Trends in fentanyl and fentanyl analogue-related overdose deaths – Montgomery County, Ohio, 2015–2017

Daniulaityte, Raminta; Juhascik, Matthew P.; Strayer, Kraig E.; Sizemore, Ioana E.; Zatreh, Mussa Y.; Nahhas, Ramzi W.; Harshbarger, Kent E.; Antonides, Heather M.; Martins, Sílvia S.; Carlson, Robert G.

doi:10.1016/j.drugalcdep.2019.01.045

Cited by 42 publications

(20 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Preliminary estimates of opioid overdose deaths in the United States in 2016 revealed that fentanyl and its analogs (e.g., acetylfentanyl, furanylfentanyl, and carfentanil) have contributed to nearly half of opioid overdose deaths 16,30,31 . Moreover, the number of deaths that were attributable to illicitly manufactured fentanyl and its analogs nearly quadrupled between July 2015 and June 2017 in Montgomery County, Ohio 32 . Heroin-positive cases declined while methamphetamine-positive cases increased in these victims.…”

Section: Epidemic and Evolution Of Illicit Fentanyl Usementioning

confidence: 99%

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

et al. 2019

View full text Add to dashboard Cite

Fentanyl is a powerful opioid anesthetic and analgesic, the use of which has caused an increasing public health threat in the United States and elsewhere. Fentanyl was initially approved and used for the treatment of moderate to severe pain, especially cancer pain. However, recent years have seen a growing concern that fentanyl and its analogs are widely synthesized in laboratories and adulterated with illicit supplies of heroin, cocaine, methamphetamine, and counterfeit pills, contributing to the exponential growth in the number of drug-related overdose deaths. This review summarizes the recent epidemic and evolution of illicit fentanyl use, its pharmacological mechanisms and side effects, and the potential clinical management and prevention of fentanyl-related overdoses. Because social, economic, and health problems that are related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.

show abstract

Section: Epidemic and Evolution Of Illicit Fentanyl Usementioning

confidence: 99%

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

et al. 2019

View full text Add to dashboard Cite

show abstract

“…We also excluded the compound 4-ANPP from the definition of novel synthetics because it is a metabolite of fentanyl and several fentanyl analogs as well as an intermediate compound generated in the manufacture of fentanyl. 9 Therefore, the presence of 4-ANPP could not definitively indicate the involvement of fentanyl analogs. 3 Our study did not require institutional review board approval by the CT DPH Human Investigations Committee because it did not involve human subjects research.…”

Section: Methodsmentioning

confidence: 99%

“…4,7,8 Fentanyl analogs and other nonfentanyl synthetic opioids are concerning because they often have higher potencies and pose a greater risk for overdose than other opioids. 9,10…”

mentioning

confidence: 99%

Improvements in Toxicology Testing to Identify Fentanyl Analogs and Other Novel Synthetic Opioids in Fatal Drug Overdoses, Connecticut, January 2016–June 2019

et al. 2021

View full text Add to dashboard Cite

Objectives Drug overdose deaths in Connecticut increasingly involve a growing number of fentanyl analogs and other novel nonfentanyl synthetic opioids (ie, novel synthetics). Current postmortem toxicology testing methods often lack the sophistication needed to detect these compounds. We examined how improved toxicology testing of fatal drug overdoses can determine the prevalence and rapidly evolving trends of novel synthetics. Methods From 2016 to June 2019, the Connecticut Office of the Chief Medical Examiner increased its scope of toxicology testing of suspected drug overdose deaths in Connecticut from basic to enhanced toxicology testing to detect novel synthetics. The toxicology laboratory also expanded its testing panels during this time. We analyzed toxicology results to identify and quantify the involvement of novel synthetics over time. Results From 2016 to June 2019, 3204 drug overdose deaths received enhanced toxicology testing; novel synthetics were detected in 174 (5.4%) instances. Ten different novel synthetics were detected with 205 total occurrences. Of 174 overdose deaths with a novel synthetic detected, most had 1 (n = 146, 83.9%) or 2 (n = 26, 14.9%) novel synthetics detected, with a maximum of 4 novel synthetics detected. Para-fluorobutyrylfentanyl/FIBF, furanylfentanyl, and U-47700 were most identified overall, but specific novel synthetics came in and out of prominence during the study period, and the variety of novel synthetics detected changed from year to year. Conclusions Enhanced toxicology testing for drug overdose deaths is effective in detecting novel synthetics that are not identified through basic toxicology testing. Identifying emerging novel synthetics allows for a timely and focused response to potential drug outbreaks and illustrates the changing drug market.

show abstract

“…Historically, prescription opioids have made up a larger share of rural drug-related deaths than either heroin or illicit fentanyl and in contrast, illicit fentanyl contributed the largest share of drug overdoses in urban locations (24). However, emerging research is showing increased fentanyl saturation in drug markets in rural locations (25,26). Overdose risk in rural locations is further exacerbated by health care shortages, underfunding of social services, and longer distances to emergency services (27,28).…”

Section: Introductionmentioning

confidence: 99%

Rural and Urban Differences in Overdose Response and Prevention Among Persons Who Inject Drugs

Walters

Felsher

Frank

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundOverdose is a leading cause of morbidity and mortality among people who inject drugs (PWID). Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths. This analysis explores rural-urban differences in overdose experiences among PWID. We focus on perceptions of fentanyl and overdose prevention and reversal strategies.MethodsSemi-structured interviews were conducted with 59 participants who injected drugs, 19 from rural southern Illinois and 40 from New York City (NYC). Seven key informants were also interviewed (three from Illinois and four from NYC) to provide additional perspectives. Data were analyzed using constant comparison and theoretical sampling methods.ResultsParticipants in urban NYC described most commonly injecting heroin and fentanyl, which differed from the rural Illinois drug market that was dominated by methamphetamines. Despite these geographic differences, participants from both locations were concerned about the growing presence of fentanyl in their drug supply and many disclosed overdose experiences. Strategies to lower overdose risk included purchasing drugs from trusted network members and partial drug injection, however, fentanyl test strip use was low in both locations. A key difference emerged related to the use of naloxone; NYC participants commonly described using naloxone as a primary overdose response, but participants in rural Illinois did not. Low naloxone use in Illinois was attributed to perceived risks of its use, such as fear of arrest and opioid withdrawal symptoms the naloxone receiver may experience. ConclusionsDespite similarities in fentanyl awareness and concern, important rural-urban differences emerged related to access to overdose prevention and reversal resources. Findings can inform regional-specific interventions to reduce overdose risk among PWID.

show abstract

Trends in fentanyl and fentanyl analogue-related overdose deaths – Montgomery County, Ohio, 2015–2017

Cited by 42 publications

References 25 publications

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

Improvements in Toxicology Testing to Identify Fentanyl Analogs and Other Novel Synthetic Opioids in Fatal Drug Overdoses, Connecticut, January 2016–June 2019

Rural and Urban Differences in Overdose Response and Prevention Among Persons Who Inject Drugs

Contact Info

Product

Resources

About