2020 Annual Report Muskegon Deaths related to opioids and other drugs Please email Chloe Bielby for additional information or to set up a time to discuss your county's report: [email protected]This report is in memory of those who lost their life or a loved one to substance use. These losses must motivate us all to prevent future deaths. A few notes... Purpose: This data was collected by the Office of the Medical Examiner in the Department of Pathology at WMed. Unless otherwise noted, data is from 2020 and includes deaths where drugs were the immediate cause of death. This report is meant to provide up to date statistics to those involved in efforts to reduce the number of drug-related deaths. Sections with the following headings are approximations and frequencies may be higher than what is reported: Health Factors, Mental Health Factors, Social Factors, Children and Substance Use History. Sources: All data was extracted from a Medical Examiner database, law enforcement (LE) and EMS reports, death certificates, obituaries, Swift Toxicology of Overdose-Related Mortalities (STORM) results, medical records, toxicology reports, MDHHS reports, and autopsy reports. 2020 Annual Report Deaths related to opioids and other drugs Muskegon
Transcript
2020 Annual Report
Muskegon
Deaths related to opioids and other drugs
Please email Chloe Bielby for additional information or to set up a time to discuss your county'sreport: [email protected]
This report is in memory of those who lost theirlife or a loved one to substance use.
These losses must motivate us all to prevent future deaths.
A few notes...Purpose:This data was collected by the Office of the Medical Examiner in the Department of Pathology atWMed. Unless otherwise noted, data is from 2020 and includes deaths where drugswere the immediate cause of death. This report is meant to provide up to date statistics to thoseinvolved in efforts to reduce the number of drug-related deaths.
Sections with the following headings are approximations and frequencies may be higher than what is reported:Health Factors, Mental Health Factors, Social Factors, Children and Substance Use History.
Sources: All data was extracted from a Medical Examiner database, law enforcement (LE) and EMS reports,death certificates, obituaries, Swift Toxicology of Overdose-Related Mortalities (STORM) results,medical records, toxicology reports, MDHHS reports, and autopsy reports.
2020 Annual ReportDeaths related to opioids and other drugs
Muskegon
InjuryZip Code
Death Certificate: Substances Contributing to DeathAge Race Sex
All Drug-Related Deaths
M
M
F
M
M
F
M
F
M
M
M
M
F
M
M
F
F
F
M
M
M
M
M
F
F
M
M
M
F
M
M
21
23
26
27
27
27
28
28
29
29
30
33
33
34
35
35
35
35
37
37
37
38
38
38
39
39
40
40
40
41
41
W
W
B
W
W
W
W
W
W
B
W
W
B
B
B
W
W
W
W
W
W
B
W
W
W
W
W
W
B
B
W
Pt. I: Fentanyl
Pt. I: Heroin, temazepam, 7-amino clonazepam, amphetamine
Pt. I: Hydrocodone, fentanyl
Pt. I: Amphetamine, cocaine, fentanyl
Pt. I: Fentanyl, morphine, lorazepam
Pt. I: Methamphetamine, fentanyl, para-fluorofentanyl
Pt. I: Cocaine, fentanyl
Pt. I: Para-flourofentanyl, fentanyl, morphine, gabapentin
Pt. I: Flualprazolam, ethanol, hydrocodone, diphenhydramine, fentanyl
Pt. II: Amphetamine
Pt. I: Cocaine, fentanyl
Pt. I: Amphetamine, methamphetamine, fentanyl, xylazine
Pt. I: Cocaine, fentanyl
Pt. I: Acute and chronic ethanol use*
Pt. I: Fentanyl, cocaine, dextromethorphan, diphenhydramine
Pt. I: Diazepam, hydrocodone, oxycodone, gabapentin, fentanyl
Pt. I: Fentanyl, heroin
Pt. I: Fentanyl, methamphetamine
Pt. I: Fentanyl, heroin
Pt. I: Fentanyl
Pt. I: Heroin, fentanyl, ethanol
Pt. I: Fentanyl, morphine, gabapentin, diphenhydramine, flualprazolam
Pt. I: Fentanyl
Pt. I: Cocaine, heroin, methamphetamine, fentanyl, buprenorphine
Pt. I: Amphetamine
Pt. I: Cocaine, fentanyl
Pt. I: Fentanyl, diphenhydramine
Pt. I: Fentanyl, heroin, methamphetamine
Pt. I: Amitriptyline, nortriptyline, cyclobenzaprine, clonidine
Pt. I: Fentanyl, cocaine, ethanol, cocaethylene, tramadol
Pt. I: Fentanyl, heroin, methamphetamine
49442
49441
49444
49442
49451
49444
49444
49442
49441
49457
49441
49442
Unknown
49444
49444
49444
49441
49442
49442
49437
49444
49442
49444
49442
49415
49441
49442
49442
49442
49441
49440
Annual 2020 Report
Deaths Related to Opioids and Other DrugsMuskegon
Office of the Medical Examiner
InjuryZip Code
Death Certificate: Substances Contributing to DeathAge Race Sex
M
F
M
M
M
F
M
M
M
M
M
F
M
M
F
F
M
M
M
M
M
F
M
F
F
M
M
M
M
M
W
B
B
W
W
W
W
W
W
B
W
W
B
W
W
W
W
W
W
B
W
W
B
W
W
W
W
B
W
W
Pt. I: Fentanyl, heroin, methamphetamine
Pt. I: Amitriptyline, nortriptyline, cyclobenzaprine, clonidine
Pt. I: Fentanyl, cocaine, ethanol, cocaethylene, tramadol
Pt. I: Fentanyl, heroin, methamphetamine
Pt. I: Cocaine, tramadol, xylazine, fentanyl, acetyl-fentanyl
Pt. I: Fentanyl, cocaine, gabapentin
Pt. I: Methamphetamine, fentanyl
Pt. I: Diphenhydramine, doxylamine, dextromethorphan, acetaminophen
Pt. I: Methamphetamine
Pt. I: Cocaine
Pt. I: Fentanyl, heroin, methamphetamine
Pt. I: Methadone, duloxetine, gabapentin, hydroxyzine
Pt. I: Para-fluorofentanyl, tramadol, fentanyl
Pt. I: Heroin, methamphetamine
Pt. I: Fentanyl, cocaine, cocaethylene, ethanol
Pt. I: Cocaine, methamphetamine, fentanyl
Pt. I: Fentanyl, xylazine, tramadol, lorazepam
Pt. I: Cocaine, ethanol, cocaethylene, heroin, gabapentin, fentanyl
Pt. I: Fentanyl
Pt. I: Acetaminophen
Pt. II: Heroin, buprenorphine, fentanyl, acetyl fentanyl*
Pt. I: Fentanyl
Pt. I: Fentanyl, heroin, ethanol, gabapentin, cyclobenzaprine, trazodone
Pt. I: Cocaine, morphine, fentanyl
Pt. I: Fentanyl, acetyl-fentanyl, heroin
Pt. I: Morphine, fentanyl
Pt. I: Cocaine
Pt. I: Fentanyl
49442
49442
49441
49440
49457
49442
49444
49415
49441
49441
49442
49441
49442
Unknown
Unknown
49442
49461
49444
49442
49442
49444
49417
49441
49441
49441
49442
49441
49444
49444
49442
40
40
41
41
43
44
44
45
49
51
51
52
53
54
55
55
56
57
58
58
59
59
59
61
62
65
66
66
67
69
Pt. I: Fentanyl, heroin, methadone, alprazolam, clonazepam, diphenhydramine
Pt. I: Fentanyl, cocaine, ethanol, cocaethylene, gabapentin, diphenhydramine
57 W F
W F
F
59
60 B
49441
49442
49444
Pt. I: Fentanyl, heroin, cocaine, mitragynine, gabapentin,diphenhydramine, hydroxyzine, orphenadrine, dextromethorphan
Pt. I: Methamphetamine, cyclobenzaprine, gabapentin, paroxetine,dextro-levomethorphan
Pt. I: Alprazolam, methadone, hydrocodone, acetaminophen, xylazine,clonidine, fentanyl
* Case is not included in the following report
All Drug-Related Deaths (cont.)
Annual 2020 Report
Deaths Related to Opioids and Other DrugsMuskegon
Office of the Medical Examiner
Total deaths due to drugs: 2018, 2019, 2020
2018 2019 202050 deaths 55 deaths 57 deaths
opioid only
non-opioid only
opioid & non-opioid
1512
23
Freq
uen
cy
Number of all drug-related deaths by month and year
555
444
666
333 333
555
444
222
444 444
666
444
222 222
444 444
777
111
444
666
333
121212
777
333
222 222
666
101010
666
999
333
444
333
444
333
5552018
2019
2020
January
February
Marc
hApril
May
JuneJuly
August
Septem
ber
Octo
ber
November
December
0
2.5
5
7.5
10
12.5
2.9deaths per 10,000
3.2 3.3
Annual 2020 Report
Deaths Related to Opioids and Other DrugsMuskegon
Office of the Medical Examiner
opioid only
non-opioid only
opioid & non-opioid
1010
35
opioid only
non-opioid only
opioid & non-opioid
117
39
deaths per 10,000 deaths per 10,000
Percent increasefrom 2018 to 2019
Percent increasefrom 2019 to 202010% 4%
Number of nonfataloverdoses among ED
discharges, 2020Nonfatal overdoses
per 10,0001027 59.6
Annual 2020 Report
Grand Traverse
Office of the Medical Examiner
Deaths Related to Opioids and Other Drugs
Demographics
65%
35%
Sex
White (80%)
African American/Black (18%)
Multiracial (2%)
RaceUnemployed
Employed
Disability
Unknown
Retired
Minimum Age
21 years
Maximum Age
69 years
Average Age
45 years
Age
44
6 7
0
25
Frequency
363636
999
555
555
222
0 5 10 15 20 25 30 35
County of Residence by County of Death
Decedent's Employment status
Decedent has residency in county of deathDecedent did not have residency in county of deathDecedent was experiencing homelessness or insecure housing at time of death
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Frequency
222
121212
303030
888
333
111
111
0 5 10 15 20 25 30
Decedent's Highest Level of EducationLess than 9th grade
9th-12th grade, no diploma
High school graduate/GED
Some college credit, no degree
LPN
Associate's Degree
Bachelor's degree
Muskegon
Frequency
111
161616
232323
101010
333
333
111
0 5 10 15 20
Body Mass Index (BMI)
Annual 2020 Report
Grand Traverse
Office of the Medical Examiner
Deaths Related to Opioids and Other Drugs
Health Factors
At least 12 decedents wereHepatitis C positive
5 of these decedents wereknown to use
substances intravenously
Decedentused
tobacco
Decedentdrank
alcohol
Decedenthad
a PCP54%
84%+
61%+
Most prevalent ailments*
*Decedents may berepresented in morethan one category.Only illnesses withofficial diagnosisare included.**Lungs includesasthma, COPD, andemphysema
GERD (12%)
Chronic pain (37%)
Hypertension (30%)
Lungs** (21%)
Underweight
Normal weight
Overweight
Obese class 1
Obese class 2
Obese class 3
Unknown
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Diabetes (11%)
Muskegon
Annual 2020 Report
Grand Traverse
Office of the Medical Examiner
Deaths Related to Opioids and Other Drugs
Mental Health Factors
...who have ever had
suicidal ideation
Percentage of decedents...
16%...with previous
suicide attempts
12%
Depression (49%)
Anxiety (32%)
Bipolar (21%)
ADD/ADHD (11%)
Most
prevalent
mental illnesses*
*Decedents may be represented inmore than one category.Only mental illnesses withofficial diagnosis are included.
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Number of diagnosed mental illnesses
Freq
uen
cy a
mo
ng
dec
eden
ts
25
11 11
43 3
0 1 2 3 4 5+0
10
20
Number Diagnosed Mental Illnesses among decedents
Muskegon
Social Factors
Annual 2020 Report
Grand Traverse
Office of the Medical Examiner
Deaths Related to Opioids and Other Drugs
Decedent was
a veteran
4% Decedent was experiencing
homelessness or insecure
housing at time of death
Decedent has everbeen incarcerated
12%
42% Decedents everincarcerated were released
in past 60 days<60DAYS
58%
Frequency of decedents
666
333
222
111
111
0 1 2 3 4 5 6
Number of Minor biological children decedent had....
Adultchildren
only
At leastone minor
child
Nochildren
42%
23%
35%
3 decedentslived with
their minorchild(ren) at
time of death
Employment status of those with minor children
Disability
Unknown
Employed
Unemployed
0%
15%70%
15%
Children
1 minor
2 minors
3 minors
4 minors
Unknown
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Muskegon
Annual 2020 Report
Grand Traverse
Office of the Medical Examiner
Deaths Related to Opioids and Other Drugs
Substance Use History
At least 55% of those decedents used
substancesintravenously
At least 94% ofdecedents were knownto use or abusesubstances
At least 20% of all decedents substanceuse started from the
prescribed opioid
At least 40% ofdecedents wereprescribed an opioidin the past two years
At least 66% of those decedents have had
two or moreprior overdoses
At least 26% ofdecedents have had atleast oneprior overdose
*ONLY decedents known to use substancesincluded.
**These factors were mentioned by thoseclose to decedent for why they may have begun to use substances again after a fewmonths to years of living substance free.***Life stress includes job loss, lack ofrehabilitation access, and social circle
influence.
35%
10%
Decedent has been to asubstance rehabilitation
clinic at least one time
31% Decedent was recentlysubstance free in the
past three weeks
44%Left jail/rehab
25%Life stress***
31%Unknown
Suspected reasons for relapse**
recovery history (n=51*) Decedent's substance of choice vs. whatwas determined to cause death*
Decedent was currentlyreceiving or has received
a form of medication-assisted treatment (MAT)
in the past two years
Substance determinedto cause death
Substance ofchoice
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
252525
292929
111111
111111
121212
000
181818
141414
121212
696969
363636
333333
0 20 40 60
Cocaine
Heroin
Methamphetamine
Other Opioids
Prescriptions
Other
*Decedent may have had more than one substance of choiceand in their toxicology.
NOTE: 5 decedents would use any substance available, 4 werenot known to use substances and 3 decedent's substance of
choice is unknown.Prescriptions do not include opioids.
Other includes acetaminophen, cocaethylene,dextromethorphan, diphenhydramine, ethanol, flualprazolam,
mitragynine, and xylazine.
Muskegon
Who Administered Naloxone?
How many doses (2 mg) ofnaloxone were administered
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Allegan, Barry, Berrien, Calhoun, Grand Traverse, Kalamazoo, Leelanau, Mason, Muskegon, Osceola, St. Joseph, and Van Buren County
222
111
222
111
Bystander
Bystander; EMS
EMS
Hospital
0 1 20.25 0.5 0.75 1.25 1.5 1.75
Naloxone Administration
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
naloxone administration status
No Naloxoneadministered
Naloxoneadministered
651
2
1
0
1
2
1 dose 2 doses 3 doses 4 doses Unknown0
0.5
1
1.5
2
Muskegon
10 decedents were given extensiveresuscitative efforts (CPR, epinephrine,
etc.) but were not given Naloxone.
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Allegan, Barry, Berrien, Calhoun, Grand Traverse, Kalamazoo, Leelanau, Mason, Muskegon, Osceola, St. Joseph, and Van Buren County
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Death Scene Findings
39%Were foundby family
60%Died at their
residence
4%Were foundby a minor
19%Used the fatal substance(s)
alone
19%Died at the
hospital
11%Were given
Narcan
50%Were deadupon EMS
arrival
Syringes andsuspected illicitdrugs were themost commonparaphernaliafound on scene
7%Had Narcan onscene and/or
were prescribedNarcan
Autopsy and Toxicology Results
545454
333
000
0 20 40
Manner of DeatH
1112
22
12Decedent
frequency
Number of substancescontributing to death
1 substance
2 substances
3 substances
4+ substances
Accident
Suicide
Indeterminate
Muskegon
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Allegan, Barry, Berrien, Calhoun, Grand Traverse, Kalamazoo, Leelanau, Mason, Muskegon, Osceola, St. Joseph, and Van Buren County
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Frequency of substance
464646
333333
181818
181818
141414
121212
888
777
444
444
444
333
222
222
222
222
111
111
111
Fentanyl
Non-opioid prescription
Cocaine
Opioid prescription
Heroin
Methamphetamine
Diphenhydramine
Ethanol
Cocaethylene
Dextromethorphan
Xylazine
Acetaminophen
Acetyl-fentanyl
Flualprazolam
Hydroxyzine
Para-Fluorofentanyl
Doxylamine
Mitragynine
Para-Flourofentanyl
0 5 10 15 20 25 30 35 40 45
Please see graphs on the next page for a list of opioid and non-opioid prescriptions.
substances contributing to death
Substance Breakdown
5 decedents had methamphetamineand heroin in their toxicology
10 decedents had methamphetamineand opioid(s) in their toxicology
Methamphetamine & Opioids2 decedents had a benzodiazepineand an opioid in their toxicology
0 decedents were prescribed thatopioid and benzodiazepine
Benzodiazepines & Opioids
14 decedents had heroin in theirtoxicology
12 of these decedents also hadfentanyl in their toxicology
Heroin & Fentanyl4 decedents had xylazine in theirtoxicology
4 of these decedents also hadfentanyl in their toxicology
Xylazine & Fentanyl
Muskegon
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
Allegan, Barry, Berrien, Calhoun, Grand Traverse, Kalamazoo, Leelanau, Mason, Muskegon, Osceola, St. Joseph, and Van Buren County
Annual 2020 Report
Deaths Related to Opioids and Other DrugsOffice of the Medical Examiner
non-opioid Prescriptions present in toxicology
Freq
uen
cy
4 4
21
2 21 1 1 1 1
6
1
12
1 1 1
Gabapentin
Ampheta
min
e
Cyclobenzaprin
e
Alpra
zolam
Clonazepam
Clonid
ine
Lorazepam
Amitr
ipty
line
Diazepam
Duloxetin
e
Nortrip
tylin
e
Orp
henadrine
Paroxetin
e
Temazepam
Trazodone
0
2.5
5
7.5
10
Decedent was prescribed drug Decedent was not prescribed drug
