Department of Forensic Pathology Office of the Medical Examiner 2018 Q3 (July 1-September 30) Drug Report
Introduction Drug-Related Deaths - Defined We define drug deaths as those which result entirely or partially from the physiologic effects of acute toxicity. Therefore, included here are deaths which resulted from a combination of natural disease and acute intoxication (e.g. lung disease complicated by opioid intoxication).
Our definition does not include deaths by violence, in which the violent behavior may have been caused or contributed to by intoxication (e.g. death due to injury from motor vehicle crash in which the at-fault driver was intoxicated). We also do not include deaths related to the effects of chronic substance use (e.g. deaths due to alcoholic liver disease or heart disease which may have been contributed to by chronic cocaine use) if not combined with acute toxicity.
Methods The majority of the drug deaths reported are due to more than one substance, as you will see in the detailed tables that follow. Often, decedents have even more substances present in their body at the time of death or overdose incident than just the substances listed as having caused or contributed to death. After autopsy and review of records, including toxicology report, the medical examiner assigned to the case determines which of the substances present played a causal role in the death. Thus, there may be substances present in a given case which are not included in the cause of death statement. Occasionally, intoxicated decedents survive in the hospital for a time prior to death, following acute drug intoxication. In these cases, all efforts are made to obtain and test the earliest blood and urine available from their time in the hospital for the overdose incident, so that the toxicology results reflect what was in the body at the time the overdose occurred. New information occasionally becomes available after a “final” cause and manner of death was determined, which sometimes, albeit rarely, results in a change to the “final” cause or manner of death. As such, the statistics contained herein may be subject to change at any time. The extent of toxicology testing is determined by the medical examiner assigned to the case, based upon the circumstances of death. During the period reported, our office used Axis Forensic Toxicology for toxicology testing.1
Highlights2 Unless otherwise indicated, all comparisons on the Highlights page are made to the data from the previous quarter (Q2 2018). As stated above, most drug-related deaths are due to a combination of more than one substance. As such, numerous deaths fall into multiple of the below statistical categories (i.e. all heroin, fentanyl, methadone, and fentanyl analogue-related deaths are included in the opioid-related deaths category, and many deaths involved both heroin and fentanyl, and are included in both specific categories).
Total drug-related deaths increased by 4 (deaths)
Opioid-related deaths increased by 4 (deaths)
Fentanyl and/or fentanyl analogue-related deaths decreased by 1 (death)
Fentanyl and/or fentanyl analogue(s) were identified as substances causing death in 58% of all drug-related deaths in Q3 2018
Q3 2018 marked the first time we have seen the fentanyl analogue valerylfentanyl in any of our counties (two occurrences)
Fentanyl analogues identified as having caused or contributed to death in Q3 2018 included: acetylfentanyl and valerylfentanyl
Benzodiazepine deaths increased by 1 (death)
Cocaine-related deaths remained constant at 11 (deaths)
Amphetamine/Methamphetamine-related3 deaths increased by 1 (death)
83.7% of all drug-related deaths in Q3 2018 were due to two or more substances
Fentanyl was present and contributed to death in 8 of the 11 (72.7%) cocaine-related deaths in Q3 2018
A link provided below takes you to Sparrow Forensic Pathology’s quarterly report for local health and law enforcement officials about drug-related deaths in the five local counties for which Sparrow serves as Medical Examiner.
You will notice in this report that for the first time we have seen the use of a fentanyl analogue (related drug) in any of our local counties. Two such occurrences were reported.
This report was compiled in response to interest in drug deaths sparked by the opioid crisis and covers the period from July 1 to Sept. 30, 2018. You can also find the report posted at .