There are grim numbers being released from Cuyahoga County Medical Examiner Dr. Thomas Gilson.

Today Gilson said that Cuyahoga County had at least 42 confirmed fatal overdoses in the month of October due to heroin, fentanyl, or a combination of the two, according to a news release.

To date, at least 446 victims have died in 2016.

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Gilson released the October statistics of those who died in the county:

20 were City of Cleveland residents

22 were suburban residents: Bedford Heights, Broadview Heights (2), East Cleveland, Euclid, Highland Heights, Lakewood, Lyndhurst, Mayfield Heights, North Olmsted (2), Parma (6), and 5 out-of -county residents – Akron, Eastlake, Richfield, and Warren (2).

To date, Gilson said October’s current results do not indicate any fatalities due to carfentanil, a large animal sedative, 100 times more deadly than fentanyl and 2500 times more deadly than heroin, according to the news release.

Gilson said 16 cases from October are pending further toxicology testing, " it is possible October’s overdose total could increase. To date, at least 446 victims have died in 2016.