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Thomas P. Gilson, M.D.

11001 Cedar Avenue, Cleveland, Ohio 44106


A National Association of Medical Examiners (N.A.M.E.) accredited office

CUYAHOGA COUNTY

MEDICAL EXAMINERS OFFICE


Heroin/Fentanyl/Cocaine
Related Deaths in
Cuyahoga County
MAY 15, 2017
Cuyahoga County Overdose Deaths 2006-2017*
900 Most Common Drugs (*projected based on ruled cases as of May 15)

800 775

700
666
600

500 487

400 370 399


340 353 376
310 320
300
301 284
269 267
250 251 260
226
194 198 184
200
161 192 149
176 134
107 117 116 124 119
114 103 113 107 111 115
99
100 127 116 112 92
81 103 101 91 106 92
87 87 91 91 98 85 87
49 40 64 64 37 80
11 9 7 13 8 10 5 49
0 23
2006 - 250 2007 - 226 2008 - 251 2009 - 269 2010 - 267 2011 - 301 2012 - 310 2013 -340 2014- 353 2015 - 370 2016- 666 2017**-805
cases cases cases cases cases cases cases cases cases cases cases cases
Heroin Non-fentanyl associated Heroin deaths Cocaine
Non-fentanyl associated Cocaine deaths Fentanyl All Opioids (not inc. Fentanyl)
Source: Cuyahoga County Medical
Examiners Office revised 5-15-17
CURRENT PUBLIC HEALTH CRISIS at least 19 fatalities since May 1
Fatal Cases due to heroin/fentanyl in Aprilat least 41 (9 cases pending additional testing)
25 - City of Cleveland Residents
16 - Suburban Residents- Bedford, Brooklyn, Euclid, Garfield Hts., Lakewood (2), Newburgh Hts.,
Parma, Richmond Hts., Shaker Hts., Strongsville (2) and (3) Out of County Kent, Mentor and
Willard (1 UNKNOWN).
VICTIMS
Victims ages range from 27 65
31 Male victims; 10 Female victims
7 African American victims; 34 Caucasian victims (3 Hispanic victims)

TRENDS
At least 187 victims have died from heroin/fentanyl or in combination in 2017. This compares to
140 in the first trimester of 2016 and at least 506 in 2016 which was more than double the 228 from
2015. Cocaine deaths are projected to have more than doubled from 115 to 260 in 2016. The 2017
total is at least 236 fatalities when including cocaine as well.
Carfentanil: 54 CONFIRMED FATAL CASES TO DATE in 2016
Rate of African American deaths involving fentanyl is 20.5% of all victims, nearly double the rate in
2016 (13%). At least 33 cocaine related deaths occurred in April (at least 139 for 2017), with 13 being
mixed with Fentanyl, Heroin or both (at least 84 for the year).
Source: Cuyahoga County Medical
Examiners Office revised 5-15-17
CCMEO 2016-17 Fentanyl & Heroin Related Deaths, by Month
35
33

30

25 25 25
25 24
23 23
22 22 22 22
21
20
20 19 19 19
18
17 17
16 16
15
15 14 14
13 13
12 12 12 12
11

10 9 9 9 9 9
8 8
7 7 7
6 6 6
5
5 4 4
3

0
0
JAN- 30 FEB- 27 MAR- 50 APR- 33 MAY- 46 JUNE- 31 JULY- 48 AUG- 56 SEP- 57 OCT- 51 NOV- 44 DEC- 44 JAN- 49 FEB- 61 MAR- 35 APR- 41
total total total total total total total total total total total total total total total total

Heroin Fentanyl Combined Opioid ODs (awaiting confirmation tests)

Source: Cuyahoga County Medical


Examiners Office revised 5-15-17
CCMEO Heroin, Fentanyl and Heroin/Fentanyl Combination Deaths
200
1st Trimester 2014-2017
180

160

140 78

120 43

100

80

18 60
60 85
6
4
18
40

51
20 39 37
17
0
1st Tri 2014 1st Tri 2015 1st Tri 2016 1st Tri 2017

Heroin only Fentanyl only Combined

Source: Cuyahoga County Medical


Examiners Office revised 5-15-17
Cuyahoga County Heroin Related Overdose Deaths 2007-2017*
Projected deaths with DAWN Saves and Fentanyl as overdose Deaths
1200 (* 2017 projected based on preliminary data thru May 15)
1134
1100 1061

1000

900

800

700

600 588
517
500 471

400
334
299
300 282
230 223 228
194 197 198 184
200 161
91 107
100 64 64
40
0

Source: Cuyahoga County Medical DAWN includes all documented naloxone saves
Examiners Office revised 5-15-17 through DAWN including police reversals. Does not
include EMS administration (nearly 1,000 in 2015, and
over 2,000 thru October 2016).
Cuyahoga County Fentanyl Deaths 2006-2017
100% 3
1.5
3 88
2.25
3.5
90%
5

13.67 100
80%

70% 100 Cuyahoga County has


seen 188 more
60% fentanyl related
100 deaths in the past 13
months than the
50% previous 10 years.
100
40%
105

100
30%

20% 100

10%
100

0%
Months Deaths
2006-Sept. 2014 Oct. 2014-Nov.21, 2015 Nov. 21, 2015 - Apr. 7, 2016
Apr. 8 - July 20, 2016 July 21 - Sept 30, 2016 Oct. 1 - Dec 31, 2016
Jan 1 - Feb 15, 2017 Feb 16 - May 15, 2017

Source: Cuyahoga County Medical


Examiners Office revised 5-15-17
2017 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

30

26
25
25 24
23
22 22
20
20 19

16 16
15
13
12
11
10
10 9

6
5 4 4
3

0
JAN- 60 total FEB- 71 total MAR- 47 total APR- 61 total

Heroin Fentanyl
Heroin/Fentanyl Combined Cocaine
Cocaine/Fentanyl Combined Opioid ODs (awaiting confirmation tests)

Source: Cuyahoga County Medical


Examiners Office revised 5-15-17
CCMEO Fentanyl-related fatalities among
African Americans 2014-2017*
(Blue - Projected for remainder of year, as of May 15, 2017)
140
50
120

100

80

60 58

40 78

25
20

6
0
2014 2015 2016 2017

Source: Cuyahoga County Medical


Examiners Office revised 5-15-17