The ‘fentanyl epidemic’ in Canada – Some cautionary observations focusing on opioid-related mortality

Fischer, Benedikt; Vojtila, Lenka; Rehm, Jürgen

doi:10.1016/j.ypmed.2017.11.001

Cited by 73 publications

(58 citation statements)

References 20 publications

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“…In contrast with the 2005-2007 epidemic occurred in Cook County, where "most deaths were fentanyl intoxication without other drugs or alcohol (50%)," in the vast majority of 2015-2017 fentanyl cases, fentanyl was associated with other products. This is in accordance with the findings of other authors (11). The most common drug used with fentanyl was heroin (12) The statistical analyses performed within our study population showed that some combinations of drugs were significantly more common in specific demographic subgroups (male/females; Caucasian/African American; and certain age groups): This could be due to increased use/choice of these combinations in these groups or to a possible greater susceptibility of these groups to the effect of some specific drug association:…”

Section: Discussionsupporting

confidence: 94%

“…In contrast with the 2005–2007 epidemic occurred in Cook County, where “ most deaths were fentanyl intoxication without other drugs or alcohol (50%), ” in the vast majority of 2015–2017 fentanyl cases, fentanyl was associated with other products. This is in accordance with the findings of other authors . The most common drug used with fentanyl was heroin , followed by cocaine and ethanol.…”

Section: Discussionsupporting

confidence: 93%

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The Outbreak of Fentanyl‐Related Deaths in Cook County, Illinois, Between October 2015 and December 2017: A Retrospective Study and a Comparison with Previous Data

Serinelli

White²,

Arunkumar

et al. 2019

Journal of Forensic Sciences

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The National Institute on Drug Abuse has observed an increase in fentanyl deaths in the United States. One epidemic related to the abuse of fentanyl happened in Cook County in 2005–2007 (350 deaths). Another outbreak of fentanyl deaths occurred in 2015–2017 in the same area. The database of the Cook County Medical Examiner's Office was searched for cases of fentanyl deaths between 2015 and 2017: 1244 deaths were found. A comparison was performed with the previous data: an increase in the number of females was observed in 2015–2017. Also, in 2005–2007, the majority of deaths occurred among African American, while in 2015–2017, Caucasians were more involved. Within our population, some drug combinations were more common in specific demographic subgroups (male/females; Caucasian/African American; and certain age groups). The epidemiology and the most significant drug associations found at the toxicology are discussed, highlighting the usefulness of the knowledge about this outbreak for public health.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 93%

The Outbreak of Fentanyl‐Related Deaths in Cook County, Illinois, Between October 2015 and December 2017: A Retrospective Study and a Comparison with Previous Data

Serinelli

White²,

Arunkumar

et al. 2019

Journal of Forensic Sciences

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“…It is recognised that war on drugs approaches fail to reduce drug use, production and sale [1][2][3][4]. In the last several years, preventable overdose deaths, especially due to opioid use, have increasingly been reported in North America, while concerning trends have also emerged in Australia and countries in Europe and Asia [5][6][7][8][9][10]. In response, rapid expansion of life-saving harm reduction services is underway with greater public support reported in some parts of the world [1,8,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

A scoping review of harm reduction training for police officers

Khorasheh

Naraine

Watson

et al. 2019

Drug and Alcohol Review

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Issues Preventable overdose deaths, especially due to opioids, have increasingly been reported worldwide. Expansion of life‐saving harm reduction services is underway with increasing public support in some jurisdictions. However, such services often fall short of reaching people who use drugs (PWUD), in part, due to law enforcement practices that are aligned with punitive drug laws and incongruent with harm reduction principles. One suggested strategy to facilitate police understanding and uptake of practices that are more congruent with harm reduction is to provide police with relevant training. Approach This scoping review synthesises English‐language peer‐reviewed and grey literature on harm reduction training programs for police. Key Findings We reviewed 31 sources and found that most trainings covered topics related to harm reduction objectives, overdose recognition and response, occupational safety and policing practices. Information was often presented via single‐session, 1‐hour long, slide‐assisted presentations that were integrated into in‐service trainings. Inconsistent throughout the literature was the career stage or position/rank of training audience (e.g. cadets, senior officers, street‐level officers), when and how much training should be provided, and the occupational background of the training facilitator. Implications The available literature contains significant gaps pertaining to descriptions of training development, design and content specific to facilitating positive police‐PWUD interactions, and formal evaluations. These gaps limit our understanding of what well‐designed trainings may look like, if and how training alters policing practices, and to what extent training completion may lead to improved outcomes. Conclusion Greater research and formal evaluations of harm reduction training for police is recommended.

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“…These aim not to eliminate opioid use, but to minimize their associated sequelae. Peer‐based overdose recognition and management interventions have, consequently, become more common, corresponding with increases in opioid use and overdose over the last decade in many Western countries (Fischer, Vojtila, & Rehm, ). The outcome is that the previous harm reduction approach of methadone maintenance treatment (MMT) has received less attention (College of Physicians & Surgeons of Ontario [CPSO], ; Fischer & Argento, ).…”

Section: Introductionmentioning

confidence: 99%

Methadone maintenance treatment as social control: Analyzing patient experiences

O’Byrne

Pearson

2018

Nursing Inquiry

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Methadone maintenance treatment (MMT) is a harm reduction approach for persons who wish to stop using opioids and is rather effective if used for a minimum of 12 months. Notably, research demonstrates that many persons enrolled in MMT programs discontinue care before this time, limiting its effects. To better understand this process, we undertook an exploratory descriptive qualitative study and interviewed 12 men and women who were using MMT. Using the theoretical work of Foucault and Hardt and Negri, the interview data highlighted that MMT continues to be strongly stigmatized, and that it is a system of care that involves rewards and penalties, based on if patients behave according to prescribed norms. These results suggest that MMT is a disciplinary mechanism, albeit one that impedes its own access. We consequently recommend that healthcare providers work to facilitate access to MMT, which means altering care delivery.

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The ‘fentanyl epidemic’ in Canada – Some cautionary observations focusing on opioid-related mortality

Cited by 73 publications

References 20 publications

The Outbreak of Fentanyl‐Related Deaths in Cook County, Illinois, Between October 2015 and December 2017: A Retrospective Study and a Comparison with Previous Data

The Outbreak of Fentanyl‐Related Deaths in Cook County, Illinois, Between October 2015 and December 2017: A Retrospective Study and a Comparison with Previous Data

A scoping review of harm reduction training for police officers

Methadone maintenance treatment as social control: Analyzing patient experiences

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