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Related Experiment Videos

Fatal Fentanyl: One Pill Can Kill.

Mark E Sutter1,2, Roy R Gerona3, M Thais Davis1,2

  • 1Division of Medical Toxicology, Department of Emergency Medicine, University of California, Davis, Sacramento, CA.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|June 21, 2016
PubMed
Summary

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A public health emergency: street-purchased hydrocodone/acetaminophen tablets were found to contain fentanyl, causing severe opioid toxicity. Patients required intensive treatment, including high-dose naloxone and prolonged monitoring due to recurrent symptoms.

Area of Science:

  • Toxicology
  • Public Health
  • Emergency Medicine

Background:

  • The national opioid epidemic presents a critical public health challenge.
  • Illicit drug markets pose risks through adulterated medications.

Observation:

  • An 8-day period in March 2016 saw 18 patients with exaggerated opioid toxicity.
  • Patients reported taking usual doses of hydrocodone/acetaminophen tablets with severe symptoms.

Findings:

  • All 18 patients tested positive for fentanyl, with high serum concentrations (mean 52.9 ng/mL).
  • Pills contained significant fentanyl (600-6,900 μg/pill) and were visually identical to legitimate medication.
  • Patients required aggressive treatment, including high-dose naloxone (26-39 hour infusions) and extended observation for recurrent toxicity.

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Implications:

  • This fentanyl adulteration outbreak strains healthcare resources, including emergency departments and intensive care units.
  • The findings highlight the urgent need for public health interventions, law enforcement strategies, and enhanced healthcare preparedness for novel synthetic opioid threats.