CLEVELAND, Ohio -- Close to 200 people died of heroin overdoses last year in Cuyahoga County alone, and another 85 died from opiate-related medications, proving that a deadly epidemic continues to swell as officials begin to grapple with how to reduce it.
About 195 people died of heroin overdoses in 2013, compared to 64 back in 2009 and 40 in 2007.
The figures, released Friday by Cuyahoga County Medical Examiner Thomas P. Gilson, paint a sobering picture of an epidemic that the FOX 8 I-Team has been tracking for three years.
In 2011, the I-Team traveled to Portsmouth in southern Ohio for a series of reports entitled "Prescription for Disaster."
We traced the path of opiate-based pills, with names such as Oxycodone and Oxycontin, north toward Cleveland.
Cuyahoga County Drug Court Judge David Matia was one of the first officials to sound the alarm, calling the heroin problem an "epidemic" back in 2011.
Matia said there is a pathway that often starts with people taking opiates prescribed by their doctors, and then transitioning to street heroin.
"We need to question our doctors," Matia said, "and ask, 'doctor, do I really need this prescription? Does my child really need this when he gets a tooth pulled?'"
People come to addiction by treatment for regular medical conditions - and that is the real tragedy.
Last year, the number of heroin deaths was almost evenly split between the city of Cleveland and the county's suburbs.
Three-quarters of those who died, or 143 people, were men but the quarter who were women, 52 in all, represent the highest percentage of female deaths recorded so far.
There is a little good news. Thirty one people were saved by the administration of Naloxone, the heroin antidote drug.
The state legislature has recently passed a bill making it easier for families to get the antidote drug.
And more and more people, including doctors and medical institutions, are paying more and more attention to the problem.
Last month, the I-Team broadcast a series of follow-up reports entitled "Heroin Hits Home" that probed deeper into the problem and looked for solutions.
Matia said the number of opiates prescribed must come down for the deaths to come down.
"Until that flow is turned off," he said, "we're going to continue to see people die."