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

被引:38
作者
Daniulaityte, Raminta [1 ]
Juhascik, Matthew P. [2 ]
Strayer, Kraig E. [3 ]
Sizemore, Ioana E. [3 ]
Zatreh, Mussa [1 ]
Nahhas, Ramzi W. [4 ,5 ]
Harshbarger, Kent E. [2 ]
Antonides, Heather M. [2 ]
Martins, Silvia S. [6 ]
Carlson, Robert G. [1 ]
机构
[1] Wright State Univ, Boonshoft Sch Med, Ctr Intervent Treatment & Addict Res, Dept Populat & Publ Hlth Sci, 3171 Res Blvd, Kettering, OH 45420 USA
[2] MCCO MVRCL, 361 W Third ST, Dayton, OH 45402 USA
[3] Wright State Univ, Dept Chem, Coll Sci & Math, 202 Oelman Hall, Dayton, OH 45435 USA
[4] Wright State Univ, Boonshoft Sch Med, Dept Populat & Publ Hlth Sci, 3171 Res Blvd, Kettering, OH 45420 USA
[5] Wright State Univ, Boonshoft Sch Med, Dept Psychiat, 627 S Edwin C Moses Blvd,Suite 1, Dayton, OH 45417 USA
[6] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, 722 West 168th St, New York, NY 10032 USA
关键词
Fentanyl; Illicitly manufactured fentanyl; Fentanyl analogs; Carfentanil; Unintentional overdose deaths; Ohio; UNITED-STATES; INCREASES; HEROIN; DRUG; USERS; RISK;
D O I
10.1016/j.drugalcdep.2019.01.045
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Introduction: There is a lack of information on illicitly manufactured fentanyl and fentanyl analogue-related (IMF) unintentional overdose death trends over time. The study analyzes IMF-related unintentional overdose fatalities that occurred between July 2015 and June 2017 in Montgomery County, Ohio, an area with the highest rates of unintentional overdose mortality in Ohio. Methods: LC-MS/MS-based method was used to identify fentanyl analogs and metabolites in 724 unintentional overdose death cases. The Chi-square statistic was used to assess differences over time in demographic and drug-related characteristics. Results: The number of unintentional overdose death cases testing positive for IMFs increased by 377% between second half of 2015 and first half of 2017. The majority of decedents were white (82.5%) and male (67.8%). The proportion of fentanyl-only (no other analogs) cases declined from 89.2%-24.6% (p < 0.001), while proportion of fentanyl analogue-containing cases increased from 9.8%-70.3% (p < 0.001) between the second half of 2015 and first half of 2017. The most commonly identified fentanyl analogs were carfentanil (29.7%), furanyl fentanyl (14.1%) and acryl fentanyl (10.2%). Proportion of IMF cases also testing positive for heroin declined from 21.6% to 5.4% (p < 0.001), while methamphetamine positive cases increased from 1.4%-17.8% (p < 0.001) over the same time period. Discussion: Emergence of fentanyl analogs contributed to substantial increases in unintentional overdose deaths. The data indicate a growing overlap between the IMF and methamphetamine outbreaks. Continuous monitoring of local IMF trends and rapid information dissemination to active users are needed to reduce the risks associated with IMF use.
引用
收藏
页码:116 / 120
页数:5
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