New and Emerging Opioid Overdose Risk Factors

Foglia, Ralph; Kline, Anna; Cooperman, Nina A.

doi:10.1007/s40429-021-00368-6

Cited by 15 publications

(18 citation statements)

References 97 publications

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“…The only statistically significant changes in toxicology between 2019 and 2020 were decreases in use of heroin and alprazolam. The decrease in heroin in Tennessee is in accordance with other jurisdictions [ 7 , [31] , [32] , [33] ]. Some studies have reported decreasing benzodiazepine use as well [ 34 ].…”

Section: Discussionsupporting

confidence: 80%

Characteristics of fatal drug overdoses among college age decedents in Tennessee, 2019–2020

Korona-Bailey¹,

Mukhopadhyay²

2022

Dialogues in Health

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Section: Discussionsupporting

confidence: 80%

Characteristics of fatal drug overdoses among college age decedents in Tennessee, 2019–2020

Korona-Bailey¹,

Mukhopadhyay²

2022

Dialogues in Health

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“…Additionally, heroin in any combination was only detected in 5.6% of testing results. Taken together, these results help to describe the local drug landscape, which consists predominantly of fentanyl, and most often with no additional illicit adulterants, and a dwindling presence of heroin (36,37). On a more participant-centric level, using DCS with FTS to inform participants about the presence of fentanyl in their submitted specimen has been shown to be an effective risk mitigating strategy as demonstrated in previous studies (15,16,30,31,38).…”

Section: Discussionsupporting

confidence: 59%

“…In this vein, our results indicated that over half (52.9%) of the participants reported their specimens as heroin and, more importantly, 16.6% reported fentanyl alone or in combination with heroin or cocaine. Perhaps participants testing specimens that they believed to be fentanyl re ects an increase in opioid tolerance and dependence that is di cult to satisfy with heroin alone, leading to fentanyl seeking behaviors in drug use (36,37,39,40). Another possibility is that those reporting specimens as heroin, might have been using the term as a catch all reference to opioids, including fentanyl, as has been previously reported (41).…”

Section: Discussionmentioning

confidence: 96%

Measuring adulterants in street drugs: Implementation of drug residue testing using portable mass spectrometry in a Northeastern U.S. harm reduction program, 2019-2020

Boulad

Matsumoto

Santelices

et al. 2021

Preprint

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Background: Fatal opioid overdose deaths involving illicitly manufactured fentanyl continue to escalate in the U.S. Drug checking services, as a harm reduction intervention for people who use drugs, has gained support as an effective strategy to reduce fatal overdoses. We examined implementation of drug checking services using portable devices in a syringe services program in the Northeastern U.S. Methods: Trained staff collected trace drug specimens from used paraphernalia provided by participants who requested drug checking services. All the specimens were tested using a portable mass spectrometer and sub-samples were tested for the detection of fentanyl using fentanyl testing strips. We assessed characteristics of participants who used drug checking services, self-reported types of trace specimens of substances that participants reported providing for testing, the actual mass spectrometer test results of these specimens, and agreement of the mass spectrometer and fentanyl testing strips results in detection of fentanyl and fentanyl analogues. Results: Of 155 unique participants who provided demographic information, 59% identified as male and 74.1% as White, with a mean age of 37.7 years. Based on analysis of 396 specimens tested with the portable mass spectrometer, the most common single substance detected was fentanyl (37.7%), without a trace of heroin or other adulterants, followed by methamphetamine (18.2%), and cocaine (13.6%). Fentanyl and fentanyl analogues were detected in specimens provided by participants that were reported as heroin (60.8%), cocaine (11.1%), and methamphetamine (6.7%). We found modest agreement of testing results between the mass spectrometer and fentanyl testing strips. Conclusions: Use of drug checking services within syringe services programs is in its initial test stages. Knowledge about the contents of substances purchased, and conversations between syringe services program participants and staff, have the potential to facilitate informed decisions to decrease overdose risks through engagement in harm reduction strategies. Through analysis of newly implemented drug checking services, we noted participant characteristics and dissonance between participants’ reports of the trace drug specimens submitted for testing and the actual drugs and adulterants detected by mass spectrometer results, which has implications for overdose risk, highlighting opportunities for harm reduction responses.

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“…Esta substância é 50-100 vezes mais potente que a morfina, podendo levar a overdose com doses muito pequenas. Como dito, a pandemia levou a um isolamento social, fazendo com que mais pessoas utilizassem drogas sozinhas, fator que aumenta a letalidade das overdoses, uma vez que não é possível a chamada de socorro (FOGLIA et al, 2021).…”

Section: Resultsunclassified