Fentanyl-laced cocaine increasing preeminence is No. 1 overdose death combination.
State yet to respond to change.

The Ohio Health Department added more than 300 drug overdose deaths from 2017 to its mortality database this morning. The new autopsy results confirm that cocaine-fentanyl combinations are now the leading fentanyl-related overdose death threat in Ohio.

The change was first reported by Harm Reduction Ohio here and here and has caught state health authorities flat-footed. Ohio’s massive response to overdose deaths has focused exclusively on opioid users and missed the dramatic change driving the state’s death toll to record levels.

Nalaxone distribution must be immediately widened to protect cocaine, meth and other drug users. Other policies needed to save lives are proposed at the end of this article.

But, first, a close look at the drugs being found in the blood of overdose victims.

Beware fentanyl-laced cocaine 

The autopsy data released today bring drug overdose deaths to 3,793 in 2017 — counted so far. Counties are still submitting reports and completing lab analysis. When finished, Ohio’s overdose death toll for last year is likely to exceed 5,000, up from 4,050 in 2016 and 3,050 in 2015.

The deaths documented for 2017 so far provide a deep look at disturbing trends in who’s dying and from what drug combinations.

Fentanyl and its many analogues (such as carfentanil) dominate the graveyard. That’s no surprise. Fentanyl was found in the blood of 76% of the 313 deaths recently added to the data, mostly from late 2017. For all of 2017 analyzed thus far, fentanyl was found in the systems of 70.7% of overdose victims.

Cocaine vs. heroin 

Although fentanyl is sometimes taken alone, it is primarily added to other drugs as a compact, low-cost potency boost. Cocaine-fentanyl is the drug combination most often found in the blood of overdose victims today. Fentanyl combined with heroin or other opioids appears to be declining or flat in autopsy results.

Jennifer Ayars of Bay Village, Ohio, died of fentanyl-laced cocaine in 2016. Her family established the Emerald Jenny Foundation to help others.

So far, cocaine-fentanyl has been found in the blood of 843 Ohio residents who suffered fatal overdoses in 2017. By comparison, heroin-fentanyl was found in 532 bodies.

What about victims who had both cocaine and heroin in their system? That happened 195 times.

When you look at cases where drugs overlap, cocaine plays an even more prominent role in overdose deaths. Cocaine-fentanyl (but NO heroin) was found in 646 victims; meanwhile, heroin-fentanyl (but NO cocaine) was found 337 times.

To get a sense of the enormity of this shift, look at the year-to-year change — and remember that 2017 data is incomplete!

The five years of numbers  shown above lets you analyze trends yourself.

Other opiates

An analysis of what’s happening with “other opioids” (i.e., oxycodone, hydrocodone, etc.) shows a tilt toward fentanyl-adulterated cocaine playing a greater role in overdose deaths as well, although less dramatically so.  Other opioids are sometimes prescription drugs and sometimes fake, fentanyl-laced pills sold illegally.

Here’s what those numbers show:


What can be done

We’ll discuss what can be done to reduce cocaine-fentanyl deaths in a future article. Key options are listed at the end of this article in the Cleveland Plain Dealer.

Also, I have obtained a list of drug combinations found in 5,600 drug seizures analyzed by the three state crime labs in 2016 and 2017. An analysis of this data will help understand the extent of fentanyl’s contamination of Ohio’s cocaine supply.

— Dennis Cauchon, Harm Reduction Ohio

COMING SOON: What’s in Ohio’s illegal drug supply, according to drug seizures analyzed at state crime labs?



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