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Author Spotlight: An Efficient Methodology to Confidently Differentiate and Characterize Fentanyl Analogs
Published on: November 8, 2024
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Overdose Deaths Related to Fentanyl and Its Analogs - Ohio, January-February 2017
MMWR. Morbidity and Mortality Weekly Report
|September 1, 2017
Summary
Illicitly manufactured fentanyl (IMF) is driving overdose deaths in Ohio, with many fatalities involving multiple fentanyl analogs. Standard toxicology testing needs to include IMFs to address this public health crisis.
Area of Science:
- Forensic Toxicology
- Public Health
- Organic Chemistry
Background:
- Ohio faces an unprecedented rise in drug overdose fatalities, largely driven by illicitly manufactured fentanyl (IMF).
- IMF, a synthetic opioid, presents unique detection challenges due to its variable potency and chemical composition.
- Overdose deaths in Ohio surged by 98% between 2010 and 2015, with Montgomery County experiencing a 40% increase in one year.
Purpose of the Study:
- To investigate the prevalence of IMF and its analogs in unintentional overdose fatalities in Ohio.
- To assess the role of IMF compared to pharmaceutical opioids and heroin in recent overdose deaths.
- To highlight the limitations of current toxicology testing in identifying IMF.
Main Methods:
- A collaborative study by Wright State University and the Montgomery County Coroner's Office analyzed 281 unintentional overdose fatalities across 24 Ohio counties.
- Toxicology testing focused on identifying fentanyl analogs, metabolites, and other drugs in biological specimens.
- Data from January-February 2017 were compared with previous years' data from Ohio and other states.
Main Results:
- Approximately 90% of decedents tested positive for fentanyl, with high prevalence of specific analogs: acryl fentanyl (48%) and furanyl fentanyl (31%).
- Carfentanil was detected in 8% of cases, and a majority of decedents tested positive for multiple types of fentanyl.
- Pharmaceutical opioids were found in 23% of cases, and heroin in 6%, indicating a declining presence compared to IMF.
Conclusions:
- Illicitly manufactured fentanyl analogs are increasingly prevalent in Ohio overdose fatalities, often in combination with other substances.
- The findings underscore the urgent need to incorporate IMF testing into standard toxicology panels.
- Enhanced forensic and medical toxicology protocols are crucial for public health surveillance and intervention strategies against the evolving opioid crisis.
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