Cuyahoga County’s medical examiner issued a public-health alert on Friday, Nov. 6, after 40 suspected drug overdose deaths were recorded across the county over a five-week period spanning October and November, the Cuyahoga County Medical Examiner’s Office announced in a press release reported by WKYC.
Dr. Thomas Gilson, the county medical examiner, issued the alert for what the office called a “sustained increase in suspected overdose deaths during October and November,” according to WKYC’s reporting of the release. The count is countywide — it covers all of Cuyahoga County, including Cleveland — and it was independently reported by WJW/FOX 8 from the same Nov. 6 release.
The demographics in the alert are stark. Seventeen of the 40 people who died — 42.5 percent — were Black residents, the Medical Examiner’s Office said, as reported by WKYC. “While things have improved, it is important to remember that we still see drug overdoses, especially involving cocaine and our Black population,” Dr. Gilson warned in the Medical Examiner’s Office press release, as reported by WKYC.
Cocaine, not fentanyl alone, sits at the center of this spike. A majority of the preliminary drug screenings in these cases were positive for cocaine, and about half of those screenings also included fentanyl, the Medical Examiner’s Office said, as reported by WKYC. The office explained the shift this way, as reported by WKYC: “As a result of this decrease, cocaine now drives all drug overdose deaths in the county” — a reference to fentanyl-related deaths having declined in recent years.
That mixture is what makes the current wave so dangerous, WJW/FOX 8 reported: people may not know fentanyl has been mixed into the drugs they are taking. And unlike an opioid overdose, there is no medication that reverses a cocaine overdose — which is why officials still urge people to keep naloxone on hand wherever drugs might be used, because of the fentanyl that so often travels with cocaine.
“Even though we’re talking about cocaine related overdoses and deaths, administering the Narcan is still important because, again, you could have mixtures, you could have fentanyl within your drug supply,” Senior Forensic Epidemiologist Manreet Bhullar told FOX 8 (WJW).
The Medical Examiner’s Office used the alert to push out harm-reduction guidance, as reported by WJW/FOX 8: learn the signs of a cocaine overdose — dizziness, confusion, shortness of breath, heavy sweating, a racing pulse, paranoia, chest pain, seizure or unresponsiveness; keep naloxone and fentanyl test strips ready; do not use alone; sit upright; and call 911, noting that Ohio’s Good Samaritan Law provides immunity for a minor drug possession or paraphernalia offense for both the person who overdosed and the person who calls. The office also urged people who are struggling to seek treatment. In Cleveland, the nonprofit Save Our Families, which works with Project DAWN, offers free naloxone to Ohio residents and can be reached at 216-282-4292, according to the organization’s alert page.
The alert also lands against a complicated backdrop. County officials have spent several years reporting progress against fentanyl, the synthetic opioid that drove Ohio’s overdose crisis to its worst years, and the Medical Examiner’s Office framed Friday’s warning as a reversal worth acting on immediately rather than a statistic to file away, WKYC reported. Cocaine has a long history in the county’s drug supply, but the office’s data now shows it — alone and in combination with fentanyl — at the center of the deaths again, which is why the alert speaks directly to people who may not consider themselves part of the opioid crisis at all, and to the families and friends around them.
What we know — and what we’re still waiting on
What we know: 40 suspected overdose deaths in five weeks, preliminary screenings dominated by cocaine with fentanyl in about half, and a county alert urging naloxone, test strips and 911 calls. What we’re still waiting on: final toxicology. The screenings behind the alert are preliminary — not final determinations of cause of death — and each case will be finalized individually, which could revise the suspected count. Related enforcement coverage: Canton police raided two homes this week, arresting 18 people and seizing cash, narcotics and a gun.
What happens next: the Medical Examiner’s Office said it will continue to evaluate its own data and data from community partners to determine whether the upward trend is continuing, WKYC reported. No new mandate or program was announced with the alert — it is guidance, aimed at the weeks ahead, and county officials are asking anyone who uses drugs, or loves someone who does, to treat every supply as potentially mixed.
Photo: Intropin, CC BY