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 SEPTEMBER UPDATE OCTOBER 5, 217
9 8 Cuyahoga County Overdose Deaths 26-217* Most Common Drugs (*projected based on ruled as of Oct. 5) 783 7 666 6 5 445 4 3 2 25 226 251 269 267 31 31 34 353 194 198 184 161 192 176 134 114 17 117 13 17 111 116 124 113 115 127 116 112 91 92 81 87 87 13 91 91 98 85 11 87 49 4 64 64 37 8 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 32 119 99 399 26 17 216-666 Heroin Non-fentanyl associated Heroin deaths Cocaine Non-fentanyl associated Cocaine deaths Fentanyl All Opioids (not inc. Fentanyl) 273 167 65 377 124 217*-783 Examiner s Office revised 1-5-17
CURRENT PUBLIC HEALTH CRISIS 11 fatalities since Oct. 1 Fatal Cases due to heroin/fentanyl/analogs in SEPTEMBER at least 35 (41 pending additional testing) 21 - City of Cleveland Residents 12 - Suburban Residents- Broadview Hts., East Cleveland, Euclid, Garfield Hts., (3) North Olmsted, North Royalton, Olmsted Falls, Parma, and (2) Out of County Chicago, IL and Geneva (Ashtabula). 1 UNKNOWN VICTIMS Victims ages range from 21 68 27 Male victims; 8 Female victims 4 African American victims; 1 Asian American; 3 Caucasian victims (3 Hispanic victims) TRENDS At least 396 victims have died from heroin/fentanyl/analog or in combination in 217. This compares to 366 through end of September 216. Drug deaths in 217 total at least 521 fatalities when including cocaine as well. Carfentanil: 58 CONFIRMED FATAL CASES in 216; 64 CONFIRMED as of 1/5 in 217 Rate of African American deaths involving fentanyl is 23.7% of all victims, a significantly higher rate than 216 (14.5%). At least 25 cocaine related deaths occurred in September (at least 286 for 217), with at least 14 being mixed with Fentanyl, Heroin or both (at least 159 for the year). Examiner s Office revised 1-5-17
45 CCMEO Heroin, Fentanyl and Heroin/Fentanyl Combination Deaths (*217 through Oct. 5, 217) 4 35 3 158 25 116 2 15 5 7 33 12 179 38 144 92 49 3rd Q 214 3rd Q 215 3rd Q 216 3rd Q 217* Heroin only Fentanyl only Combined Examiner s Office revised 1-5-17
12 1 9 8 7 Cuyahoga County Heroin Related Overdose Deaths 27-217* Projected deaths with DAWN Saves and Fentanyl as overdose Deaths (* 217 projected based on preliminary data thru Oct. 5) 916 137 6 5 444 56 522 4 3 2 4 64 64 91 17 161 194 197 23 198 223 329 184 228 32 273 Examiner s Office revised 1-5-17 DAWN includes all documented naloxone saves through DAWN including police reversals. Does not include EMS administration (nearly 1, in 215, and over 2, thru October 216). No 217 EMS data yet.
% 9% 8% 3.25 1.5 3 1.5 3 2.25 3.5 5 13.67 Cuyahoga County Fentanyl Deaths 26-217 9 7% 6% 5% Cuyahoga County has seen 59 more fentanyl related deaths in the past 23 months than the previous 1 years. 4% 3% 2% 1% % 15 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 5, 217 Examiner s Office revised 1-5-17
217 CCMEO Overdose Deaths, Most Common Drugs Involved Combined is heroin and fentanyl in some combination (Fentanyl analogues will be counted under Fentanyl Columns). 35 33 3 25 2 15 1 5 24 23 22 11 4 3 26 1 27 25 16 12 9 4 21 2 16 14 6 25 14 9 2 8 18 18 18 17 8 2 15 14 14 1 5 24 2 13 9 18 14 11 1 7 JAN- 6 total FEB- 72 total MAR- 5 total APR- 63 total MAY-5 total JUNE- 61 total JULY- 59 total AUG- 47 total SEP- 46 total Heroin Fentanyl Heroin/Fentanyl Combined Cocaine Cocaine/Fentanyl Combined Examiner s Office revised 1-5-17
CCMEO, Proliferation of Fentanyl and Cocaine/Fentanyl mixtures in fatalities 213-217* (through Sept. 25) 217 159 158 338 216 161 213 399 215 24 47 92 214 12 22 37 213 2 2 5 5 15 2 25 3 35 4 45 Cocaine + Fentanyl Heroin + Fentanyl Fentanyl Examiner s Office revised 1-5-17
CCMEO/CCRFSL Drug Chemistry testing # Items or powder with both cocaine and fentanyl (includes fentanyl analogs) 35 3 299 25 2 15 134 5 9 215 216 217 (thru June 3, 217) Examiner s Office revised 9-25-17
CCMEO Fentanyl-related fatalities among African Americans 214-217* (Blue - Projected for remainder of year, as of October 5, 217) 78 9 8 7 6 58 5 4 3 2 25 1 7 26 214 215 216 217 Examiner s Office revised 1-5-17
9 8 7 CCMEO/CCRFSL Drug Chemistry Testing, Monthly Positive Results for Fentanyl Analogs 217 (Jan. 1 - June 3) 77 83 6 5 53 4 3 29 3 2 1 11 8 14 January February March April May June 3-Methylfentanyl 4-ANPP Acetylfentanyl Acrylfentanyl Butyrylfentanyl Carfentanil Cyclopropylfentanyl FIBF Furanyl Fentanyl Methoxyacetylfentanyl U-477 U-51754 Examiner s Office revised 9-25-17
CCMEO/CCRFSL Fentanyl and It's Most Common Analogs, Overdose Deaths in Cuyahoga County 213-217 (*projected based on ruled through June 3, 217) 5 45 445 4 399 35 3 25 2 15 5 192 176 167 116 112 134 119 92 17 112 91 55 65 37 45 5 4 7 28 213-34 214-353 215-37 3 216-666 217*-78 Non-fentanyl associated Heroin deaths Non-fentanyl associated Cocaine deaths Carfentanil Acetyl-fentanyl Fentanyl Acryl-fentanyl Furanyl-fentanyl Examiner s Office revised 9-25-17