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Cuyahoga County, Ohio, Heroin and Crime Initiative: Informing the Investigation and Prosecution of Heroin-Related Overdose: Final Research Overview Report

NCJ Number
Daniel J. Flannery
Date Published
222 pages

This is the Final Research Overview Report on the rationale for and design, implementation, and evaluation of Cuyahoga County’s (Ohio) Heroin and Crime Initiative (HCI), whose goal is to contribute to the effective investigation and prosecution of crimes that have contributed to heroin-related overdoses in the county.


In response to an extended, alarming increase in heroin-involved overdose deaths in the county, in 2013 the Cuyahoga County Medical Examiner’s Office (CCMEO) and Regional Forensic Science Laboratory developed the Heroin Involved Death Investigation (HIDI) alert system and protocol. The HIDI protocol initiates and governs Heroin Early Alert (HEAT) emails sent by the CCMEO. These alerts give notice that the CCMEO has learned of 1) an active suspected opioid overdose via a death scene presenting physical evidence of opioid misuse or through evidence provided by family/friends or medical personnel regarding the victim’s history of drug misuse or a suspected opioid overdose death occurring at a hospital (what the alert identifies as “not an active scene”). Alerts are provided to professionals in the region’s public health and hospital systems and agencies that include the Cleveland Division of Police (CPD), County Sheriff’s Department, and other county and federal agencies that investigate and prosecute major drug traffickers. The HIDI protocol governs chain of custody and laboratory testing submissions of evidence items found on the body at the scene. The HIDI protocol is designed to support a safe, coordinated, and rapid response to an active scene by alerting investigators to potential dangers (lethal drugs) and facilitating the timely protection of the scene and collection of evidence. The primary goal of this protocol is to connect the victim (drug buyer) to the seller, with a focus on mid-level dealers and major traffickers. This report concludes with a discussion of the implications of this protocol for criminal justice practice and policy in investigative drug law enforcement, as well as the use of investigative evidence in the building of a case for prosecution. 2 figures