Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Public Health Mortality topic
No spam. Unsubscribe anytime.
Cuyahoga County medical examiner: homicides drop to 2019 levels; fentanyl deaths fall as cocaine overdoses rise
Summary
The county medical examiner reported that 2025 homicides fell back to roughly 2019 levels (about 170–185) and fentanyl overdose fatalities have declined since late 2023, while cocaine overdoses increased and disproportionately affected African‑American residents, officials said.
The Cuyahoga County medical examiner on Tuesday told the Public Safety and Justice Affairs Committee that several major causes of death shifted in 2025, with homicides returning to pre‑pandemic levels even as the pattern of drug fatalities changed.
"In 2025, we got back to the same level that we were at in 2019," Medical Examiner Dr. Gilson said, summarizing homicide counts at roughly 170–185 a year after four years above 200. He added that firearms account for about 80–85 percent of homicide cases and that victims are disproportionately young Black men.
The presentation placed gun violence in a broader forensic context. Dr. Gilson described a past increase in multi‑gunshot homicide victims and noted the office’s National Integrated Ballistics Information Network (NIBIN) work. "There was virtually no overlap" between guns used in suicides and guns tied to criminal activity, he said, underscoring that suicide and criminal gun harms may require different prevention strategies.
On suicide, the county reported five‑year totals that fluctuate between about 180 and 218 annually, with approximately 60 percent involving firearms. Dr. Gilson urged tailored suicide‑prevention measures, saying outreach at places where firearms are sold — for example, point‑of‑sale pamphlets — could be part of a prevention mix.
Motor‑vehicle fatalities, another leading class of accidental death, fell to 93 in 2025 from 106 in 2019, the medical examiner said. He estimated roughly one in four motor‑vehicle fatalities involved some intoxicating substance, based on toxicology and crash analysis.
On drug overdoses, Dr. Gilson reported a multi‑year downward swing: 635 deaths in an earlier peak period, 419 the prior year and 362 in 2025. He said fentanyl‑related fatalities began declining in late 2023 and that the county has seen a relative rise in stimulant‑related deaths, particularly cocaine. "In 2025 we had more cocaine overdoses than we had fentanyl overdoses," he said, and added that cocaine overdoses were more common among African‑American residents in Cuyahoga County.
The medical examiner described local prevention work supported by grant funding, including an advertising campaign and targeted messaging under the federal Overdose to Action grant. He emphasized continued need for naloxone and community‑specific outreach, plus basic guidance to recognize stimulant overdose signs such as severe shortness of breath, chest pain or sudden neurological symptoms.
Committee members asked follow‑ups on data gaps — for example, whether e‑bike fatalities are separately tallied — and Dr. Gilson offered to follow up where his office’s death‑certificate coding leaves questions. The committee did not take action; the presentation concluded with an invitation to provide additional data for prevention planning.
