Cuyahoga County, Ohio, Heroin and Crime Initiative: Informing the Investigation and Prosecution of Heroin-Related Overdose, 2012-2021 (ICPSR 38295)
Version Date: Sep 27, 2023 View help for published
Principal Investigator(s): View help for Principal Investigator(s)
Daniel J. Flannery, Case Western Reserve University
https://doi.org/10.3886/ICPSR38295.v1
Version V1
Summary View help for Summary
In 2013, the Cuyahoga County (Ohio) Medical Examiner's Office (CCMEO) and the Regional Forensic Science Laboratory developed the Heroin Involved Death Investigation (HIDI) alert system and protocol in response to a substantial increase in opioid-related overdose fatalities. The HIDI protocol is designed to support a safe, coordinated, and rapid response to an active, suspected opioid-overdose death scene, or suspected opioid-overdose deaths occurring at hospitals that are not considered active scenes, by alerting investigators to potential dangers and facilitating the timely protection of scene integrity and evidence collection in order to successfully investigate and prosecute drug traffickers.
The primary goals of the project were to:
- Complete extended coding of local medical examiner decedent data--investigative reports and toxicology to identify demographic or geographic trends or patterns of overdose deaths, as well as paraphernalia and evidence present at death scenes that may be useful to prosecutions;
- Examine the efficiency of how cases flow through the investigative and prosecutorial stages and how these could be improved;
- Identify key variables that may contribute to the successful indictment of traffickers connected to fatal and non-fatal overdose cases; and
- Evaluate the implementation and perceived effectiveness of the Cuyahoga County HIDI protocol.
This multi-method project involved three phases of data collection and analysis. First, a forensic epidemiologist coded and analyzed existing CCMEO records for decedent toxicology and death scene characteristics, focusing on drug-related fatalities. Second, county and federal cases prosecuted for drug trafficking, especially those linked to deaths, were systematically reviewed to determine what evidence was deemed important for successful indictment. Third, interviews and focus groups were conducted with key stakeholders from local and federal law enforcement, intelligence analysts, public health officials, and local and federal prosecutors to learn about the HIDI protocol.
Data and documentation for interviews and focus groups will be made available in a future update.
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ZIP code
Restrictions View help for Restrictions
Access to these data is restricted. Users interested in obtaining these data must complete a Restricted Data Use Agreement, specify the reason for the request, and obtain IRB approval or notice of exemption for their research.
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Date of Collection View help for Date of Collection
Data Collection Notes View help for Data Collection Notes
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Please refer to Appendix C in the final NACJD project report (see Data-related Publications) for medical examiner record coding instructions and Appendix F for the qualitative interview guide.
Study Purpose View help for Study Purpose
The purpose of this study was to evaluate the Heroin Involved Death Investigation (HIDI) protocol and other contributing factors in successfully investigating and prosecuting drug traffickers in and around Cuyahoga County, Ohio.
Study Design View help for Study Design
Medical examiner decedent records (DS1). Death certificates, toxicology reports, and elements of investigative files dated 2014 to 2019 were transferred from paper/electronic copies into a REDcap database. An MPH-level epidemiologist served as the primary coder, but over the course of the project, five master's and PhD level coders participated. In total, 3,261 cases were coded.
Northern District of Ohio (NDO) trafficking cases (DS2). Indictments for violations in Title 21, Sections 841, 843 and 846 in the Eastern Division of the U.S. Attorney's Office (USAO)-NDO totaled 469 cases from 2015-2020.
Prosecution data (DS3). Data on drug-related homicide cases were selected from public documents available online from the state and federal clerk of court websites (n=121). The identification of court cases for review were determined by USAO-NDO and the Office of the Cuyahoga County Prosecutor. Cases included 43 federal cases prosecuted by USAO-NDO within Cuyahoga County (n=12) and neighboring counties (n=31) for the period of 2012 through 2019. Federal cases were selected if the defendant was charged with the federal death penalty enhancement. Cases selected from state prosecutions in Cuyahoga County included all cases where the defendant was indicted for involuntary manslaughter either based on corrupting another with drugs or trafficking in drugs from the period of 2013 through 2018 (n=78).
Individual and focus group interviews. Between April 2018 and September 2021, heroin involved death investigation (HIDI) protocol stakeholders were invited to participate in the focus groups or interviews to provide information on their part of the process and the value of the HIDI protocol as implemented in Cuyahoga County. All participants were invited to participate in person or over email. Between April 2018 and February 2020, all interviews (n=15) and focus groups (n=3) were conducted in-person, and 3 interviews were conducted via phone. The remaining interviews (March 2020 to September 2021) were conducted via phone.
Sample View help for Sample
Medical examiner's office data (DS1): All deaths with a drug in the cause of death between 2014 and 2019 were included in the sample.
Review of prosecution data (DS2, DS3): All trafficking cases (21:841, 843 and 846 violations) were provided with indicted violations. Cases identified as drug-induced homicide cases by the Cuyahoga County prosecutor's office and the US Attorney's Office of the Northern District of Ohio were reviewed.
Qualitative data: The researchers initially identified a convenience sample of 25 eligible participants before using snowball sampling to identify similar participants. Fifty-four stakeholders were interviewed individually or as part of a focus group.
Time Method View help for Time Method
Universe View help for Universe
- Fatal overdose victims in Cuyahoga County from 2014-2019
- Court cases/indictments that involved drug trafficking or drug-related homicide
- Professionals working in Cuyahoga County on the heroin-opioid crisis, including first responders, death scene investigators and medical examiner, police detectives, parent advocates, county and federal prosecutors, and data analysts
Unit(s) of Observation View help for Unit(s) of Observation
Data Source View help for Data Source
Cuyahoga County Prosecutor's Office
Cuyahoga County Medical Examiner's Office
U.S. Attorney's Office - Northern District of Ohio
Data Type(s) View help for Data Type(s)
Mode of Data Collection View help for Mode of Data Collection
Description of Variables View help for Description of Variables
Medical examiner records (DS1): Items coded from death certificates include cause of death (including "due to"), manner of death, other conditions, and drugs present. Items coded from investigation files include drug paraphernalia present at the scene, prescriptions on scene, drug use history, health history, treatment history, law enforcement/legal contact, and if naloxone/Narcan was administered. Decedent demographic items include death date (month/year), race, ethnicity, gender, age at time of death, education level, veteran status, and marital status.
Drug trafficking indictment case records (DS2): Items include year of case filing, county/region in which the defendant was tried, and U.S. code(s) violated.
Drug-induced homicide cases (DS3): Demographics for defendant and related decedent(s) include age, race, ethnicity, and gender. Charges indicted, date of indictment (month/year), counts in the indictment, motions filed, case result (e.g., pled out, trial, dismissed, withdrawn), and types of documents reviewed.
Individual interviews and focus groups: Questions were grouped thematically around participant experiences in investigations that used the HIDI protocol; inter-agency collaboration; data sharing, collection, and analysis processes; facilitators and challenges to using the HIDI protocol; and the impact of opioid overdoses on day-to-day work.
Response Rates View help for Response Rates
Not applicable.
Presence of Common Scales View help for Presence of Common Scales
Not applicable.
HideOriginal Release Date View help for Original Release Date
2023-09-27
Version History View help for Version History
2023-09-27 ICPSR data undergo a confidentiality review and are altered when necessary to limit the risk of disclosure. ICPSR also routinely creates ready-to-go data files along with setups in the major statistical software formats as well as standard codebooks to accompany the data. In addition to these procedures, ICPSR performed the following processing steps for this data collection:
- Checked for undocumented or out-of-range codes.
Notes
The public-use data files in this collection are available for access by the general public. Access does not require affiliation with an ICPSR member institution.
One or more files in this data collection have special restrictions. Restricted data files are not available for direct download from the website; click on the Restricted Data button to learn more.