CUYAHOGA COUNTY MEDICAL EXAMINER’S OFFICE...

Thomas P. Gilson, M.D.

11001 Cedar Avenue, Cleveland, Ohio 44106

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

2020 May UPDATE

REVISED June 11, 2020

CURRENT PUBLIC HEALTH EMERGENCY –

Fatal Cases due to heroin/fentanyl/analogs in MAY– at least 52 (0 cases pending testing)

28 - City of Cleveland Residents

18 - Suburban Residents- Beachwood, Bedford (2), Berea, Brook Park, East Cleveland, Euclid (2), Fairview

Park, Garfield Hts., Lakewood (2), North Olmsted, Olmsted Falls, Parma (4) and

6 – Out of County – Avon Lake (Lorain Co.), Elyria (Lorain Co.), Medina (Medina Co.), Jefferson (Ashtabula

Co.), Painesville and Willoughby (Lake Co.)

VICTIMS

Victims’ ages range from 19 - 70

40 Male victims; 12 Female victims

13 African American victims; 1 Asian Indian victim, 1 Native American and 36 Caucasian victims (3 hispanic

victims)

TRENDS

At least 166 victims have died from heroin/fentanyl/analog or in combination through May 2020. This

compares to 141 in 2019; 154 in 2018 and 239 in 2017. 2020 total is at least 238 fatalities when including

cocaine as well.

Carfentanil: 191 cases in 2017; 24 cases in 2018; 220 in 2019; 48 confirmed in 2020 as of 6/9/20

Rate of African American deaths involving fentanyl is 25.97% of all victims in 2020, slightly less than the

27.11% in 2019, but much higher than 2016 (14.5%), the 20.33% in 2017 and 21.11 in 2018. As many as 42

cocaine related deaths occurred in May 2020 with as many as 26 being mixed with Fentanyl, Heroin or

both. Source: Cuyahoga County Medical Examiner’s Office revised 6-11-20

49 40 64 6491

107

161194 198 184

320

240

150

119144

127 114 107 117 103

98

111 116 124 115

260

300

246

243

392

0 0 0 0 0 0 0 0 0 0

56

191

24

240

160

84 8187 103 91

113

85

101 87

80

99 103

67

69

250226

251269 267

301 310340 353 370

673

727

550

582

628

2311 9 7 13 8 10 5

3792

425

493

398431

356

0

100

200

300

400

500

600

700

800

2006 - 250cases

2007 - 226cases

2008 - 251cases

2009 - 269cases

2010 - 267cases

2011 - 301cases

2012 - 310cases

2013 -340cases

2014- 353cases

2015 - 370cases

2016- 673cases

2017-727cases

2018-551cases

2019-582cases

2020*-628 cases

Cuyahoga County Overdose Deaths 2006-2020* Most Common Drugs

(*2020 projections based on data through June 11, 2020)

Heroin Cocaine Carfentanil All Opioids (not inc. Fentanyl after 2013) TOTAL DRUG OD DEATHS Fentanyl (ALL)

Source: Cuyahoga County Medical Examiner’s Office revised 6-11-20

2

0

3 3

5

22

13

22

14

30

5

10

6

13

17

20

10

17

10

1615

17

14

19

26

0 0 0 0 00

5

10

15

20

25

30

35

JAN - 49 total FEB- 33 total MAR - 47 total APR - 40 total MAY - 68 total

2020 CCMEO Overdose Deaths, Most Common Drugs Involved* (thru May 31, 2020)Combined is heroin and fentanyl or cocaine and fentanyl in some combination

(Fentanyl analogues will be counted under Fentanyl Columns)

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


105

100

27.33

500

12

500

22.5

500

13.75

404

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Months Deaths

Cuyahoga County Fentanyl Deaths 2006-2020

2006-Sept 30, 2014 Oct 1, 2014-Dec. 31, 2016 2017 Jan 1 2018 - Feb 28, 2019 March 1, 2019 - May 31, 2020

Cuyahoga County

has seen 904 more

fentanyl related

deaths in the past

48 months than the

entire decade prior.

2016 2nd fentanyl crisis

20171st Carfentanil outbreak

Brief fentanyl outbreak in 2006

2019 Carfentanil returns

2018 China crackdown onfentanyl / carfentanil

COVID19 pandemic 2020; China locks down


7

25

58

100

86

119

4039

53

75

110

95

130

43

0

20

40

60

80

100

120

140

2014 2015 2016 2017 2018 2019 2020

CCMEO Fentanyl-related fatalities among African Americans 2014-2020* (*thru June 11, 2020)

All Fentanyl African American Deaths All Opioid African American Deaths


5

37

92

399

492

398

379

158

2

22

47

213

217

139

115

54

2

12

24

161

190

156

169

96

0

0

0

20

67

8

84

18

0 100 200 300 400 500 600

2013

2014

2015

2016

2017

2018

2019

2020

CCMEO, Proliferation of Heroin/Fentanyl and Cocaine/Fentanyl mixtures in fatalities 2013-2020* (* thru June 11, 2020)

Cocaine + Carfentanil Cocaine + Fentanyl Heroin + Fentanyl Fentanyl


0

50

100

150

200

250

300

350

400

450

010

2030

4050

60

NO

VD

ECJA

NFE

BM

AR

AP

RM

AY

JUN

EJU

LYA

UG

SEP

OC

TN

OV

DEC

JAN

FEB

MA

RA

PR

MA

YJU

NE

JULY

AU

GSE

PO

CT

NO

VD

ECJA

NFE

BM

AR

AP

RM

AY

JUN

EJU

LYA

UG

SEP

OC

TN

OV

DEC

JAN

FEB

MA

RA

PR

MA

YJU

NE

JULY

AU

GSE

PO

CT

NO

VD

ECJA

NFE

BM

AR

AP

RM

AY

JUN

EJU

LYA

UG

SEP

OC

TN

OV

DEC

JAN

FEB

MA

RA

PR

2014 2015 2016 2017 2018 2019 2020

Lab su

bm

ission

sFa

talit

ies

CCMEO/CCRFSL Relationship of Fentanyl and Carfentanil Fatalities and Fentanyl and Carfentanil Lab Submissions 2014-2020 (thru 1st Trimester)

Fentanyl submissions Carfentanil submissions Fentanyl deaths Carfentanil deaths


39

6

10

6

16

2 11

5

11

7

68

93

59

12

22

21

47

8

24

8 18

7

17

4 12

8

96

78

76

52

36

19

35

4

17

2 11

2

12

1

12

3

81

43

71

32

20 8

18

1 13

7 55

78

43

39

28

42

31 5

10

1668

917

640683

591

402

263

327

192134

70

0

200

400

600

800

1000

1200

1400

1600

1800

CCMEO Drug Chemistry Lab Submissions 2020 YTD thru May Top Ten Substances and Results

JAN FEB MAR APR MAY TOTAL THRU MAY


1704

1440

734633

540 466346

100 88 99 104 54

3747

2851

13791268

540

1015

667

276 242 184 170 91

5043

4028

1931

1709

1335

1100

402502

255 302149

4959

5399

2344

2013

15451372

459

899

320502

221

0

1000

2000

3000

4000

5000

6000

CCRFSL Drug Chemistry Top 10 Drug Submissions 2019

TOTAL 1st Q

TOTAL thru Midyear

TOTAL thru 3rd Q

TOTAL 2019


2392

494

1154

1041

148 176

1000

0

16788

1668

917

640683

402

263327

192134

70

0

500

1000

1500

2000

2500

3000

CCRFSL Drug Chemistry Submissions and Results2019 TOP 10 vs. 2020 TOP 10

THRU MAY TOT 2019 THRU MAY TOT 2020


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