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Medical examiner: homicides easing, firearm suicides rising; drug-overdose mix shifting toward stimulants
Summary
Cuyahoga County Medical Examiner Thomas Gilson reported an expected modest decline in homicides for 2025, rising suicide rates driven increasingly by firearms, and a projected dip in overdoses with an emerging stimulant (cocaine) pattern that will require adjusted public-health responses.
Dr. Thomas Gilson, the Cuyahoga County medical examiner and crime laboratory director, presented annual trends and a budget summary to county council on Nov. 10. He said the office remains fully accredited and is seeking upgrades to case-management IT and radiology equipment, funded in part by the coroner's lab special‑revenue fund.
On causes of death, Gilson said homicides should decline slightly in 2025 compared with the prior year but warned that suicides are rising, with firearms increasingly implicated. "Most of the guns that are used to commit suicide are owned by the individual," he said, noting a demographic shift toward more urban and older decedents in stimulant‑involved overdoses.
Gilson reported that drug-overdose counts may fall in 2025 compared with the peak but that the composition of overdoses is changing: he said cocaine and other stimulants are a growing component of fatal overdoses in the county and that public-health responses crafted for opioid overdoses (for example, naloxone distribution and medication-assisted therapy) do not fully address stimulant overdose mechanisms.
He provided budget figures for the office: approximately $20.33 million for 2026 and $20.89 million for 2027, with about 76% of costs dedicated to salaries. Gilson said staff shortages had artificially reduced autopsy counts in recent years and that the office expects higher autopsy volumes as staffing stabilizes.
Next steps: Gilson offered to continue sharing detailed analytic products and to work with council and community partners on targeted interventions, including firearm-safety messaging and improved death-certificate training for clinicians to increase data quality.
