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 MARCH UPDATE APRIL 5, 218
9 8 7 6 Cuyahoga County Overdose Deaths 26-217* Most Common Drugs Found in Cause of Death (*projected by ruled as of Dec. 31, 217) 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 the end of the 1 st quarter of 218. 666 822 5 477 4 3 2 25 226 251 269 267 31 31 34 353 194 198 184 161 114 17 117 13 113 111 116 124 115 127 17 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 99 399 26 56 216-668 349 25 192 16 217*-822 Heroin Cocaine Carfentanil Fentanyl All Opioids (not inc. Fentanyl) TOTAL DRUG OD DEATHS Examiner s Office revised 1-25-18
CURRENT PUBLIC HEALTH EMERGENCY At least 5 fatalities since APR. 1 Fatal Cases due to heroin/fentanyl/analogs in MARCH at least 38 (52 pending additional testing) 13 - City of Cleveland Residents 24 - Suburban Residents- Berea, Brook Park, Brooklyn, East Cleveland, Euclid (2), Garfield Hts., Lakewood (2), Maple Hts., North Olmsted (2), North Royalton, Parma Hts., Richmond Hts., Strongsville and (8) Out of County Cortland (Warren), Mantua (Portage), Willowick (Lake) North Ridgeville (Lorain), Chesne (SC), Clayville (PA), Morgantown (WV) and Salvation (FL) 1 - Unknown VICTIMS Victims ages range from 17 78 26 Male victims; 12 Female victims 4 African American victims; 34 Caucasian victims (1 hispanic victim) TRENDS At least 112 victims have died from heroin/fentanyl/analog or in combination in 218. This compares to 152 through March of 217 and 16 in 216. 218 total is at least 144 fatalities when including cocaine as well. Carfentanil: 56 CONFIRMED FATAL CASES in 216; 182 CONFIRMED as of 12/31 in 217 Rate of African American deaths involving fentanyl has dropped to 12.9% of all victims so far in 218, a rate more in line with 216 (14.5%), than the 2+% in 217. At least 29 cocaine related deaths occurred in March 218 (at least 78 for 218), with at least 2 being mixed with Fentanyl, Heroin or both (at least 46 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 16 15 1 13 11 1 12 1 14 9 5 4 3 5 JAN- 48 total FEB- 49 total MAR- 47 total Heroin Fentanyl Heroin/Fentanyl Combined Cocaine alone Cocaine/Fentanyl Combined
9 Cuyahoga County Overdose Deaths 26-218* Most Common Drugs (*projected based upon estimated as of Apr. 5, 218) 8 7 6 666 743 732 5 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 32 399 26 25 28 56 477 182 99 89 216-666 217*-743 396 37 194 218**- 732 Heroin Cocaine Carfentanil Fentanyl All Opioids (not inc. Fentanyl) TOTAL DRUG OD DEATHS
13 12 1 9 8 7 Cuyahoga County Heroin/Fentanyl Related Overdose Deaths 27-217* Projected deaths with DAWN Saves as overdose Deaths (* based on preliminary data thru December 31) 923 139 6 5 445 58 522 4 3 2 4 64 64 91 17 161 194 197 23 198 223 329 184 228 32 25 DAWN includes all documented naloxone saves through DAWN including police reversals. Does not include EMS administrations:(1,93 doses in 215, over 5,156 in 216 and 6,643 dose administrations in 217).
% 9% 8% 7% 3 2.75 3.5 1.5 3 1.5 3 2.25 3.5 5 13.67 Cuyahoga County Fentanyl Deaths 26-218 6% 5% 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
CCMEO Fentanyl-related fatalities among African Americans 214-218* (Red - Projected for remainder of year, as of April 1, 218) 12 8 6 99 4 58 4 2 25 7 13 214 215 216 217 218
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
CCMEO, Proliferation of Fentanyl and Cocaine/Fentanyl mixtures in fatalities 213-218* (* thru end of March) 218 47 38 12 217 2 25 477 216 161 213 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