Fentanyl and fentanyl analogs in the illicit stimulant supply: Results from U.S. drug seizure data, 2011–2016

Park, Ju Nyeong; Rashidi, E.; Foti, Kathryn; Zoorob, Michael; Sherman, Susan G.; Alexander, G. Caleb

doi:10.1016/j.drugalcdep.2020.108416

Cited by 90 publications

(51 citation statements)

References 36 publications

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“…Assuming that overdose deaths and ED encounters for suspected OOD are correlated, the preliminary death data show that overdoses have increased, especially in Kentucky, New York, and Ohio, and suggest that an increase in fentanyl may be driving the increase in ED encounters in Kentucky ( Slavova et al, 2020 ) and possibly Ohio. Similar trends were seen in 2015 when the increase in OOD deaths across the U.S. were driven by the introduction of illicitly manufactured fentanyl ( Gladden et al, 2016 ; Park et al, 2021 ; Peterson et al, 2016 ).…”

Section: Discussionsupporting

confidence: 52%

The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

Root

Slavova

Larochelle

et al. 2021

Drug and Alcohol Dependence

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Background Although national syndromic surveillance data reported declines in emergency department (ED) visits after the declaration of the national stay-at-home order for COVID-19, little is known whether these declines were observed for suspected opioid overdose. Methods This interrupted time series study used syndromic surveillance data from four states participating in the HEALing Communities Study: Kentucky, Massachusetts, New York, and Ohio. All ED encounters for suspected opioid overdose (n = 48,301) occurring during the first 31 weeks of 2020 were included. We examined the impact of the national public health emergency for COVID-19 (declared on March 14, 2020) on trends in ED encounters for suspected opioid overdose. Results Three of four states (Massachusetts, New York and Ohio) experienced a statistically significant immediate decline in the rate of ED encounters for suspected opioid overdose (per 100,000) after the nationwide public health emergency declaration (MA: -0.99; 95% CI: -1.75, -0.24; NY: -0.10; 95% CI, -0.20, 0.0; OH: -0.33, 95% CI: -0.58, -0.07). After this date, Ohio and Kentucky experienced a sustained rate of increase for a 13-week period. New York experienced a decrease in the rate of ED encounters for a 10-week period, after which the rate began to increase. In Massachusetts after a significant immediate decline in the rate of ED encounters, there was no significant difference in the rate of change for a 6-week period, followed by an immediate increase in the ED rate to higher than pre-COVID levels. Conclusions The heterogeneity in the trends in ED encounters between the four sites show that the national stay-at-home order had a differential impact on opioid overdose ED presentation in each state.

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Section: Discussionsupporting

confidence: 52%

The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

Root

Slavova

Larochelle

et al. 2021

Drug and Alcohol Dependence

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“…51 Geographic variability is also present in these drug combinations, with methamphetamine-fentanyl drug submissions most often found in the Northeast, specifically New Hampshire, Massachusetts, Vermont, and Maine. 52 With these changes in availability, there has also been a proliferation of new product forms. Traditionally, methamphetamine is sold in powder or crystal form, 53,54 but increasingly, new forms, including precursor chemicals, are being seized.…”

Section: How Illicit Drug Supply Changes Are Contributing To Methamph...mentioning

confidence: 99%

Methamphetamine use in the United States: epidemiological update and implications for prevention, treatment, and harm reduction

Jones

Houry

Han

et al. 2021

Annals of the New York Academy of Sciences

100

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Recent attention has focused on the growing role of psychostimulants, such as methamphetamine in overdose deaths. Methamphetamine is an addictive and potent stimulant, and its use is associated with a range of physical and mental health harms, overdose, and mortality. Adding to the complexity of this resurgent methamphetamine threat is the reality that the increases in methamphetamine availability and harms are occurring in the midst of and intertwined with the ongoing opioid overdose crisis. Opioid involvement in psychostimulant-involved overdose deaths increased from 34.5% of overdose deaths in 2010 to 53.5% in 2019-an increase of more than 50%. This latest evolution of the nation's overdose epidemic poses novel challenges for prevention, treatment, and harm reduction. This narrative review synthesizes what is known about changing patterns of methamphetamine use with and without opioids in the United States, other characteristics associated with methamphetamine use, the contributions of the changing illicit drug supply to use patterns and overdose risk, motivations for couse of methamphetamine and opioids, and awareness of exposure to opioids via the illicit methamphetamine supply. Finally, the review summarizes illustrative community and health system strategies and research opportunities to advance prevention, treatment, and harm reduction policies, programs, and practices.

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“…Despite widespread concern about fentanyl-contaminated methamphetamine, the prevalence of fentanyl-positive methamphetamine samples tested with more accurate methods appears to be low. Data from the National Forensic Laboratory Information System reflects only 0.1% ( n = 272) of methamphetamine seized in the USA during 2016 contained fentanyl [ 61 ]. One study of samples collected between 2017 and 2018 at a supervised drug consumption site in Vancouver, BC, found that 5.9% ( n = 15) of methamphetamine samples contained fentanyl, using a FTRI spectrometer [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

“It’s called overamping”: experiences of overdose among people who use methamphetamine

et al. 2022

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Background The USA is experiencing increases in methamphetamine use and methamphetamine-related or attributed deaths. In the current study, we explore qualitative narratives of methamphetamine overdose and strategies used by people who use drugs to reduce the undesirable effects associated with methamphetamine use. Methods We conducted 21 qualitative interviews with people over the age of 18 who reported using methamphetamine in the previous 3 months in Nevada and New Mexico. Interviews were recorded, transcribed, and analyzed using qualitative thematic analysis. Results Respondents described a constellation of psychological and physical symptoms that they characterized as “overamping,” experienced on a continuum from less to more severe. Reports of acute, fatal methamphetamine overdose were rare. Few reported seeking medical attention for undesirable effects (usually related to psychological effects). General self-care strategies such as sleeping and staying hydrated were discussed. Conclusions When asked directly, our respondents claimed that acute, fatal methamphetamine overdose is rare or even impossible. However, they described a number of undesirable symptoms associated with overconsumption of methamphetamine and had few clinical or harm reduction strategies at their disposal. Addressing this current wave of drug-related deaths will require attention to the multiple factors that structure experiences of methamphetamine “overdose,” and a collaborative effort with PWUDs to devise effective harm reduction and treatment strategies.

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Fentanyl and fentanyl analogs in the illicit stimulant supply: Results from U.S. drug seizure data, 2011–2016

Cited by 90 publications

References 36 publications

The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

Methamphetamine use in the United States: epidemiological update and implications for prevention, treatment, and harm reduction

“It’s called overamping”: experiences of overdose among people who use methamphetamine

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