Trends in Opioid Overdose Fatalities in Cuyahoga County, Ohio: Multi-Drug Mixtures, the African-American Community and Carfentanil

• Published in: Drug and alcohol dependence reports 2022-09, Vol.4, p.100069, Article 100069
• Main Authors: Bhullar, Manreet K., Gilson, Thomas P., Singer, Mendel E.
• Format: Article
• Language: English
• Subjects: Carfentanil; Cocaine; Fentanyl; Full Length Report; Harm reduction; Opioid-related overdose; Overdose fatalities; Polysubstance use
• ISSN: 2772-7246; 2772-7246
• DOI: 10.1016/j.dadr.2022.100069

•3 or more cause of death drugs were identified in nearly two-thirds of opiate/opioid decedents.•Cocaine/opioid mixtures led to 4 times as many African American decedents than 2 years prior.•Fentanyl and its analogs were present in 90% of decedents, and carfentanil was present in 35%.•Carfentanil was more common in people with prior illicit drug use, but no relevant medical history. : Ohio's age-adjusted opioid overdose fatality rate is double the national average. In an ever-evolving epidemic, it is crucial to monitor trends to inform public health interventions. : A retrospective study was conducted using the Medical Examiner's decedent case files for all accidental opioid-related adult overdose deaths in Cuyahoga County (Cleveland), Ohio in 2017. Characterization of trends was based on autopsy/toxicology and first responder reports, medical records and death scene investigations. : Of 543 accidental opioid-related adult overdose fatalities, 64.1% died from 3+ drugs. The most common cause of death (COD) drugs included fentanyl (63.4%), heroin (44.4%), cocaine (37.0%) and carfentanil (35.0%). There were four times as many African American decedents as two years prior. Three or more COD drugs was >50% more common in those with fentanyl (Prevalence Ratio (PR) = 1.56[1.34-1.70]; p