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Preventing Fentanyl-Related Overdose Deaths with Naloxone-A Medical Examiner Study
Gabriel D Alexander1, Pamela A Ferreira2, Stephanie A Dean2
1Gilman School, Baltimore, Maryland.
The American Journal of Forensic Medicine and Pathology
|February 13, 2025
Summary
Fentanyl overdose deaths in Maryland were reviewed. A small percentage of deaths were possibly preventable with naloxone, with most occurring in residences, not businesses.
Area of Science:
- Public Health
- Toxicology
- Emergency Medicine
Background:
- Fentanyl overdose deaths are a major public health crisis.
- Community naloxone administration is critical for saving lives.
- Legal liability for businesses regarding naloxone provision is under discussion.
Purpose of the Study:
- To review fentanyl-related overdose deaths in Maryland in 2022.
- To determine the proportion of deaths potentially preventable by naloxone.
- To assess the role of businesses in providing naloxone for overdose reversal.
Main Methods:
- Retrospective review of 2047 fentanyl-related overdose deaths in Maryland in 2022.
- Defined criteria for naloxone-preventable deaths, including witnessed arrests and proximity to last known alive.
- Analyzed circumstances and locations of overdose deaths to identify opportunities for naloxone intervention.
Main Results:
- 13.5% of overdose deaths were deemed possibly preventable with naloxone.
- 2.7% of deaths occurred in locations where businesses could have potentially provided naloxone.
- Most preventable overdose deaths were found by close contacts in residential settings.
Conclusions:
- Targeted naloxone education and distribution to people who use drugs and their close contacts is the most effective strategy.
- This study does not support mandating naloxone availability in all businesses.
- Focusing on community-based interventions offers the best approach to reducing fentanyl overdose fatalities.
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