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Fentanyl contaminated "M30" pill overdoses in pediatric patients
Patrick Y Joynt1, George Sam Wang1
1Section of Emergency Medicine and Medical Toxicology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO, USA.
Background:
Fentanyl is a high potency opioid that has become an increasingly large proportion of the illicit drug supply. Fentanyl overdoses and deaths, including in pediatric patients, has concomitantly increased.
Purpose:
To describe two cases of pediatric fentanyl overdoses via "M30" pills illicitly sold as oxycodone.
Basic Procedures:
Two cases of pediatric opioid toxicity reportedly from oxycodone are presented in which mass spectrometry was used to confirm fentanyl and not oxycodone exposure.
Main Findings:
Both pediatric patients required naloxone and admission to the intensive care unit following exposure. Both had urine drug screens that did not show the presence of opioids but mass spectrometry testing confirmed fentanyl exposure.
Conclusions:
Providers should be aware of these illicit tablets, know not to assume they are pharmaceutical, and consider the risk they pose to pediatric patients through exploratory ingestion or misuse. Further inquiry, including social investigation, should be considered for pediatric patients presenting with reported oxycodone ingestion, especially blue "M30" pills.
Insights
Pediatric fentanyl overdoses are rising due to illicit "M30" pills disguised as oxycodone. Even with negative initial drug screens, mass spectrometry confirmed fentanyl exposure in two critical cases.
Area of Science:
- Toxicology
- Pediatric Emergency Medicine
- Forensic Chemistry
Background:
- Fentanyl, a potent synthetic opioid, constitutes a growing share of the illicit drug market.
- There has been a concurrent rise in fentanyl-related overdoses and fatalities, including in pediatric populations.