{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:11:40Z","timestamp":1786122700219,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    Overdose deaths have steadily decreased in the United States from 105\u202f000 deaths in 2023 to 79\u202f384 deaths in 2024. To better understand emerging trends in overdose deaths, we conducted a pilot epidemiological study of fatal drug overdose data from the Cuyahoga County Medical Examiner\u2019s Office (Cleveland, Ohio) from 2023 through mid-2025 (all accidental drug overdose deaths from January through June). During the study period, all fentanyl-related accidental drug overdose deaths decreased from 75.8% to 45.6% (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001). During the same period, all cocaine deaths that included fentanyl decreased from 69.8% to 40.7% (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.004), and all cocaine deaths that excluded fentanyl increased from 17.6% to 39.2% (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001). Drug overdose deaths decreased among White males but increased by 9% among Black males, largely driven by Black men aged \u226555 years. Percentages of overdoses among Black men aged \u226555 years in the all-fentanyl group (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001) decreased from 53.4% (47 of 88) to 34.1% (15 of 44) but remained steady in the all-cocaine group (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001) from 85.2% (75 of 88) to 84.1% (37 of 44). Overdoses increased in the cocaine-without-fentanyl group (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001) from 46.6% (41 of 88) to 63.6% (28 of 44) but decreased in the cocaine-only group (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001) from 31.8% (28 of 88) to 27.3% (12 of 44). Our results showed a shift in demographic characteristics with regard to decreases in fentanyl-related overdose deaths and increases in cocaine-related overdose deaths. Because no stimulant antidote analogous to naloxone for opioids is available, public health policy will need to pivot in response to the increase in stimulant-involved overdose deaths.\n                  <\/jats:p>","DOI":"10.1177\/00333549261435474","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T06:53:20Z","timestamp":1777013600000},"page":"640-644","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Decline in Fentanyl-Related Overdose Deaths and Subsequent Change in Decedent Demographic Characteristics: Trends in Cuyahoga County, Ohio, 2023-2025"],"prefix":"10.1177","volume":"141","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0565-9547","authenticated-orcid":false,"given":"Manreet K.","family":"Bhullar","sequence":"first","affiliation":[{"name":"Cuyahoga County Medical Examiner\u2019s Office, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2625-4947","authenticated-orcid":false,"given":"Stephanie D.","family":"Franks","sequence":"additional","affiliation":[{"name":"Cuyahoga County Medical Examiner\u2019s Office, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas P.","family":"Gilson","sequence":"additional","affiliation":[{"name":"Cuyahoga County Medical Examiner\u2019s Office, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Centers for Disease Control and Prevention. U.S. overdose deaths decrease almost 27% in 2024. May 14 2025. Accessed August 27 2025. https:\/\/www.cdc.gov\/nchs\/pressroom\/releases\/20250514.html"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.15620\/cdc\/170565"},{"key":"e_1_3_2_4_2","unstructured":"US Census Bureau. Cuyahoga County Ohio. 2024. Accessed June 26 2024. https:\/\/data.census.gov\/profile\/Cuyahoga_County _Ohio?g=050XX00US39035"},{"key":"e_1_3_2_5_2","unstructured":"The Big Cities Health Inventory Data Platform. Explore health issues in urban communities across the country. June 4 2024. Accessed June 25 2024. https:\/\/bigcitieshealthdata.org"},{"key":"e_1_3_2_6_2","unstructured":"Cuyahoga County Ohio Medical Examiner. About us. No date. Accessed September 3 2025. https:\/\/cuyahogacounty.gov\/medical-examiner\/about-us"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-013-0323-x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:112340"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2022.100069"},{"key":"e_1_3_2_10_2","unstructured":"National Center for Health Statistics. Provisional drug overdose data. September 9 2025. Accessed November 12 2025. https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm"},{"key":"e_1_3_2_11_2","unstructured":"North Carolina Office of the Chief Medical Examiner. Fentanyl-positive deaths North Carolina Office of the Chief Medical Examiner (OCME) toxicology data: March 2025. June 25 2025. Accessed September 3 2025. https:\/\/www.dph.ncdhhs.gov\/office-chief-medical-examiner\/ocmemonthlyfentanyldeathsmar25pdf\/open"},{"key":"e_1_3_2_12_2","unstructured":"Virginia Department of Health. Drug overdose deaths. Published online July 22 2025. Accessed September 3 2025. https:\/\/www.vdh.virginia.gov\/drug-overdose-data\/overdose-deaths"},{"key":"e_1_3_2_13_2","unstructured":"Tacoma\u2013Pierce County Health Department. Quarterly drug-involved death reporting\u2014Pierce County Medical Examiner quarter 2 2025 report. July 30 2025. Accessed November 12 2025. https:\/\/www.piercecountywa.gov\/DocumentCenter\/View\/152175\/Q2_2025_PierceCountyMEPoisoningReport-30jul2025"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107658"},{"key":"e_1_3_2_15_2","unstructured":"US Drug Enforcement Administration. National drug threat assessment. May 2025. Accessed September 3 2025. https:\/\/www.dea.gov\/sites\/default\/files\/2025-07\/2025NationalDrugThreatAssessment.pdf"},{"key":"e_1_3_2_16_2","unstructured":"US Customs and Border Protection. Drug seizure statistics. 2025. Accessed September 3 2025. https:\/\/www.cbp.gov\/newsroom\/stats\/drug-seizure-statistics"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.14997"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.16276"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-022-01384-6"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwab290"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.2728"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.1992.10471658"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7432a1"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.josat.2022.208941"}],"updated-by":[{"DOI":"10.1177\/00333549261467365","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000}}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549261435474","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00333549261435474","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549261435474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:54:24Z","timestamp":1786103664000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00333549261435474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,23]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/00333549261435474"],"URL":"https:\/\/doi.org\/10.1177\/00333549261435474","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,23]]}}}