days. CCMEO is providing this very preliminary data in the interest of public safety but final statistical results will not be fully accurate or available until at least the end of the following quarter of the date below. 666 727 714 5 492 4 3 2 25 226 251 269 267 31 31 34 353 194 198 184 161 114 17 117 13 113 127 17 111 116 124 115 81 92 87 87 13 91 91 98 85 11 87 49 4 8 64 64 37 23 11 9 7 13 8 1 5 26-25 27-226 28-251 Heroin Carfentanil 29-269 21-267 211-31 212-31 213-34 214-353 Cocaine Fentanyl 37 215-37 32 99 399 26 56 216-666 29 24 191 13 217-727 367 329 193 72 218*- 714
CURRENT PUBLIC HEALTH EMERGENCY At least 15 fatalities since JULY 1 Fatal Cases due to heroin/fentanyl/analogs in MAY at least 37 (38 pending additional testing) 22 - City of Cleveland Residents 5 - Suburban Residents- Brook Park, Euclid, Lakewood (2) and Parma 9 - Out of County/State Brunswick (Medina), Canton (Stark), Columbus (Franklin), Hessmer (LA), Lagrange (Lorain), Oxford (GA), McKeesport (PA), North Ridgeville (Lorain) and Streetsboro (Portage). VICTIMS Victims ages range from 26 68 27 Male victims; 9 Female victims 7 African American victims; 29 Caucasian victims (3 hispanic victims) TRENDS At least 17 victims have died from heroin/fentanyl/analog or in combination through Mid-Year in 218. This compares to 239 through Mid-Year of 217 and 179 in 216. 218 total is at least 282 fatalities when including cocaine as well. Carfentanil: 56 FATAL CASES in 216; 191 in 217; 18 confirmed fatal in 218 as of 6/31/18 Rate of African American deaths involving fentanyl has dropped to 16.4% of all victims so far in 218, a rate slightly above 216 (14.5%), and below the 2+% in 217. At least 39 cocaine related deaths occurred in June 218 (at least 167 for 218), with at least 17 being mixed with Fentanyl, Heroin or both (at least 91 for 218).
218 CCMEO Overdose Deaths, Most Common Drugs Involved Combined is heroin and fentanyl in some combination (Fentanyl analogues will be counted under Fentanyl Columns). 3 25 24 22 2 2 19 2 2 19 15 1 13 11 16 1 12 1 14 9 13 9 12 15 1 1 13 14 17 5 4 4 5 2 3 4 JAN- 48 total FEB- 5 total MAR- 47 total APR- 36 total MAY- 43 total JUNE- 59 total Heroin Fentanyl Heroin/Fentanyl Combined Cocaine alone Cocaine/Fentanyl Combined
14 13 Cuyahoga County Heroin/Fentanyl Related Overdose Deaths 213-218* 1417 Projected deaths with Saves as overdose Deaths (* 218 based on preliminary data thru May 31) 12 1 9 93 8 7 6 5 4 3 2 194 197 23 198 223 328 184 228 439 32 58 24 542 193 42 64 213 213 plus Fentanyl 213 w/o 214 214 plus fentanyl 214 w/o 215 215 215 proj w/fentanyl w/o 216 216 216 proj w/fentanyl w/o 217 proj 217 proj 217 proj w/fentanyl w/o 218 proj 218 proj w/fent 218 proj w/o includes all documented naloxone saves through including police reversals. Does not include EMS administrations: (1,93 doses in 215, 5,156 in 216 and 7,745 dose administrations in 217).
Cuyahoga County Fentanyl Deaths 26-218 % 9% 8% 3 2.75 3.5 1.5 3 1.5 3 2.25 3.5 5 87 7% 6% 5% 4% 13.67 Cuyahoga County has seen 187 more fentanyl related deaths in the past 32 months than the entire decade prior. 15 3% 2% 1% % Months Deaths 26-Sept. 214 Oct. 214-Nov.21, 215 Nov. 21, 215 - Apr. 7, 216 Apr. 8 - July 2, 216 July 21 - Sept 3, 216 Oct. 1 - Dec 31, 216 Jan 1 - Feb 15, 217 Feb 16 - May 15, 217 May 15- June 3, 217 July 1 - Oct 15, 217 Oct. 16- Dec. 31, 217 Jan 1 - Apr 4, 218 April 5 - July 6, 218
12 CCMEO Fentanyl-related fatalities among African Americans 214-218* *(Red - Projected for remainder of year, as of June 3, 218) 8 6 4 3 2 58 25 3 7 214 215 216 217 218 Fentanyl (YTD) Fentanyl (Projected)
9 CCMEO Quarterly Heroin/Fentanyl/Combined Deaths 214-218* (*218 suspected as of 6-3-18) 8 7 6 59 7 68 75 63 71 64 81 65 63 5 4 3 37 48 32 32 29 39 37 3 43 35 38 51 41 5 31 4 39 39 47 37 37 2 1 21 15 14 12 13 13 14 12 11 12 13 1 11 8 8 9 7 4 4 2 3 1 Q1 214 Q2 214 Q3 214 Q4 214 Q1 215 Q2 215 Q3 215 Q4 215 Q1 216 Q2 216 Q3 216 Q4 216 Q1 217 Q2 217 Q3 217 Q4 217 Q1 218 Q2 218 Heroin only Fentanyl only Combined
CCMEO, Proliferation of Fentanyl and Cocaine/Fentanyl mixtures in fatalities 213-218* (* thru June 3, 218) 218 79 94 194 217 19 217 492 216 161 213 399 215 24 47 92 214 12 22 37 213 2 2 5 2 3 4 5 6 Cocaine + Fentanyl Heroin + Fentanyl Fentanyl
217-218* CCMEO/CCRFSL Drug Chemistry testing (* through June 3, 218) 12 122 8 751 778 6 567 4 39 361 453 348 41 2 22 Items or powder with both cocaine and fentanyl Items or powder with both cocaine and heroin Items or powder with both heroin and fentanyl Items with cocaine and fentanyl analog/synth opioid Items or powder with heroin and fentanyl analog/synth opioid
45 CCMEO/CCRFSL Drug Chemistry testing # Items or powder with both cocaine and fentanyl (*through June 3, 218) 4 35 39 361 3 25 2 15 134 5 9 215 216 217 218 *