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 217 APRIL UPDATE May 15, 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 which have now stretched to 9 days due to heavy caseloads. 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 1 st quarter of 218. 666 724 684 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 29-269 21-267 211-31 212-31 213-34 214-353 37 215-37 32 99 41 26 56 216-666 29 24 191 89 217*-727 36 35 18 84 218**- 684 Heroin Cocaine Carfentanil Fentanyl All Opioids (not inc. Fentanyl) TOTAL DRUG OD DEATHS
CURRENT PUBLIC HEALTH EMERGENCY At least 15 fatalities since MAY 1 Fatal Cases due to heroin/fentanyl/analogs in APRIL at least 24 (3 pending additional testing) 1 - City of Cleveland Residents 14 - Suburban Residents- Brooklyn (2), Lakewood, Mayfield Hts. (2), North Royalton, Olmsted Falls, Parma Hts. (2), Warrensville Hts., Westlake and (3) Out of County Mentor (Lake), Strasburg (Tuscarawas) and Hayward (CA) VICTIMS Victims ages range from 18 64 18 Male victims; 6 Female victims 1 African American victim; 1 Asian Indian victim; 22 Caucasian victims (4 hispanic victims) TRENDS At least 137 victims have died from heroin/fentanyl/analog or in combination in 218. This compares to 192 through April of 217 and 139 in 216. 218 total is at least 181 fatalities when including cocaine as well. Carfentanil: 56 FATAL CASES in 216; 191 in 217; 15 confirmed fatal in 218 as of 5/15/18 Rate of African American deaths involving fentanyl has dropped to 11.5% of all victims so far in 218, a rate lower than 216 (14.5%), and well below the 2+% in 217. At least 27 cocaine related deaths occurred in April 218 (at least 15 for 218), with at least 15 being mixed with Fentanyl, Heroin or both (at least 65 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 2 2 19 2 15 1 13 11 16 1 12 1 14 9 13 9 12 15 5 4 4 5 2 JAN- 48 total FEB- 5 total MAR- 47 total APR- 36 total Heroin Fentanyl Heroin/Fentanyl Combined Cocaine alone Cocaine/Fentanyl Combined
14 13 Cuyahoga County Heroin/Fentanyl Related Overdose Deaths 213-218* Projected deaths with Saves as overdose Deaths (* 218 based on preliminary data thru March 31) 1341 12 1 9 923 8 7 6 5 4 3 2 194 197 23 198 223 329 184 228 445 32 58 24 542 18 422 66 213 213 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 6,643 dose administrations in 217).
% 9% 8% 3 2.75 3.5 1.5 3 1.5 3 2.25 3.5 5 13.67 Cuyahoga County Fentanyl Deaths 26-218 116 17 7% 6% 5% 98 94 Cuyahoga County has seen more fentanyl related deaths in the past 29 months than the previous decade. 4% 3% 15 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 Examiner s Office revised 4-5-18
CCMEO Fentanyl-related fatalities among African Americans 214-218* (Red - Projected for remainder of year, as of May 1, 218) 12 8 6 99 4 2 58 25 7 214 215 216 217 218 28 14
9 CCMEO Quarterly Heroin/Fentanyl/Combined Deaths 214-218* (*218 suspected as of 4-4-18) 8 7 6 59 7 68 78 76 63 64 74 63 5 4 3 37 48 32 32 29 39 37 3 43 35 38 51 5 41 31 4 44 39 39 37 2 1 21 15 14 12 13 13 14 12 1 11 11 8 7 8 12 12 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 Heroin only Fentanyl only Combined Examiner s Office revised 4-5-18
CCMEO, Proliferation of Fentanyl and Cocaine/Fentanyl mixtures in fatalities 213-218* (* thru end of April 218) 218 5 65 132 217 19 217 492 216 161 213 41 215 24 47 92 214 12 22 37 213 2 2 5 2 3 4 5 6 Cocaine + Fentanyl Heroin + Fentanyl Fentanyl
CCRFSL, Drug Chemistry Lab Positive Findings of Fentanyl Analogs 216-217 9 95 8 7 6 5 4 3 2 51 1 22 25 59 7 288 71 9 19 128 12 61 27 18 88 6 13 29 196 12 216 217 Examiner s Office revised 3-8-18
CCMEO/CCRFSL Drug Chemistry testing # Items or powder with both cocaine and fentanyl (includes fentanyl analogs) 45 4 39 35 3 25 2 15 134 5 9 215 216 217 Examiner s Office revised 1-25-18