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Heroin Initiative

Understanding the shift towards heroin

Local heroin use is not only on the rise, it is taking lives at unprecedented levels. According to the Cuyahoga County Medical Examiner, heroin is now the most commonly-abused drug associated with overdose deaths in Cuyahoga County.

The shift toward heroin is due to a number of factors: 

  • Increasing availability throughout Ohio
  • The shutdown of pill mills
  • More hospitals adopting proper prescribing guidelines resulting in fewer pills on the street

With fewer pills on the street, heroin has become a cheaper alternative for abusers.  Although prescription pills are still readily available, the increased presence and purity of heroin as well as changes in the formulation of some pills to make them tamper resistant have caused users to make the switch.

For more information, please visit the microsite produced by  
The Cuyahoga County Prosecutor’s Office:  

CCMEO Quarterly Heroin/Fentanyl/Combined Deaths 2014-2018* (*2018 suspected cases as of 10-1-18)

CCMEO Heroin, Fentanyl and Heroin/Fentanyl Combination Deaths (* through Oct. 1, 2018)

Local steps taken to combat the epidemic

Over 600 public officials, medical and legal professionals, educators, addiction specialists and individuals whose lives have been impacted by heroin gathered at the Cleveland Clinic on November 21, 2012 for a day-long discussion of Cuyahoga County’s opiate epidemic in an effort to find practical solutions to the regions heroin epidemic. 

A Community Action Plan was formulated over the course of several planning meetings and finalized during the summit.

The Action Plan is divided into four specific areas:

Prevention and Education | Healthcare Policy | Law Enforcement | Treatment

A PDF version is available at:

Cuyahoga County Project D.A.W.N. (Deaths Avoided With Naloxone)

Project DAWNProject D.A.W.N. (Deaths Avoided With Naloxone) is a pilot program designed to prevent death from opioid overdose. Death from opioid overdose occurs because these drugs can cause respiratory depression and ultimately stop the victims breathing.   Common opioids that are abused include heroin, morphine, methadone, Oxycontin, Percocet (Oxycodone/acetaminophen) , Opana, Fentanyl, and  Vicodin (hydrocodone/acetaminophen).Naloxone is a drug which is commonly used by EMS and hospitals to reverse opioid overdose.  Naloxone rapidly restores breathing if it is given in a timely manner.  When an overdose occurs, every minute counts.  Overdose must be recognized quickly and reversed before permanent brain damage or death occurs. If naloxone is given immediately when overdose is recognized, it can be lifesaving.

Naloxone ONLY reverses opioids.  Naloxone does NOT reverse other sedating drugs like Xanax, Ativan, Klonapin, or alcohol.

Project DAWN staff will educate participants on RISK FACTORS for opioid overdose such as:

  1. Mixing drugs like alcohol and other sedating drugs with an opioid
  2. Using the same dose of a drug after a period of abstinence, due to a lowered tolerance (commonly after completing detox or after release from jail)
  3. Medical conditions such as COPD, asthma, heart disease, cirrhosis , or kidney disease  

We will teach you to RECOGNIZE an opioid overdose:

  1. Victim is difficult to arouse and does not respond to painful stimuli
  2. May have slow or shallow breathing
  3. Gurgling breath sounds
  4. Vomiting
  5. May have a bluish or gray skin color

We will train you to RESPOND to an opioid overdose

  1. Call 911- Tell them “ I need an ambulance for someone who is not breathing”
  2. Clear the airway
  3. Administer intranasal naloxone

Project DAWN will provide a Naloxone Kit to all participants FREE OF CHARGE Each kit will contain:

  1. 2 prefilled Naloxone syringes
  2. 2 nasal atomizers  
  3. Instructional DVD
  4. Quick reference Guide
  5. Reference pamphlet 

Project DAWN will enroll participants at the Free Clinic of Greater Cleveland Located at:

12201 Euclid Avenue, Cleveland Ohio
(216) 721-4010
or call the MetroHealth Line at (216) 778- 7878 for more information 
Fridays from 1 pm until 5 pm
No appointment is necessary
Refills will be provided as needed

In addition to the free clinic, kits can be picked up at:

The Cuyahoga County Board of Health
5550 Venture Dr.
Parma, OH 44130
Fridays from 9-12

Thomas F. McCafferty Health Center
4242 Lorain Ave.
Cleveland, OH 44113
Thursdays from 4pm-8pm