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Characteristics of Fentanyl Overdose - Massachusetts, 2014-2016.

Abstract Opioid overdose deaths in Massachusetts increased 150% from 2012 to 2015 (1). The proportion of opioid overdose deaths in the state involving fentanyl, a synthetic, short-acting opioid with 50-100 times the potency of morphine, increased from 32% during 2013-2014 to 74% in the first half of 2016 (1-3). In April 2015, the Drug Enforcement Agency (DEA) and CDC reported an increase in law enforcement fentanyl seizures in Massachusetts, much of which was believed to be illicitly manufactured fentanyl (IMF) (4). To guide overdose prevention and response activities, in April 2016, the Massachusetts Department of Public Health and the Office of the Chief Medical Examiner collaborated with CDC to investigate the characteristics of fentanyl overdose in three Massachusetts counties with high opioid overdose death rates. In these counties, medical examiner charts of opioid overdose decedents who died during October 1, 2014-March 31, 2015 were reviewed, and during April 2016, interviews were conducted with persons who used illicit opioids and witnessed or experienced an opioid overdose. Approximately two thirds of opioid overdose decedents tested positive for fentanyl on postmortem toxicology. Evidence for rapid progression of fentanyl overdose was common among both fatal and nonfatal overdoses. A majority of interview respondents reported successfully using multiple doses of naloxone, the antidote to opioid overdose, to reverse suspected fentanyl overdoses. Expanding and enhancing existing opioid overdose education and prevention programs to include fentanyl-specific messaging and practices could help public health authorities mitigate adverse effects associated with overdoses, especially in communities affected by IMF.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title mmwr. morbidity and mortality weekly report
Publication Year Start




PMID- 28406883
OWN - NLM
STAT- MEDLINE
DA  - 20170413
DCOM- 20170421
LR  - 20170421
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Linking)
VI  - 66
IP  - 14
DP  - 2017 Apr 14
TI  - Characteristics of Fentanyl Overdose - Massachusetts, 2014-2016.
PG  - 382-386
LID - 10.15585/mmwr.mm6614a2 [doi]
AB  - Opioid overdose deaths in Massachusetts increased 150% from 2012 to 2015 (1). The
      proportion of opioid overdose deaths in the state involving fentanyl, a
      synthetic, short-acting opioid with 50-100 times the potency of morphine,
      increased from 32% during 2013-2014 to 74% in the first half of 2016 (1-3). In
      April 2015, the Drug Enforcement Agency (DEA) and CDC reported an increase in law
      enforcement fentanyl seizures in Massachusetts, much of which was believed to be 
      illicitly manufactured fentanyl (IMF) (4). To guide overdose prevention and
      response activities, in April 2016, the Massachusetts Department of Public Health
      and the Office of the Chief Medical Examiner collaborated with CDC to investigate
      the characteristics of fentanyl overdose in three Massachusetts counties with
      high opioid overdose death rates. In these counties, medical examiner charts of
      opioid overdose decedents who died during October 1, 2014-March 31, 2015 were
      reviewed, and during April 2016, interviews were conducted with persons who used 
      illicit opioids and witnessed or experienced an opioid overdose. Approximately
      two thirds of opioid overdose decedents tested positive for fentanyl on
      postmortem toxicology. Evidence for rapid progression of fentanyl overdose was
      common among both fatal and nonfatal overdoses. A majority of interview
      respondents reported successfully using multiple doses of naloxone, the antidote 
      to opioid overdose, to reverse suspected fentanyl overdoses. Expanding and
      enhancing existing opioid overdose education and prevention programs to include
      fentanyl-specific messaging and practices could help public health authorities
      mitigate adverse effects associated with overdoses, especially in communities
      affected by IMF.
FAU - Somerville, Nicholas J
AU  - Somerville NJ
FAU - O'Donnell, Julie
AU  - O'Donnell J
FAU - Gladden, R Matthew
AU  - Gladden RM
FAU - Zibbell, Jon E
AU  - Zibbell JE
FAU - Green, Traci C
AU  - Green TC
FAU - Younkin, Morgan
AU  - Younkin M
FAU - Ruiz, Sarah
AU  - Ruiz S
FAU - Babakhanlou-Chase, Hermik
AU  - Babakhanlou-Chase H
FAU - Chan, Miranda
AU  - Chan M
FAU - Callis, Barry P
AU  - Callis BP
FAU - Kuramoto-Crawford, Janet
AU  - Kuramoto-Crawford J
FAU - Nields, Henry M
AU  - Nields HM
FAU - Walley, Alexander Y
AU  - Walley AY
LA  - eng
PT  - Journal Article
DEP - 20170414
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Street Drugs)
RN  - 36B82AMQ7N (Naloxone)
RN  - UF599785JZ (Fentanyl)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Distribution
MH  - Analgesics, Opioid/poisoning
MH  - Drug Overdose/*epidemiology/ethnology/mortality/prevention & control
MH  - Ethnic Groups/statistics & numerical data
MH  - European Continental Ancestry Group/statistics & numerical data
MH  - Female
MH  - Fentanyl/*poisoning
MH  - Humans
MH  - Male
MH  - Massachusetts/epidemiology
MH  - Middle Aged
MH  - Naloxone/therapeutic use
MH  - Risk Factors
MH  - Sex Distribution
MH  - Street Drugs/legislation & jurisprudence/poisoning
MH  - Young Adult
EDAT- 2017/04/14 06:00
MHDA- 2017/04/22 06:00
CRDT- 2017/04/14 06:00
AID - 10.15585/mmwr.mm6614a2 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2017 Apr 14;66(14):382-386. doi:
      10.15585/mmwr.mm6614a2.

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