Citation

Marshall BDL, Krieger MS, Yedinak JL, Ogera P, Banerjee P, Alexander-Scott NE, Rich JD, Green TC. Int. J. Drug Policy 2017; 46: 130-135.

Affiliation

Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-2, Providence, RI 02912, United States; Department of Emergency Medicine, Boston University School of Medicine, 771 Albany Street, Room 1208, Boston, MA 02118, United States; Department of Emergency Medicine, The Warren Alpert School of Medicine of Brown University, Rhode Island Hospital, 55 Claverick Street, Providence, RI 02903, United States.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.drugpo.2017.05.029

PMID

28601512

Abstract

BACKGROUND: We conducted an epidemiological investigation of fentanyl and non-fentanyl overdose deaths in Rhode Island to inform overdose prevention efforts.

METHODS: All drug overdose deaths occurring in Rhode Island between January 1, 2014 and September 30, 2016 were included. Overdose circumstances and decedent characteristics were ascertained from medical examiner files. Toxicological reports provided quantification of fentanyl and metabolites. ArcGIS was used to map exact overdose locations. We compared fentanyl-associated with non-fentanyl overdose deaths using chi-square tests and Wilcoxon rank sum tests. To identify overdose clusters, we used the Getis-Ord Gi* statistic.

RESULTS: A total of 778 overdose deaths were observed during the study period. In total, 358 (46.0%) were attributable to acute fentanyl intoxication, increasing from 84 (35.0%) in 2014 to 138 (55.6%) during the first nine months of 2016 (Mantel-Haenszel test for trend P<0.001). Compared to non-fentanyl overdoses, fentanyl overdose decedents were younger, more likely to have multiple drugs contribute to the death, and have evidence of injection drug use. The geospatial distribution of fentanyl and non-fentanyl involved deaths were similar.

CONCLUSIONS: Findings suggest widespread penetration of fentanyl in the drug supply, impacting a diverse group of users. An immediate scale-up of harm reduction and overdose prevention interventions is needed.

Copyright © 2017 Elsevier B.V. All rights reserved.

Language: en

Keywords

Drug use; Fentanyl; Geospatial analysis; Mortality; Overdose; Substance use