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Carfentanil Outbreak - Florida, 2016-2017.

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    Illicitly manufactured fentanyl analogs like carfentanil are driving overdose deaths. A Florida outbreak centered in Sarasota showed a sharp increase and subsequent decline in carfentanil deaths, highlighting surveillance needs.

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    Area of Science:

    • Public Health
    • Toxicology
    • Epidemiology

    Background:

    • Illicitly manufactured fentanyl and its analogs have significantly increased overdose deaths in the U.S.
    • Carfentanil, an analog 100 times more potent than fentanyl, has no approved therapeutic use in humans and is associated with fatal overdoses.
    • A carfentanil outbreak emerged in Florida during 2016-2017, with the Sarasota area identified as the epicenter.

    Purpose of the Study:

    • To describe the toxicology, sociodemographics, and geographic distribution of carfentanil-involved fatal overdoses in the Sarasota area compared to the rest of Florida.
    • To analyze the temporal trends of a carfentanil outbreak in the Sarasota area.
    • To inform public health and safety organizations about the threat of rapid overdose outbreaks.

    Main Methods:

    • Retrospective analysis of carfentanil-involved fatal overdose data from January 2016 to December 2017.
    • Comparison of data from the Sarasota Medical Examiner jurisdiction with the rest of Florida.
    • Examination of toxicology profiles, sociodemographic information, and geographic distributions.

    Main Results:

    • The Sarasota area accounted for 19.0% of Florida's 1,181 carfentanil deaths during 2016-2017.
    • The Sarasota area experienced a peak in carfentanil deaths preceding the larger Florida outbreak.
    • A significant decline in reported carfentanil deaths was observed in late 2017, marking the apparent end of the outbreak in the area.

    Conclusions:

    • The Sarasota area carfentanil outbreak demonstrated the potential for rapid, intense fatal overdose events.
    • Accelerated reporting, reliable data sharing, and proactive surveillance are crucial for targeted prevention and response.
    • Effective public health and safety strategies are needed to address the evolving threat of potent synthetic opioids.