cuyahoga county medical examiner’s office...
TRANSCRIPT
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
SEPTEMBER UPDATE
OCTOBER 5, 2017
Source: Cuyahoga County Medical Examiner’s Office revised 10-5-17
49 40 64 6491
107
161194 198 184
320
273
192 176 134
107
65
127114 107 117 103
98
111 116 124 115
260
377
116 112 91
119
167
23 11 9 7 13 8 10 537
92
399
445
81 87 87 10391
113
85 101 8780
99
124
250226
251269 267
301 310340 353 370
666
783
0
100
200
300
400
500
600
700
800
900
2006 - 250cases
2007 - 226cases
2008 - 251cases
2009 - 269cases
2010 - 267cases
2011 - 301cases
2012 - 310cases
2013 -340cases
2014- 353cases
2015 - 370cases
2016- 666cases
2017*-783cases
Heroin Non-fentanyl associated Heroin deaths Cocaine
Non-fentanyl associated Cocaine deaths Fentanyl All Opioids (not inc. Fentanyl)
Cuyahoga County Overdose Deaths 2006-2017* Most Common Drugs (*projected based on ruled cases as of Oct. 5)
CURRENT PUBLIC HEALTH CRISIS – 11 fatalities since Oct. 1
Fatal Cases due to heroin/fentanyl/analogs in SEPTEMBER–at least 35 (41 cases 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; 30 Caucasian victims (3 Hispanic victims)
TRENDS
At least 396 victims have died from heroin/fentanyl/analog or in combination in 2017. This
compares to 366 through end of September 2016. Drug deaths in 2017 total at least 521 fatalities
when including cocaine as well.
Carfentanil: 58 CONFIRMED FATAL CASES in 2016; 64 CONFIRMED as of 10/5 in 2017
Rate of African American deaths involving fentanyl is 23.07% of all victims, a significantly higher rate
than 2016 (14.5%). At least 25 cocaine related deaths occurred in September (at least 286 for 2017),
with at least 14 being mixed with Fentanyl, Heroin or both (at least 159 for the year).
Source: Cuyahoga County Medical Examiner’s Office revised 10-5-17
144
100 92
49
7
38
120179
7 33
116
158
0
50
100
150
200
250
300
350
400
450
3rd Q 2014 3rd Q 2015 3rd Q 2016 3rd Q 2017*
CCMEO Heroin, Fentanyl and Heroin/Fentanyl Combination Deaths (*2017 through Oct. 5, 2017)
Heroin only Fentanyl only Combined
Source: Cuyahoga County Medical Examiner’s Office revised 10-5-17
DAWN includes all documented naloxone saves through
DAWN including police reversals. Does not include EMS
administration (nearly 1,000 in 2015, and over 2,000
thru October 2016). No 2017 EMS data yet.
4064 64
91 107
161194 197
230 198223
329
184 228
444
320
506
916
273
522
1037
0
100
200
300
400
500
600
700
800
900
1000
1100
1200
Cuyahoga County Heroin Related Overdose Deaths 2007-2017*Projected deaths with DAWN Saves and Fentanyl as overdose Deaths
(* 2017 projected based on preliminary data thru Oct. 5)
Source: Cuyahoga County Medical Examiner’s Office revised 10-5-17
105
100
13.67
100
5
100
3.5
100
2.25
100
3
100
1.5
100
3
100
1.5
100
3.25
90
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Months Deaths
Cuyahoga County Fentanyl Deaths 2006-2017
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 May 15- June 30, 2017 July 1 - Oct 5, 2017
Source: Cuyahoga County Medical Examiner’s Office revised 10-5-17
Cuyahoga County has
seen 590 more
fentanyl related
deaths in the past 23
months than the
previous 10 years.
43
4
6
2
8
10
5
7
22
2625
21
25
18
14
9
18
23
33
9
16
14
18
15
20
1011
10
12
20
9
17
20
13
11
24
27
16
14
8
18
14
24
14
0
5
10
15
20
25
30
35
JAN- 60 total FEB- 72 total MAR- 50 total APR- 63 total MAY-50 total JUNE- 61 total JULY- 59 total AUG- 47 total SEP- 46 total
2017 CCMEO Overdose Deaths, Most Common Drugs InvolvedCombined is heroin and fentanyl in some combination (Fentanyl analogues will be counted under
Fentanyl Columns).
Heroin Fentanyl Heroin/Fentanyl Combined Cocaine Cocaine/Fentanyl Combined
Source: Cuyahoga County Medical Examiner’s Office revised 10-5-17
5
37
92
399
338
2
22
47
213
158
2
12
24
161
159
0 50 100 150 200 250 300 350 400 450
2013
2014
2015
2016
2017
CCMEO, Proliferation of Fentanyl and Cocaine/Fentanyl mixtures in fatalities2013-2017* (through Sept. 25)
Cocaine + Fentanyl Heroin + Fentanyl Fentanyl
Source: Cuyahoga County Medical Examiner’s Office revised 10-5-17
9
134
299
0
50
100
150
200
250
300
350
2015 2016 2017 (thru June 30, 2017)
CCMEO/CCRFSL Drug Chemistry testing# Items or powder with both cocaine and fentanyl (includes fentanyl analogs)
Source: Cuyahoga County Medical Examiner’s Office revised 9-25-17
267
25
58
78
0
10
20
30
40
50
60
70
80
90
100
2014 2015 2016 2017
CCMEO Fentanyl-related fatalities among African Americans 2014-2017*
(Blue - Projected for remainder of year, as of October 5, 2017)
Source: Cuyahoga County Medical Examiner’s Office revised 10-5-17
29
77
11 8 14
30
53
83
0
10
20
30
40
50
60
70
80
90
January February March April May June
CCMEO/CCRFSL Drug Chemistry Testing, Monthly Positive Results for Fentanyl Analogs 2017 (Jan. 1 - June 30)
3-Methylfentanyl 4-ANPP Acetylfentanyl Acrylfentanyl
Butyrylfentanyl Carfentanil Cyclopropylfentanyl FIBF
Furanyl Fentanyl Methoxyacetylfentanyl U-47700 U-51754
Source: Cuyahoga County Medical Examiner’s Office revised 9-25-17
192 176
134
107
65
116 112
91
119
167
55
112
405
37
92
399
445
3
45
00 0 7 28
0
50
100
150
200
250
300
350
400
450
500
2013 -340 cases 2014- 353 cases 2015 - 370 cases 2016- 666 cases 2017*-780 cases
CCMEO/CCRFSL Fentanyl and It's Most Common Analogs, Overdose Deaths in Cuyahoga County 2013 - 2017 (*projected based on ruled cases through June 30, 2017)
Non-fentanyl associated Heroin deaths Non-fentanyl associated Cocaine deaths Carfentanil
Acetyl-fentanyl Fentanyl Acryl-fentanyl
Furanyl-fentanyl
Source: Cuyahoga County Medical Examiner’s Office revised 9-25-17