Cass County coroner reports rise in yearly deaths and shifts in overdose causes

Cass County staff meeting · February 18, 2026

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Summary

The county coroner’s office told staff that reported deaths have risen from about 550 a few years ago to more than 800 last year and highlighted growing fentanyl, xylazine and methadone toxicity amid ongoing suicide‑prevention work.

Unidentified Speaker, presenting for the coroner’s office, told county staff that annual reported deaths in the four jurisdictions the office covers have climbed from roughly 550 several years ago to about 700 last year and “now above 800” this reporting period. The presenter said homicides per capita remain low locally but that some homicide cases are counted locally when injury occurs across the state line and victims are flown to Fargo.

The presenter described suicide prevention efforts tied to a recently passed state bill creating a North Dakota suicide‑prevention review team and said local partners are reviewing cases and placing 988 signs in parks and downtown parking ramps after several deaths from jumping incidents. “One of the big things for suicide prevention … we brought 988 signs to local parks and parking ramps,” they said.

On drug deaths, the presenter said opioid toxicity is increasing, with fentanyl now dominant in the local supply; xylazine — a veterinary tranquilizer that has appeared as an adulterant — and rising cocaine counts were also noted. The office reported a notable increase in methadone toxicity and said officers are seeing bottles with take‑home dosing; the presenter said this change in clinic practice appears correlated with more methadone overdoses. “Methadone toxicity has gone up greatly,” they said.

The presenter also reviewed operational matters: 28 cases that should have been reported were not, the office now performs most body removals itself (FM Ambulance was used three times this year for very heavy decedents), and many autopsies continue to be sent to Grand Forks because of limited local pathology capacity. They said increases in cremations require coordination with Minnesota coroners when a decedent’s remains cross state lines.

Staff and commissioners asked follow‑up questions about how long non‑coroner case reviews take and whether clinic practices changed. The presenter estimated one to two hours for many non‑coroner reviews but acknowledged wide variation and emphasized the office’s thorough approach to investigating possible accidental deaths.

The presenter offered to provide more detailed data to commissioners and to work with public‑health partners to monitor drug‑supply changes.

The coroner’s update closed with staff reporting improved morale after moving into larger, better‑lit office space.

The office’s statements were limited to the figures and observations reported in the meeting; where the presenter used imprecise transcript phrasing, this article follows their numeric intent (for example, “about 550” rather than “5 50”). The office did not propose or adopt new county policy during the presentation; commissioners requested additional data and clarification about clinic dosing practices and resource needs.