COIOS
Behavioural science Item confirms peer-reviewed

Fentanyl was present in three quarters of cocaine overdose deaths in one Ohio county

Across 1,150 unintentional cocaine-related overdose deaths in Cuyahoga County, Ohio, between 2014 and 2024, fentanyl was also present in 74.6%, and the two groups differed sharply by age and race.

Every unintentional cocaine-related overdose death recorded by the Cuyahoga County medical examiner between 2014 and 2024, 1,150 in all, was classified by whether fentanyl was also detected. Fentanyl was present in 74.6% of them. Those with fentanyl were younger White men, while cocaine-only deaths were concentrated among Black men over 45.

Why it is interesting: Two demographically distinct populations sit inside one cause-of-death label, and the fentanyl supply has absorbed most of the stimulant overdose burden.

Source
American Journal of Forensic Medicine & Pathology, 22 September 2026
DOI
10.1097/paf.0000000000001172
Type
Peer-reviewed article
Design
Retrospective medical examiner case series, all 1,150 unintentional cocaine-related overdose deaths, Cuyahoga County, Ohio, 2014-2024
Verdict
Confirms prior evidence
Driver
Alcohol and drug use