MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The opioid overdose epidemic has killed over 300,000 Americans from 1999 to 2015—including 33,091 in 2015. Over this time, the epidemic has evolved from being primarily driven by prescription opioids to increasingly being driven by illicit opioids. The first wave of the epidemic began in 1999 with a steep increase in deaths involving prescription opioids, such as hydrocodone, oxycodone, and morphine. The second wave began in 2010 with rapid increases in overdose deaths involving heroin. The third wave of the epidemic began in 2013, with significant increases in overdose deaths involving synthetic opioids—particularly those involving illicitly-manufactured fentanyl (IMF), which are commonly laced into heroin products. Most recently, the IMF market continues to evolve, with an ever-widening array of illicitly manufactured fentanyl analogs being distributed.
This report indicates that over half of people in 10 states who died of opioid overdoses tested positive for fentanyl during the second half of 2016. The report found that out of a total of 5,152 opioid overdose deaths, almost 3,000 tested positive for fentanyl, and over 700 tested positive for drugs that have similar chemical structures to fentanyl (fentanyl analogs) – including the extremely potent fentanyl analog, carfentanil, which is used to sedate large animals.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Fentanyl and fentanyl analogs are increasingly contributing to the devastating opioid crisis in America. Having current information on these complex illicit drugs can help us track the rapidly changing epidemic and tailor interventions to reduce overdose.
This is the first report on data from the State Unintentional Drug Overdose Reporting System (SUDORS), which tracks fatal opioid overdoses and is a component of CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) program. SUDORS makes it possible to use toxicology and death scene investigation data previously unavailable across states, to provide insights into specific substances and circumstances driving overdoses. This information can help uncover changes in the opioid epidemic and inform interventions.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Because of the large proportion of opioid overdose deaths testing positive for fentanyl and fentanyl analogs, opioid overdose surveillance must expand to track the rapidly changing illicit opioid market. Funding for enhanced and timely surveillance is one of CDC’s key investments to inform opioid overdose prevention efforts. CDC has:
- Released two Health Alert Network advisories on fentanyl and fentanyl analogs: https://emergency.cdc.gov/han/han00395.asp; https://emergency.cdc.gov/han/han00350.asp.
- Funded 32 states and Washington, D.C. through the Enhanced State Opioid Overdose Surveillance (ESOOS) program to produce more timely data on fatal and nonfatal opioid (prescription and illicit) overdoses, including circumstances of fatal overdoses such as the specific drugs involved and route of drug administration.
- Starting in fall 2017, CDC funded ESOOS states to expand forensic toxicology testing of opioid overdose deaths to detect fentanyl analogs and other illicitly manufactured synthetic opioid drugs.
- Collaborated with Drug Enforcement Administration (DEA) and High Intensity Drug Trafficking Areas (HIDTA) to share data; engage local communities; and undertake strategic, evidence-based responses designed to foster immediate reductions in overdose-related fatalities.
- Supported increased access to medication-assisted treatment and increased availability of naloxone in sufficient doses to reverse the effects of opioid overdose and reduce the number of overdoses resulting in death.
MedicalResearch.com: Is there anything else you would like to add?
Response: This report highlights the contribution of fentanyl and fentanyl analogs in opioid overdose deaths. Further analysis is needed to understand the contribution of other opioids to overdose deaths, including both prescription and illicit opioids, either alone or in combination.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
O’Donnell JK, Halpin J, Mattson CL, Goldberger BA, Gladden RM. Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 — 10 States, July–December 2016. MMWR Morb Mortal Wkly Rep 2017;66:1197–1202. DOI: http://dx.doi.org/10.15585/mmwr.mm6643e1
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.