Increases in Fentanyl-Related Overdose Deaths — Florida and Ohio, 2013–2015

Peterson, Alexis B.; Gladden, R. Matthew; Delcher, Chris; Spies, Erica; Garcia-Williams, Amanda; Wang, Yanning; Halpin, John F.; Zibbell, Jon E.; McCarty, Carolyn Lullo; DeFiore-Hyrmer, Jolene; DiOrio, Mary; Goldberger, Bruce A.

doi:10.15585/mmwr.mm6533a3

Cited by 162 publications

(128 citation statements)

References 4 publications

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“…These findings are consistent with recent reports highlighting the increasing trend in deaths involving heroin and synthetic opioids other than methadone (1)(2)(3)5). The number of deaths involving synthetic opioids other than methadone have been associated with the number of drug products obtained by law enforcement testing positive for fentanyl, but not with fentanyl prescribing rates (2,3).…”

Section: Discussionsupporting

confidence: 93%

“…Opioid death rates increased by 15.6% from 2014 to 2015. These significant increases in death rates were driven by synthetic opioids other than methadone (72.2%), most likely illicitly-manufactured fentanyl (2,3), and heroin (20.6%). Increases in these opioid subcategories occurred overall and across all demographics and regions.…”

Section: Discussionmentioning

confidence: 99%

“…The number of deaths involving synthetic opioids other than methadone have been associated with the number of drug products obtained by law enforcement testing positive for fentanyl, but not with fentanyl prescribing rates (2,3). A recent report found that these increases, likely attributable to illicitly manufactured fentanyl, were concentrated in eight of 27 states examined (2).…”

Section: Discussionmentioning

confidence: 99%

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Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Rudd¹,

Seth²,

David³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

2,033

1,423

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Rudd¹,

Seth²,

David³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

2,033

1,423

View full text Add to dashboard Cite

“…As the connection between increased opioid prescribing and rising overdose deaths was recognized and efforts were made to limit opioid prescriptions, heroin use increased, likely to meet the rising demand for illicit opioids (Rudd, Aleshire, Zibbell, & Gladden, 2016). Along with increased heroin use, the introduction of illicitly manufactured fentanyl and other synthetic opioids into many illicit opioid markets has resulted in an acute surge in overdose deaths in many communities (Peterson et al, 2016; Rudd, Aleshire, et al, 2016). These changes have brought challenges and raised new questions about what was previously known regarding overdose and our response to it.…”

Section: Introductionmentioning

confidence: 99%

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

Fairbairn

Coffin

Walley

2017

International Journal of Drug Policy

249

192

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Community-based overdose prevention programs first emerged in the 1990's and are now the leading public health intervention for overdose. Key elements of these programs are overdose education and naloxone distribution to people who use opioids and their social networks. We review the evolution of naloxone programming through the heroin overdose era of the 1990's, the prescription opioid era of the 2000's, and the current overdose crisis stemming from the synthetic opioid era of illicitly manufactured fentanyl and its analogues in the 2010's. We present current challenges arising in this new era of synthetic opioids, including variable potency of illicit drugs due to erratic adulteration of the drug supply with synthetic opioids, potentially changing efficacy of standard naloxone formulations for overdose rescue, potentially shorter overdose response time, and reports of fentanyl exposure among people who use drugs but are opioid naïve. Future directions for adapting naloxone programming to the dynamic opioid epidemic are proposed, including scale-up to new venues and social networks, new standards for post-overdose care, expansion of supervised drug consumption services, and integration of novel technologies to detect overdose and deliver naloxone.

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“…Similar to increased rates of heroin overdose, rates of overdoses from synthetic opioids (excluding methadone) increased by 88% between 2013 and 2016 [2]. This significant increase seems to be primarily the result of illicitly manufactured fentanyl [13,14], which is commonly mixed into batches of heroin [15]. This is concerning given that fentanyl is 50–100 times more potent than morphine [16].…”

mentioning

confidence: 99%

Addressing the growing opioid and heroin abuse epidemic: a call for medical school curricula

Ratycz

Papadimos

Vanderbilt

2018

Medical Education Online

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Substance abuse is a growing public health concern in the USA (US), especially now that the US faces a national drug overdose epidemic. Over the past decade, the number of drug overdose deaths has rapidly grown, largely driven by increases in prescription opioid-related overdoses. In recent years, increased heroin and illicitly manufactured fentanyl overdoses have substantially contributed to the rise of overdose deaths. Given the role of physicians in interacting with patients who are at risk for or currently abusing opioids and heroin, it is essential that physicians are aware of this issue and know how to respond. Unfortunately, medical school curricula do not devote substantial time to addiction education and many physicians lack knowledge regarding assessment and management of opioid addiction. While some schools have modified curricula to include content related to opioid prescription techniques and pain management, an added emphasis about the growing role of heroin and fentanyl is needed to adequately address the epidemic. By adapting curricula to address the rising opioid and heroin epidemic, medical schools have the potential to ensure that our future physicians can effectively recognize the signs, symptoms, and risks of opioid/heroin abuse and improve patient outcomes. This article proposes ways to include heroin and fentanyl education into medical school curricula and highlights the potential of simulation-based medical education to enable students to develop the skillset and emotional intelligence necessary to work with patients struggling with opioid and heroin addiction. This will result in future doctors who are better prepared to both prevent and recognize opioid and heroin addiction in patients, an important step in helping reduce the number of addicted patients and address the drug overdose epidemic.

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Increases in Fentanyl-Related Overdose Deaths — Florida and Ohio, 2013–2015

Cited by 162 publications

References 4 publications

Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

Addressing the growing opioid and heroin abuse epidemic: a call for medical school curricula

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