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Seven people died from suspected overdoses in Hamilton County over the weekend. Non-lethal overdoses spiked too, officials said.

The Hamilton County Heroin Coalition issued an alert on Sunday after 15 people were hospitalized in 24 hours for apparent overdoses. The one-day spike followed a heavy week of calls to first responders for overdoses.

Officials don’t have evidence of changes in the drug supply that caused the spike. But they suspect fentanyl mixed in heroin and cocaine are the main culprits, said Newtown Police Chief Tom Synan, a coordinator with the heroin coalition.

“Fentanyl remains the major factor causing daily and weekly spikes of overdoses and deaths,” Synan said “It has become the staple. No matter what drug type is surging, fentanyl is the ingredient that increases the chance of immediate overdose or death.”

Dr. Lakshmi Sammarco, the Hamilton County county coroner, saw the first death Thursday. An additional six cases from the weekend could be fatal overdose.

The spike is occurring elsewhere in Ohio, as well.

Franklin County Coroner Dr. Anahi Ortiz notified followers Friday via Facebook of a surge in overdose deaths in her office. She said nine people died of apparent overdoses from May 14-16, in 36 hours.

Synan said officials of Ohio’s major cities are working together to follow and figure out the trends in overdoses.

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“We have been sharing more information with Columbus and Cleveland. If something happens there or here, we share,” he said. “We know that what happens in one part of the state will reach other parts, and you are seeing the foundation of an information chain beginning to form.”

The heroin coalition asks people to carry naloxone, the antidote for opioid overdose; recommends that users do not use drugs alone; and keeps first responders and treatment centers aware of the increases so that they can remain vigilant and respond well to any surges in patients.

Hamilton County overdose deaths so far this year to date are at 157, compared to 177 by the end of May 2018, coroner’s records show.

Related: 7 things to know about heroin

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