RAVENNA -- Portage County hit several grim milestones in 2016 in the number of suicides reported and of people who died as a result of ingesting a deadly mix of illegal drugs tainted with synthetic painkillers or tranquilizers.

Headway has been made in the fight against heroin deaths, with fewer people in Portage County dying as a direct result of its use last year, though synthetic additives commonly found mixed with the notorious drug are increasingly killing addicts, the Portage County coroner's office warned.

Dr. Dean DePerro's office reported 146 death investigations in 2016 -- the highest number on record. Statistics also revealed that 2016 was the first time in the last 20 years that accidental deaths outpaced natural deaths investigated in five categories: Natural, accidental, suicide, homicide and undetermined.

Fifty-one people died of drug overdoses, with 47 ruled unintentional and four ruled intentional. In 2015, there were 30 accidental overdose deaths, mostly involving illegal heroin and cocaine and the prescription painkiller fentanyl.

Last year also accounted for the second-highest number of suicides investigated by the coroner's office in its history. Twenty-five suicides were reported and investigated, second only to 2010 when 28 suicides were reported. The third-highest all-time was 24 in 2015.

Generally, 90 percent of all suicide victims are men. Last year, 16 men committed suicide, and nine women did. Along with the four intentional suicides by overdose, 12 people shot themselves, there were eight hangings and one person committed suicide by jumping / falling.

Those contemplating suicide have places to get help. Call the 24/7 National Suicide Prevention Lifeline at 1-800-273-8255, Coleman Professional SErvices at 330-296-3555 or Townhall II's 24-hour helpline at 330-678-HELP. Residents also can visit www. suicidepreventionportagecounty.org.

Natural deaths from medical conditions typically account for the largest number of death certificates signed by the county coroner, but they accounted for just over one-third of cases in 2016. The accidental death category includes most drug overdoses and traffic crashes -- there were 14 of the latter in 2016 in Portage County -- agricultural, industrial and commercial mishaps.

Forty-five percent of all coroner's cases -- 65 out of 146 -- involved persons with alcohol or drugs in their systems. Last year, however, only three deaths in 2016 were directly attributable to heroin toxicity, while another six cases were blamed on a combination of heroin and other drugs.

Powerful and deadly unless controlled under a doctor's care, fentanyl began to appear more frequently in Portage County overdose victims in 2013. A synthetic opioid 50 times stronger than heroin, its incidence increased in both 2014 and 2015 and rose sharply in 2016, per the coroner's office. It is blamed for nine accidental overdose deaths in 2016.

In another eight cases, fentanyl was the main drug in a killer cocktail that included other illicit substances, according to the coroner's office.

The animal tranquilizer carfentanil, first synthesized by chemists in the 1970s under the brand name Wildnil and used to put elephants, big cats and other zoo animals to sleep for surgery or to euthanize them, has started creeping into the Northeast Ohio heroin supply as an additive mixed with the drug somewhere along the pipeline from China to Mexico to the United States.

Hundreds of times stronger than even fentanyl, carfentanil started appearing in Portage and Summit counties last summer. From July to December 2016, it caused seven accidental overdose deaths, according to the coroner's office.

Though statistics are hard to come by, the increased use of the anti-overdose drug Narcan (also known as naloxone) by Portage County police officers, paramedics and the public likely saved an unknown number of lives last year. Training and education on the drug, which blocks opioid receptors to prevent overdoses on opioids such as heroin, fentanyl and carfentanil, has increased since 2015.

Becky Lehman, director of health education and promotion and spokeswoman for the Portage County Health Department, said Narcan will stop a fentanyl or carfentanil overdose, though "it will take many more doses of Narcan to revive the person who is on either one of these."

Narcan also is available over the counter at many pharmacies in Ohio.

Email: dobrien@recorpdub.com

Phone: 330-541-9400 ext. 4155