548 results match your criteria overdose fatalities


Changes in methadone program practices and fatal methadone overdose rates in Connecticut during COVID-19.

J Subst Abuse Treat 2021 Apr 29;131:108449. Epub 2021 Apr 29.

Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06510-8034, United States of America.

Background: Due to the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) has relaxed restrictions on methadone treatment in the United States. There is concern that the relaxation may increase fatal overdose rates. This study examines opioid treatment program (OTP) changes to methadone treatment during COVID-19 and changes in fatal methadone-involved overdose rates in Connecticut. Read More

View Article and Full-Text PDF

The role of domestic violence in fatal mass shootings in the United States, 2014-2019.

Inj Epidemiol 2021 May 31;8(1):38. Epub 2021 May 31.

Department of Health Policy and Management, Johns Hopkins Center for Gun Violence Prevention and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Background: Fatal mass shootings, defined as four or more people killed by gunfire, excluding the perpetrator, account for a small percentage of firearm homicide fatalities. Research has not extensively focused on the role of domestic violence (DV) in mass shootings in the United States. This study explores the role of DV in mass shootings in the United States. Read More

View Article and Full-Text PDF

Improvements on a chemically contiguous hapten for a vaccine to address fentanyl-contaminated heroin.

Bioorg Med Chem 2021 May 19;41:116225. Epub 2021 May 19.

Departments of Chemistry and Immunology, The Skaggs Institute for Chemical Biology, Worm Institute for Research and Medicine (WIRM), The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, United States. Electronic address:

Unintentional overdose deaths related to opioids and psychostimulants have increased in prevalence due to the adulteration of these drugs with fentanyl. Synergistic effects between illicit compounds and fentanyl cause aggravated respiratory depression, leading to inadvertent fatalities. Traditional small-molecule therapies implemented in the expanding opioid epidemic present numerous problems since they interact with the same opioid receptors in the brain as the abused drugs. Read More

View Article and Full-Text PDF

Pediatric drug overdose mortality: contextual and policy effects for children under 12 years.

Pediatr Res 2021 May 21. Epub 2021 May 21.

Department of Sociology, The Ohio State University, Columbus, OH, USA.

Background: We determine trends in fatal pediatric drug overdose from 1999 to 2018 and describe the influence of contextual factors and policies on such overdoses.

Methods: Combining restricted CDC mortality files with data from other sources, we conducted between-county multilevel models to examine associations of demographic and socioeconomic characteristics with pediatric overdose mortality and a fixed-effects analysis to identify how changes in contexts and policies over time shaped county-level fatal pediatric overdoses per 100,000 children under 12 years.

Results: Pediatric overdose deaths rose from 0. Read More

View Article and Full-Text PDF

Cannabinoid CB Receptor Activation Attenuates Fentanyl-Induced Respiratory Depression.

Cannabis Cannabinoid Res 2020 Oct 21. Epub 2020 Oct 21.

Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA.

Overdose fatalities associated with the opioid epidemic are predictably attributable to drug-induced respiratory depression. In terms of illicit opioid abuse, fentanyl is the synthetic opioid responsible for the largest number of overdose deaths. There is, therefore, an urgent need to identify safe and effective therapeutics that can attenuate fentanyl-induced respiratory depression. Read More

View Article and Full-Text PDF
October 2020

Injectable opioid agonist treatment: An evolutionary concept analysis.

Res Nurs Health 2021 May 16. Epub 2021 May 16.

Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.

Canada is currently in the midst of an overdose crisis. With new and innovative approaches desperately needed, injectable opioid agonist treatment (iOAT) should be considered as an integral treatment option to prevent even more fatalities. These programs provide injectable diacetylmorphine or hydromorphone to clients with severe opioid use disorders. Read More

View Article and Full-Text PDF

Fentanyl, Heroin, and Cocaine Overdose Fatalities are Shifting to the Black Community: An Analysis of the State of Connecticut.

J Racial Ethn Health Disparities 2021 May 11. Epub 2021 May 11.

Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA.

Background: Historically, Blacks and Hispanics have had lower opioid-involved overdose death rates in Connecticut (CT). We examined if a shift has taken place where rates of Black fatal overdoses have now surpassed Whites in the state.

Methods: Drug overdose fatality rates were calculated by number of deaths per year per 100,000 population from 2012 to 2019 in Connecticut. Read More

View Article and Full-Text PDF

Drug fatalities and treatment fatalism: Complicating the ageing cohort theory.

Authors:
Fay Dennis

Sociol Health Illn 2021 May 6. Epub 2021 May 6.

Goldsmiths, University of London, London, UK.

Deaths related to drug 'misuse' remain at an all-time high in the United Kingdom (UK). Older heroin consumers are particularly at risk, with the highest rates of deaths among people aged 40-49 and the steepest rises in the over-fifty age bracket. Accordingly, a popular theory for the UK's increase in drug-related deaths, made by the government, and propelled in the media, is that there is an ageing cohort of heroin users with age-related health complications predisposing them to an overdose. Read More

View Article and Full-Text PDF

Pediatric opioid fatalities: What can we learn for prevention?

J Forensic Sci 2021 Apr 23. Epub 2021 Apr 23.

North Carolina Office of Chief Medical Examiner, Raleigh, NC, USA.

The aim of this study was to highlight 19 cases investigated by the North Carolina Office of the Chief Medical Examiner over the last 12 years involving accidental or undetermined manner of death opioid ingestions leading to fatalities in young children. These pediatric ingestions have closely mirrored the opioid epidemic in adults transitioning from prescription medications to illicit drugs including fentanyl and fentanyl analogues. Unlike a typical adult ingestion for purposes of self-harm or pleasure, poisonings in toddlers and infants are usually the result of curiosity, exploration, a decreased sense of danger, or imitation of adult or older sibling behavior. Read More

View Article and Full-Text PDF

The Pandemic Stay-at-Home Order and Opioid-Involved Overdose Fatalities.

JAMA 2021 Apr 23. Epub 2021 Apr 23.

Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

View Article and Full-Text PDF

Trends in substances involved in polysubstance overdose fatalities in Maryland, USA 2003-2019.

Drug Alcohol Depend 2021 Jun 12;223:108700. Epub 2021 Apr 12.

Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA.

Background: The substances driving the overdose epidemic in the United States have changed over time. Since 2013, fentanyl-analogues have become the primary opioids driving the epidemic. Recently, polysubstance related deaths have come to the forefront of the epidemic. Read More

View Article and Full-Text PDF

Legal Authority for Emergency Medical Services to Increase Access to Buprenorphine Treatment for Opioid Use Disorder.

Ann Emerg Med 2021 Mar 26. Epub 2021 Mar 26.

Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI.

Treatment with buprenorphine significantly reduces both all-cause and overdose mortality among individuals with opioid use disorder. Offering buprenorphine treatment to individuals who experience a nonfatal opioid overdose represents an opportunity to reduce opioid overdose fatalities. Although some emergency departments (EDs) initiate buprenorphine treatment, many individuals who experience an overdose either refuse transport to the ED or are transported to an ED that does not offer buprenorphine. Read More

View Article and Full-Text PDF

Implementation of office-based buprenorphine treatment for opioid use disorder.

Authors:
Emily Carroll

J Am Assoc Nurse Pract 2021 Mar 19. Epub 2021 Mar 19.

Director of Clinical Care, HealthFinders Collaborative; Nursing Simulation Coordinator, Saint Olaf College Department of Nursing, Northfield, Minnesota.

Background: Buprenorphine-based medication-assisted treatment (B-MAT) is a powerful, concrete intervention that can be provided by nurse practitioners (NPs) to reduce opioid-related overdoses in patients with opioid use disorder (OUD). However, multiple barriers exist to provide and access this therapy.

Local Problem: A rural Midwestern county struggled with increasing OUD and scant access to B-MAT. Read More

View Article and Full-Text PDF

"I felt like I had a scarlet letter": Recurring experiences of structural stigma surrounding opioid tapers among patients with chronic, non-cancer pain.

Drug Alcohol Depend 2021 May 18;222:108664. Epub 2021 Mar 18.

Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, rm 442e, Boston, MA, 02118, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA. Electronic address:

Background: Efforts to address opioid-involved overdose fatalities have led to widespread implementation of various initiatives to taper (i.e., reduce or discontinue) opioid prescriptions despite a limited understanding of patients' experience. Read More

View Article and Full-Text PDF

COVID-19: A new barrier to treatment for opioid use disorder in the emergency department.

J Am Coll Emerg Physicians Open 2021 Apr 17;2(2):e12403. Epub 2021 Mar 17.

Division of Emergency Medicine, University of Vermont Larner College of Medicine Burlington Vermont USA.

Objective: Start Treatment and Recover (STAR) is an emergency department (ED) program that expands access to medication for opioid use disorder by identifying patients with opioid use disorder and offering ED-initiated buprenorphine/naloxone and rapid access to outpatient treatment. We sought to determine the impacts of the coronavirus disease 2019 pandemic on STAR and the patients with opioid use disorder it serves.

Methods: We conducted a retrospective review of records comparing 2 periods: pre-pandemic (February 1, 2019-February 29, 2020) and pandemic (March 1, 2020-May 31, 2020). Read More

View Article and Full-Text PDF

2,4-Dinitrophenol overdose - Everything old is new again.

J Forensic Leg Med 2021 Apr 3;79:102148. Epub 2021 Mar 3.

Queensland Health Forensic and Scientific Services, Queensland, Australia; Princess Alexandra Hospital, Queensland, Australia.

A complete case example of a fatal 2,4-dinitrophenol (DNP) overdose involving a 23-year-old male is described. Included are details of not only the patient's presentation symptoms and treatment, but also the subsequent findings of the coronial investigation process including the autopsy, post-mortem computed tomography (PMCT) scanning and toxicological analysis and results. The patient presented with elevated temperature, heart rate and blood pressure. Read More

View Article and Full-Text PDF

Primary Care and Mental Health Prescribers, Key Clinical Leaders, and Clinical Pharmacist Specialists' Perspectives on Opioids and Benzodiazepines.

Pain Med 2021 Mar 1. Epub 2021 Mar 1.

Health Services Research & Development (HSR&D) Seattle Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, Washington, USA.

Objective: Due to increased risks of overdose fatalities and injuries associated with coprescription of opioids and benzodiazepines, healthcare systems have prioritized deprescribing this combination. Although prior work has examined providers' perspectives on deprescribing each medication separately, perspectives on deprescribing patients with combined use is unclear. We examined providers' perspectives on coprescribed opioids and benzodiazepines and identified barriers and facilitators to deprescribing. Read More

View Article and Full-Text PDF

Street-drug lethality index: A novel methodology for predicting unintentional drug overdose fatalities in population research.

Drug Alcohol Depend 2021 04 16;221:108637. Epub 2021 Feb 16.

National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA.

Background: Emerging evidence suggests the composition of local illicit drug markets varies over time and the availability and relative lethality of illicit drugs may contribute to temporal trends in overdose mortality. Law enforcement drug seizures represent a unique opportunity to sample the makeup of local drug markets. Prior research has associated shifts in the types of drugs seized and trends in unintentional drug overdose mortality. Read More

View Article and Full-Text PDF

The psychoactive drug of abuse mephedrone differentially disrupts blood-brain barrier properties.

J Neuroinflammation 2021 Mar 1;18(1):63. Epub 2021 Mar 1.

Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, 3500 N Broad St, Philadelphia, PA, 19140, USA.

Background: Synthetic cathinones are a category of psychostimulants belonging to the growing number of designer drugs also known as "Novel Psychoactive Substances" (NPS). In recent years, NPS have gained popularity in the recreational drug market due to their amphetamine-like stimulant effects, low cost, ease of availability, and lack of detection by conventional toxicology screening. All these factors have led to an increase in NPS substance abuse among the young adults, followed by spike of overdose-related fatalities and adverse effects, severe neurotoxicity, and cerebral vascular complications. Read More

View Article and Full-Text PDF

Carfentanil - from an animal anesthetic to a deadly illicit drug.

Forensic Sci Int 2021 Mar 30;320:110715. Epub 2021 Jan 30.

Institute of Forensic Research, Krakow, Poland.

The use of novel synthetic opioids as recreational drugs has become a public health concern as they are implicated in numerous fatal intoxications across the world. Synthetic opioids have played a major role in the United States opioid crisis and may contribute to a similar opioid epidemic in Europe. The most prominent group of designer opioids consists of fentanyl and its analogues. Read More

View Article and Full-Text PDF

Between Emergency Department Visits: The Role of Harm Reduction Programs in Mitigating the Harms Associated With Injection Drug Use.

Ann Emerg Med 2021 05 10;77(5):479-492. Epub 2021 Feb 10.

Department of Emergency Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX.

Injection drug use is a major public health problem in the United States. Cocaine, heroin, and methamphetamine are the most commonly injected illicit drugs, whereas opioids are responsible for the majority of overdose fatalities. Although recent emergency department (ED) efforts have focused on expanding capacity for buprenorphine induction for opioid use disorder treatment, the injection of illicit drugs carries specific health risks that require acknowledgment and management, particularly for patients who decline substance use treatment. Read More

View Article and Full-Text PDF

Illicit synthetic opioid consumption in Asia and the Pacific: Assessing the risks of a potential outbreak.

Drug Alcohol Depend 2021 03 2;220:108500. Epub 2021 Jan 2.

RAND Corporation, 1200 South Hayes Street, Arlington, 22202 VA, United States. Electronic address:

Background: Illegally manufactured potent synthetic opioids (IMPSO) like fentanyl have contributed to rises in overdose deaths in parts of North America and Europe. While many of these substances are produced in Asia, there is little evidence they have entered markets there. We consider the susceptibility to IMPSO's encroachment in markets in the Asia-Pacific region. Read More

View Article and Full-Text PDF

Characteristics of post-overdose public health-public safety outreach in Massachusetts.

Drug Alcohol Depend 2021 02 31;219:108499. Epub 2020 Dec 31.

Grayken Center for Addiction and Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston Medical Center/Boston University School of Medicine, 801 Massachusetts Avenue, Boston, MA 02118, USA.

Background: As a response to mounting overdose fatalities, cross-agency outreach efforts have emerged to reduce future risk among overdose survivors. We aimed to characterize such programs in Massachusetts, with focus on team composition, approach, services provided, and funding.

Methods: We conducted a two-phase cross-sectional survey of public health and safety providers in Massachusetts. Read More

View Article and Full-Text PDF
February 2021

Methamphetamine exposures reported to United States poison control centers, 2000-2019.

Clin Toxicol (Phila) 2021 Jan 6:1-14. Epub 2021 Jan 6.

Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.

Objective: To investigate characteristics and trends of methamphetamine exposures reported to United States (US) poison control centers.

Methods: Data from the National Poison Data System were analyzed.

Results: From January 1, 2000 through December 31, 2019, US poison control centers managed 54,199 cases involving methamphetamine as the first-ranked substance. Read More

View Article and Full-Text PDF
January 2021

The fentanyl phase of the opioid epidemic in Cuyahoga County, Ohio, United States.

J Forensic Sci 2021 May 4;66(3):926-933. Epub 2021 Jan 4.

Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.

Since late 2014, fentanyl has become the major driver of opioid mortality in the United States. However, a descriptive analysis of fentanyl victims is limited. We studied the 2016 fentanyl and heroin overdose deaths and compared them to previously studied heroin-associated fatalities from 2012 over a wide range of demographic and investigative variables, including overdose scene findings, toxicology results, and prescription drug history. Read More

View Article and Full-Text PDF

Abuse-Deterrent Opioid Formulations and the Opioid Crisis: A Pharmacist's Perspective.

Ther Drug Monit 2021 02;43(1):35-41

Division of Epidemiology, Department of Internal Medicine, Program for Addiction Research, Clinical Care, Knowledge, and Advocacy, School of Medicine, University of Utah; and.

Background: For over 20 years, the United States has suffered the detrimental effects of an opioid epidemic. Extended-release opioid products are particularly prone to abuse due to the high amount of opioid present. By bypassing the controlled-release mechanisms and nonoral administration, individuals experience intense and dangerous "highs. Read More

View Article and Full-Text PDF
February 2021

Post-mortem Redistribution of Alprazolam in Rats.

Prague Med Rep 2020 ;121(4):244-253

Institute of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.

The post-mortem toxicological findings may be misinterpreted, if the drug undergoes substantial post-mortem redistribution. As alprazolam is one of the most frequently evaluated drug for legal/forensic reasons in drug-related fatalities, we studied possible changes in alprazolam distribution after death in a rat model. Rats were sacrificed 30 minutes after alprazolam administration. Read More

View Article and Full-Text PDF
January 2021

U-47700 and Its Analogs: Non-Fentanyl Synthetic Opioids Impacting the Recreational Drug Market.

Brain Sci 2020 Nov 23;10(11). Epub 2020 Nov 23.

Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, 19090 PA, USA.

The recreational use of opioid drugs is a global threat to public health and safety. In particular, an epidemic of opioid overdose fatalities is being driven by illicitly manufactured fentanyl, while novel synthetic opioids (NSOs) are appearing on recreational drug markets as standalone products, adulterants in heroin, or ingredients in counterfeit drug preparations. -3,4-dichloro--[2-(dimethylamino)cyclohexyl]--methylbenzamide (U-47700) is a prime example of a non-fentanyl NSO that is associated with numerous intoxications and fatalities. Read More

View Article and Full-Text PDF
November 2020