CUYAHOGA COUNTY MEDICAL EXAMINER’S OFFICE...
Transcript of 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)
Source: Cuyahoga County Medical Examiner’s Office revised 6-11-20
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
Source: Cuyahoga County Medical Examiner’s Office revised 6-9-20
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
Source: Cuyahoga County Medical Examiner’s Office revised 6-11-20
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
Source: Cuyahoga County Medical Examiner’s Office revised 6-11-20
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
Source: Cuyahoga County Medical Examiner’s Office revised 6-9-20
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
Source: Cuyahoga County Medical Examiner’s Office revised 6-11-20
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
Source: Cuyahoga County Medical Examiner’s Office revised 1-6-20
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
Source: Cuyahoga County Medical Examiner’s Office revised 6-11-20