2024 Cuyahoga County Drug Overdose Integrated Epidemiologic Profile (DOIEP)
The 2024 Cuyahoga County Drug Overdose Integrated Epidemiologic Profile (DOIEP) is a comprehensive public health report produced by the Cuyahoga County Board of Health (CCBH) in partnership with Case Western Reserve University’s Begun Center for Violence Prevention Research and Education and the Cuyahoga County Medical Examiner’s Office. Published in August 2025, this report is supported by the CDC’s Overdose Data to Action (OD2A) LOCAL grant.
The DOIEP combines multiple data sources to provide a detailed picture of drug overdose mortality, morbidity, and the local drug supply — offering actionable insights for healthcare providers, first responders, policymakers, and community partners.
Key Findings at a Glance
- 💀 550 unintentional drug overdose deaths (UDOD) occurred in Cuyahoga County in 2023 — a 0.7% decrease from 2022
- 📊 Fentanyl and fentanyl analogues were involved in 78% of all UDOD in 2023
- 📈 Cocaine-related UDOD reached a new peak in 2023, contributing to 316 deaths — a 25% increase from 2022
- 🏥 3,603 emergency department (ED) visits for suspected drug overdose occurred in 2023, a 9% decrease from 2022
- 🚑 31,724 total EMS naloxone doses administered in Cuyahoga County between 2018 and 2024; a 31% decrease from 2023 to 2024
- 💉 6,336 individuals received Buprenorphine as MOUD/MAT in 2023 — the highest annual total on record
- 🏥 Hospital encounters related to opioid overdose decreased 34% from 2023 to 2024
Demographic Highlights
- Adults aged 35–44 had the highest rate of UDOD in 2023 at 88.5 deaths per 100,000
- Males accounted for 69.3% of UDOD in 2023
- Non-Hispanic Black males had the highest rate of UDOD at 86.8 per 100,000
- Hispanic males saw an increase in UDOD rate from 56.5 (2022) to 71.2 per 100,000 (2023)
- 62.6% of UDOD occurred among individuals who had never been married
- 52.6% of UDOD were among individuals whose highest education level was a high school diploma or GED
Geographic Highlights
- ZIP codes with the highest rates of UDOD in 2023: 44109, 44103, 44115, 44110, and 44104
- ZIP codes with the highest rates of ED visits for suspected drug overdose: 44109 (1,998.1 per 100,000) and 44114 (957.8 per 100,000)
- ZIP codes with the highest EMS naloxone administration rates: 44114 (2,335 per 100,000), 44109, 44113, 44115, and 44127
Drug Supply Data (August–December 2024)
From the Cuyahoga County Pilot Drug Checking Program (290 syringes tested):
- Most commonly detected drugs: fentanyls (57.9%), xylazine (46.9%), cocaine (41.4%)
- Over half of clients (53.8%) believed heroin was in their syringes — testing confirmed it in only 24.8%
- Cocaine ranked highest in lab submissions (CCRFSL) from 2022–2024
- Xylazine entered the top 10 drug submissions in 2023, moving to 4th place in 2024
