Seventy deaths in seven weeks drive unprecedented drug toll. (Photo: Journal Sentinel) 
 
 Earlier this month, Brian Peterson tried to give those gathered at a local opioid round-table discussion a sense of the scale of drug-related deaths in Milwaukee. 
 
 While homicides, motor vehicle and infant sleep-related deaths have loomed large in the news, Milwaukee's chief medical examiner said, when all three are added together "that's less than the number of overdoses we've had." 
 
 On Thursday, Peterson's office announced that 70 people have died from probable drug overdoses in Milwaukee County in the past seven weeks. 
 
 One of them was Peterson's son. 
 
 Adam Peterson, 29, died Monday at a friend's apartment in the 2700 block of W. Clybourn St., according to a medical examiner's report. Peterson, according to the report, had a history of drug use and was believed to be homeless when he died. 
 
 U.S. Sen. Ron Johnson, who hosted the round-table discussion, said: “I was sitting at the same table as Brian two weeks ago in Milwaukee discussing the trail of tragedies and heartbreak that addiction leaves in its wake. No family is immune. My prayers go out to Brian and his family at this time. I will continue to fight this fight for all those who have lost loved ones.” 
 
 According to the report: 
 
 Adam Peterson had been staying at the apartment for several days. His roommate told police he awoke from a nap around 6:45 p.m. and found Peterson face down on the floor, vomit coming from his mouth. An emergency medical team was unable to resuscitate Peterson, who was pronounced dead shortly before 7:30 p.m. 
 
 In a messenger-style bag that belonged to Peterson, investigators found a plastic bag that contained topiramate, which is a nerve pain and anticonvulsant medication, and citalopram, which is used to treat depression. A razor blade and a small bag containing cotton balls were also found on the floor. 
 
 ARCHIVE: Side Effects - Money, Medicine, and Patients 
 
 At the discussion hosted by Johnson at Milwaukee Area Technical College, Brian Peterson said that one out of three cases autopsied in one month earlier this year were overdose cases. 
 
 The ages of the dead spanned "63 years or so at the high end, down to 1 year old," he said. 
 
 "We had a 1-year-old found dead on a mattress of methadone poisoning," he said. "Unfortunately, that's not uncommon either." 
 
 The job of the medical examiner, he said, "is to help with clean data to help everybody understand." 
 
 "We're kind of the last responders," he said. 
 
 On Thursday, Peterson, who became the county's medical examiner in 2008, had no comment and asked for privacy for himself and his family. 
 
 His office described the number of deaths announced Thursday as "unprecedented." 
 
 "We have tossed out our projected number of total drug-related deaths for 2016," said Karen Domagalski, the medical examiner's office's operations manager. The office had estimated that there would be a record 288 deaths in 2016, she said. 
 
 As of July 27, there had been 168 confirmed deaths, more than the total for 2012. A record 254 people died from drug-related causes in 2015. 
 
 Bill Glauber of the Journal Sentinel staff contributed to this report. 
 
 Read or Share this story: http://on.jsonl.in/2d3dbPy ||||| The son of Milwaukee County's chief medical examiner died this week of an suspected drug overdose. 
 
 
 
 Adam Peterson, 29, on Monday became one of the more than 140 people whose death in Milwaukee County is believed to be related to narcotics. 
 
 
 
 Peterson was staying on the 2700 block of West Clybourn Street in Milwaukee and was found by a friend laying face down on a floor. First responders administered Narcan, a drug used as an antidote to opiates. He did not react to the drug and was pronounced dead at around 7:30 p.m., an investigative report said. 
 
 
 
 Peterson is the son of Dr. Brian Peterson, who heads the Milwaukee County Medical Examiner's Office. Data released from the office on Wednesday showed that this year is on track to outpace the previous five in heroin-related deaths and will exceed the number of deaths classified as homicides in each of the four years from 2011 to 2014. 
 
 
 
 There have been 71 overdose deaths in the county in the previous seven weeks, officials said. 
 
 
 
 Back in April, WISN 12 partnered with IMPACT, a Milwaukee organization which assists residents through health and productivity issues, including drug addiction, on an awareness campaign. If you or someone you love is struggling with addiction, contact IMPACT at 866-211-3380. 
 
 
 
 
 
 
 
 Photos: 25 facts about heroin The 25 heroin facts in this slideshow are provided by the National Institute on Drug Abuse. More ||||| AKRON, Ohio — Drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States, according to preliminary data compiled by The New York Times. 
 
 The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Drug overdoses are now the leading cause of death among Americans under 50. 
 
 Although the data is preliminary, the Times’s best estimate is that deaths rose 19 percent over the 52,404 recorded in 2015. And all evidence suggests the problem has continued to worsen in 2017. 
 
 Drug overdose deaths, 1980 to 2016 *Estimate based on preliminary data 
 
 Because drug deaths take a long time to certify, the Centers for Disease Control and Prevention will not be able to calculate final numbers until December. The Times compiled estimates for 2016 from hundreds of state health departments and county coroners and medical examiners. Together they represent data from states and counties that accounted for 76 percent of overdose deaths in 2015. They are a first look at the extent of the drug overdose epidemic last year, a detailed accounting of a modern plague. 
 
 The initial data points to large increases in drug overdose deaths in states along the East Coast, particularly Maryland, Florida, Pennsylvania and Maine. In Ohio, which filed a lawsuit last week accusing five drug companies of abetting the opioid epidemic, we estimate overdose deaths increased by more than 25 percent in 2016. 
 
 “Heroin is the devil’s drug, man. It is,” Cliff Parker said, sitting on a bench in Grace Park in Akron. Mr. Parker, 24, graduated from high school not too far from here, in nearby Copley, where he was a multisport athlete. In his senior year, he was a varsity wrestler and earned a scholarship to the University of Akron. Like his friends and teammates, he started using prescription painkillers at parties. It was fun, he said. By the time it stopped being fun, it was too late. Pills soon turned to heroin, and his life began slipping away from him. 
 
 Mr. Parker’s story is familiar in the Akron area. From a distance, it would be easy to paint Akron — “Rubber Capital of the World” — as a stereotypical example of Rust Belt decay. But that’s far from a complete picture. While manufacturing jobs have declined and the recovery from the 2008 recession has been slow, unemployment in Summit County, where Akron sits, is roughly in line with the United States as a whole. The Goodyear factories have been retooled into technology centers for research and polymer science. The city has begun to rebuild. But deaths from drug overdose here have skyrocketed. 
 
 In 2016, Summit County had 312 drug deaths, according to Gary Guenther, the county medical examiner’s chief investigator — a 46 percent increase from 2015 and more than triple the 99 cases that went through the medical examiner’s office just two years before. There were so many last year, Mr. Guenther said, that on three separate occasions the county had to request refrigerated trailers to store the bodies because they’d run out of space in the morgue. 
 
 It’s not unique to Akron. Coroners’ offices throughout the state are being overwhelmed. 
 
 Drug overdose deaths in six Ohio counties, 2010 to 2017 Totals for 2017 assume that overdose deaths continue at the same rate through the remainder of the year. Source: Butler County Coroner’s Office; Cuyahoga County Medical Examiner’s Office; Hamilton County Coroner; Montgomery County Alcohol, Drug Addiction & Mental Health Service; Montgomery County Sheriff’s Office; Summit County Department of the Medical Examiner 
 
 In some Ohio counties, deaths from heroin have virtually disappeared. Instead, the culprit is fentanyl or one of its many analogues. In Montgomery County, home to Dayton, of the 100 drug overdose deaths recorded in January and February, only three people tested positive for heroin; 99 tested positive for fentanyl or an analogue. 
 
 Fentanyl isn’t new. But over the past three years, it has been popping up in drug seizures across the country. 
 
 Drug seizures containing fentanyl Source: D.E.A. National Forensic Laboratory Information System 
 
 Most of the time, it’s sold on the street as heroin, or drug traffickers use it to make cheap counterfeit prescription opioids. Fentanyls are showing up in cocaine as well, contributing to an increase in cocaine-related overdoses. 
 
 The most deadly of the fentanyl analogues is carfentanil, an elephant tranquilizer 5,000 times stronger than heroin. An amount smaller than a few grains of salt can be a lethal dose. 
 
 “July 5th, 2016 — that’s the day carfentanil hit the streets of Akron,” said Capt. Michael Shearer, the commander of the Narcotics Unit for the Akron Police Department. On that day, 17 people overdosed and one person died in a span of nine hours. Over the next six months, the county medical examiner recorded 140 overdose deaths of people testing positive for carfentanil. Just three years earlier, there were fewer than a hundred drug overdose deaths of any kind for the entire year. 
 
 This exponential growth in overdose deaths in 2016 didn't extend to all parts of the country. In some states in the western half of the U.S., our data suggests deaths may have leveled off or even declined. According to Dr. Dan Ciccarone, a professor of family and community medicine at the University of California, San Francisco, and an expert in heroin use in the United States, this geographic variation may reflect a historical divide in the nation’s heroin market between the powdered heroin generally found east of the Mississippi River and the Mexican black tar heroin found to the west. 
 
 This divide may have kept deaths down in the West for now, but according to Dr. Ciccarone, there is little evidence of differences in the severity of opioid addiction or heroin use. If drug traffickers begin to shift production and distribution in the West from black tar to powdered heroin in large quantities, fentanyl will most likely come along with it, and deaths will rise. 
 
 Drug overdose deaths in Philadelphia and San Francisco Drug overdose deaths since 1980 have surged in Philadelphia despite a shrinking population; most heroin there is powdered. They have remained relatively flat in San Francisco, where most heroin is black tar. Source: C.D.C. WONDER 
 
 First responders are finding that, with fentanyl and carfentanil, the overdoses can be so severe that multiple doses of naloxone — the anti-overdose medication that often goes by the brand name Narcan — are needed to pull people out. In Warren County in Ohio, Doyle Burke, the chief investigator at the county coroner’s office, has been watching the number of drug deaths rise as the effectiveness of Narcan falls. “E.M.S. crews are hitting them with 12, 13, 14 hits of Narcan with no effect,” said Mr. Burke, likening a shot of Narcan to “a squirt gun in a house fire.” 
 
 Early data from 2017 suggests that drug overdose deaths will continue to rise this year. It’s the only aspect of American health, said Dr. Tom Frieden, the former director of the C.D.C., that is getting significantly worse. Over two million Americans are estimated to be dependent on opioids, and an additional 95 million used prescription painkillers in the past year — more than used tobacco. “This epidemic, it’s got no face,” said Chris Eisele, the president of the Warren County Fire Chiefs’ Association and fire chief of Deerfield Township. The Narcotics Anonymous meetings here are populated by lawyers, accountants, young adults and teenagers who described comfortable middle-class upbringings. 
 
 Back in Akron, Mr. Parker has been clean for seven months, though he is still living on the streets. The ground of the park is littered with discarded needles, and many among the homeless here are current or former heroin users. Like most recovering from addiction, Mr. Parker needed several tries to get clean — six, by his count. The severity of opioid withdrawal means users rarely get clean unless they are determined and have treatment readily available. “No one wants their family to find them face down with a needle in their arm,” Mr. Parker said. “But no one stops until they’re ready.” 
 
 About the data 
 
 Our count of drug overdoses for 2016 is an estimate. A precise number of drug overdose deaths will not be available until December. 
 
 As the chief of the Mortality Statistics Branch of the National Center for Health Statistics at the C.D.C., Robert Anderson oversees the collection and codification of the nation’s mortality data. He noted that toxicology results, which are necessary to assign a cause of death, can take three to six months or longer. “It’s frustrating, because we really do want to track this stuff,” he said, describing how timely data on cause of death would let public health workers allocate resources in the right places. 
 
 To come up with our count, we contacted state health departments in all 50 states, in addition to the District of Columbia, asking for their statistics on drug overdose deaths among residents. In states that didn't have numbers available, we turned to county medical examiners and coroners’ offices. In some cases, partial results were extrapolated through the end of the year to get estimates for 2016. 
 
 While noting the difficulty of making predictions, Mr. Anderson reviewed The Times’s estimates and said they seemed reasonable. The overdose death rate reported by the N.C.H.S. provisional estimates for the first half of 2016 would imply a total of 59,779 overdose deaths, if the death rate remains flat through the second half of the year. Based on our reporting, we believe this rate increased. 
 
 While the process in each state varies slightly, death certificates are usually first filled out by a coroner, medical examiner or attending physician. These death certificates are then collected by state health departments and sent to the N.C.H.S., which assigns what’s called an ICD-10 code to each death. This code specifies the underlying cause of death, and it’s what determines whether a death is classified as a drug overdose. 
 
 Sometimes, the cases are straightforward; other times, it’s not so easy. The people in charge of coding each death — called nosologists — have to differentiate between deaths due to drug overdose and those due to the long-term effects of drug abuse, which get a different code. (There were 2,573 such deaths in 2015.) When alcohol and drugs are both present, they must specify which of the two was the underlying cause. If it’s alcohol, it’s not a “drug overdose” under the commonly used definition. Ideally, every medical examiner, coroner and attending physician would fill out death certificates with perfect consistency, but there are often variations from jurisdiction to jurisdiction that can introduce inconsistencies to the data. 
 
 These inconsistencies are part of the reason there is a delay in drug death reporting, and among the reasons we can still only estimate the number of drug overdoses in 2016. Since we compiled our data from state health departments and county coroners and medical examiners directly, the deaths have not yet been assigned ICD-10 codes by the N.C.H.S. — that is, the official underlying cause of death has not yet been categorized. In addition, the mortality data in official statistics focuses on deaths among residents. But county coroners typically count up whichever deaths come through their office, regardless of residency. When there were large discrepancies between the 2015 counts from the C.D.C. and the state or county, we used the percent change from 2015 to calculate our 2016 estimate. 
 
 We can say with confidence that drug deaths rose a great deal in 2016, but it is hard to say precisely how many died or in which places drug deaths rose most steeply. Because of the delay associated with toxicology reports and inconsistencies in the reported data, our exact estimate — 62,497 total drug overdose deaths — could vary from the true number by several thousand.
– There have been more than 160 drug-related deaths in Milwaukee County, Wis., this year, 70 of them in the last seven weeks, and that is more than just a grim statistic for Chief Medical Examiner Brian Peterson. His own son, Adam Peterson, a 29-year-old with a history of drug use, was found on the floor of a friend's apartment Monday and was pronounced dead after failing to respond to anti-overdose drug Narcan, WISN reports. Brian Peterson, who has asked for privacy, told a conference earlier this month that his office was dealing with more overdose deaths than murders, car accident deaths, and sleep-related infant deaths combined, the Journal Sentinel reports. "We had a 1-year-old found dead on a mattress of methadone poisoning," Peterson told the round table. "Unfortunately, that's not uncommon either." He described medical examiners as "kind of the last responders," whose job it is "to help with clean data to help everybody understand." "I was sitting at the same table as Brian two weeks ago in Milwaukee discussing the trail of tragedies and heartbreak that addiction leaves in its wake," Sen. Ron Johnson tells the Journal Sentinel. "No family is immune. My prayers go out to Brian and his family at this time. I will continue to fight this fight for all those who have lost loved ones." (This small city in West Virginia had to deal with 27 overdoses in less than five hours.)