OD2A Cuyahoga County Overdose Surveillance Quarterly Bulletin – 2025 Q4
The OD2A Local Cuyahoga County Overdose Surveillance Quarterly Bulletin (2025 Q4) presents the latest drug overdose trends and surveillance data for Cuyahoga County, Ohio, covering October through December 2025. This bulletin is produced by the Cuyahoga County Board of Health and supported by CDC’s Overdose Data to Action (OD2A) LOCAL funding.
Key Findings at a Glance
- 📉 Overdose Deaths decreased by 68.1% compared to Q3 2025 (29 preliminary deaths in Q4, down from 91 in Q3)
- 📉 Emergency Room Visits for suspected drug overdoses decreased by 10.1%, with 804 visits in Q4 2025
- 💉 Project DAWN Naloxone Kits distributed decreased by 32.5%, with 10,697 kits distributed in Q4
- 🚑 EMS Naloxone Administrations decreased by 19.2%, with 559 doses administered in Q4
- 🧪 Syringe Testing (167 samples tested): Fentanyl was the most prevalent drug detected (105), followed by medetomidine (78), cocaine (63), heroin (56), and xylazine (47)
- 🔬 Drug Seizure & Lab Testing: Cocaine ranked highest in lab submissions (1,286), followed by fentanyl (512), methamphetamine (403), heroin (223), and xylazine (220) — accounting for 81% of all lab submissions this quarter
Overdose Alert Periods
No overdose alert periods were recorded from Q2 2024 through Q4 2025. The last recorded EpiCenter Alerts occurred in Q1 2024.
Notable Trends (Q3 to Q4 2025)
- Cocaine lab submissions decreased 1%
- Fentanyl lab submissions decreased 23%
- Methamphetamine lab submissions decreased 36%
- Heroin lab submissions increased 10%
- Xylazine lab submissions increased 7%
Q4 2025 Highlight: OD2A Linkage to Care Surveillance Pilot Program
The Q4 bulletin features a special highlight on the OD2A Component C Linkage to Care Surveillance Pilot Program, which engages individuals with opioid or stimulant use disorder through three coordinated entry points supported by MetroHealth:
- NFOD – Emergency department for individuals experiencing nonfatal overdoses
- ExAM – Expanded Access to MOUD for incarcerated individuals
- MEC – Walk-in Motivation and Engagement Clinic
From September 2024 through August 2025, 816 individuals were identified, of whom 770 were engaged in care, 644 were referred to MOUD treatment, and 586 initiated MOUD treatment. Both the MEC and ExAM programs reported high linkage rates of 100% and 88%, respectively.
Statement from the Cuyahoga County Medical Examiner’s Office (CCMEO)
The CCMEO projects approximately a 14% decrease in drug overdose deaths in 2025, with an estimated total of 360 deaths pending final rulings. This would represent the lowest number of overdose deaths since prior to the introduction of fentanyl in 2016. Cocaine has re-emerged as the most prevalent drug identified in overdose deaths throughout 2025, a trend being closely monitored.
