Ohio's largest county saw a record number of heroin overdose deaths last year.
The medical examiner in northeast Ohio's Cuyahoga County said Thursday that heroin killed 195 people there in 2013.
Heroin killed more people that homicide in the county of about 1.3 million people last year, and it shattered the previous record of 161 fatal overdoses in 2012.
Officials say that the pain pill epidemic has for many users been a gateway to heroin, which is cheaper and has become easier to get than prescription opiates.
The county medical examiner, Dr. Thomas Gilson, tells the Northeast Ohio Media Group that a push by the county to expand the distribution of the overdose antidote naloxone has led to the reversal of 31 possible overdoses.