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Carfentanil-Associated Mortality in Wayne County, Michigan, 2015-2017
Andrew King1, Daniel Foley1, Cynthia Arfken1
1Andrew King, Daniel Foley, and Cynthia Aaron are with Wayne State University School of Medicine, Department of Emergency Medicine, Detroit, MI. Andrew King and Cynthia Aaron are also with Michigan Regional Poison Control Center, Detroit, MI. Cynthia Arfken is with Wayne State University School of Medicine, Department of Psychiatry and Behavioral Neuroscience. Lokman Sung and Leigh Hlavaty are with Wayne County Medical Examiner Office, Detroit, MI.
Carfentanil detection correlated with a spike in opioid overdose deaths in Wayne County, Michigan. A ban on fentanyl analogs may have helped reduce these fatalities, suggesting source control is effective.
Area of Science:
- Forensic Toxicology
- Public Health Surveillance
- Epidemiology
Background:
- Opioid overdose deaths present a significant public health challenge.
- Identifying specific opioids contributing to mortality spikes is crucial for targeted interventions.
Purpose of the Study:
- To identify opioids linked to a surge in opioid-related mortality in Wayne County, Michigan.
- To analyze the temporal association between specific opioid detection and overdose deaths.
Main Methods:
- Retrospective review of 645 accidental nonmedically prescribed opioid overdose deaths from July 2015 to July 2017.
- Analysis of demographic data, locations of death, and comprehensive opioid toxicology results.
- Exclusion of hospital deaths to focus on community-based overdoses.
Main Results:
- Carfentanil was detected in 20% of all overdose deaths, rising to 27.2% during the 8-month mortality spike.
- Carfentanil was frequently found with other substances including morphine, 6-monoacetylmorphine, fentanyl, norfentanyl, tetrahydrocannabinol, and cocaine.
- The mortality spike temporally corresponded with increased carfentanil detection.
Conclusions:
- The surge in Wayne County opioid overdose deaths was associated with carfentanil detection.
- A decrease in carfentanil-detected mortality coincided with an announced ban on fentanyl analogs, indicating the effectiveness of source control measures.
