TY - JOUR PY - 2017// TI - Epidemiology of fentanyl-involved drug overdose deaths: a geospatial retrospective study in Rhode Island, USA JO - International journal on drug policy A1 - Marshall, Brandon D. L. A1 - Krieger, Maxwell S. A1 - Yedinak, Jesse L. A1 - Ogera, Patricia A1 - Banerjee, Priya A1 - Alexander-Scott, Nicole E. A1 - Rich, Josiah D. A1 - Green, Traci C. SP - 130 EP - 135 VL - 46 IS - N2 - BACKGROUND: We conducted an epidemiological investigation of fentanyl and non-fentanyl overdose deaths in Rhode Island to inform overdose prevention efforts.

METHODS: All drug overdose deaths occurring in Rhode Island between January 1, 2014 and September 30, 2016 were included. Overdose circumstances and decedent characteristics were ascertained from medical examiner files. Toxicological reports provided quantification of fentanyl and metabolites. ArcGIS was used to map exact overdose locations. We compared fentanyl-associated with non-fentanyl overdose deaths using chi-square tests and Wilcoxon rank sum tests. To identify overdose clusters, we used the Getis-Ord Gi* statistic.

RESULTS: A total of 778 overdose deaths were observed during the study period. In total, 358 (46.0%) were attributable to acute fentanyl intoxication, increasing from 84 (35.0%) in 2014 to 138 (55.6%) during the first nine months of 2016 (Mantel-Haenszel test for trend P<0.001). Compared to non-fentanyl overdoses, fentanyl overdose decedents were younger, more likely to have multiple drugs contribute to the death, and have evidence of injection drug use. The geospatial distribution of fentanyl and non-fentanyl involved deaths were similar.

CONCLUSIONS: Findings suggest widespread penetration of fentanyl in the drug supply, impacting a diverse group of users. An immediate scale-up of harm reduction and overdose prevention interventions is needed.

Copyright © 2017 Elsevier B.V. All rights reserved.

Language: en

LA - en SN - 0955-3959 UR - http://dx.doi.org/10.1016/j.drugpo.2017.05.029 ID - ref1 ER -