CLEVELAND, Ohio – For the first time in decades, a historic and “earth-shattering” shift in drug-related fatalities is occurring in Cuyahoga County: cocaine is now responsible for more deaths than opioids.

This change signals a new phase in the overdose crisis, prompting Medical Examiner Dr. Thomas Gilson to call for an urgent reevaluation of public health strategies that have long been focused on the opioid epidemic. New strategies need to focus on stimulants, like cocaine and methamphetamine.

“The winds are changing,” Gilson told cleveland.com and The Plain Dealer. “If we want to really be effective, we need to start pivoting to these stimulants as enemy number one.”

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Cocaine has overtaken opioids as the

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