Heroin file photo.jpg

More than 500 people have died of heroin or fentanyl overdoses in 2016 in Cuyahoga County, the medical examiner's office said.

(File photo)

CLEVELAND, Ohio -- At least 42 people died after overdosing on heroin, fentanyl or a combination of the two last month in Cuyahoga County, the medical examiner's office said.

The county has now seen more than 500 people die of overdoses in 2016, more than double the 228 who died in 2015, Cuyahoga County Medical Examiner Thomas Gilson said Tuesday in a statement.

"In early 2017, the Cuyahoga County Medical Examiner's Office will issue a final summary for the year," Gilson said. "It has been consistently clear that 2016 has been an unprecedented year for drug-related deaths in our county."

The number of November overdoses could rise because more than two dozen cases are pending further toxicology testing, Gilson said.

The medical examiner's office has also seen at least 18 overdose deaths since Dec. 1.

The November victims included 20 Cleveland residents, three Parma residents, three Brooklyn residents, two East Cleveland residents and two Euclid residents. The victims also included one resident from Lakewood, Maple Heights, Mayfield, Newburgh Heights, North Royalton, Richmond Heights, Rocky River, Seven Hills, and Solon.

Four victims were from out-of-county municipalities Avon, Madison, Ravenna and Wellington, the medical examiner's office said.

The totals do not include any deaths caused by carfentanil, a powerful animal sedative that has been detected in Northeast Ohio. There have been 15 confirmed carfentanil deaths this year in Cuyahoga County, the medical examiner's office said.

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