TY  - JOUR
PY  - 2017//
TI  - Heroin and fentanyl overdoses in Kentucky: epidemiology and surveillance
JO  - International journal on drug policy
A1  - Slavova, Svetla
A1  - Costich, Julia F.
A1  - Bunn, Terry L.
A1  - Luu, Huong
A1  - Singleton, Michael D.
A1  - Hargrove, Sarah L.
A1  - Triplett, Jeremy S.
A1  - Quesinberry, Dana
A1  - Ralston, William
A1  - Ingram, Van
SP  - 120
EP  - 129
VL  - 46
IS  - 
N2  - BACKGROUND: The study aims to describe recent changes in Kentucky's drug overdose trends related to increased heroin and fentanyl involvement, and to discuss future directions for improved drug overdose surveillance. <br><br>METHODS: The study used multiple data sources (death certificates, postmortem toxicology results, emergency department [ED] records, law enforcement drug submissions, and prescription drug monitoring records) to describe temporal, geographic, and demographic changes in drug overdoses in Kentucky. <br><br>RESULTS: Fentanyl- and heroin-related overdose death rates increased across all age groups from years 2011 to 2015 with the highest rates consistently among 25-34-year-olds. The majority of the heroin and fentanyl overdose decedents had histories of substantial exposures to legally acquired prescription opioids. Law enforcement drug submission data were strongly correlated with drug overdose ED and mortality data. The 2016 crude rate of heroin-related overdose ED visits was 104/100,000, a 68% increase from 2015 (62/100,000). More fentanyl-related overdose deaths were reported between October, 2015, and September, 2016, than ED visits, in striking contrast with the observed ratio of >10 to 1 heroin-related overdose ED visits to deaths. Many fatal fentanyl overdoses were associated with heroin adulterated with fentanyl; <40% of the heroin overdose ED discharge records listed procedure codes for drug screening. <br><br>CONCLUSIONS: The lack of routine ED drug testing likely resulted in underreporting of non-fatal overdoses involving fentanyl and other synthetic drugs. In order to inform coordinated public health and safety responses, drug overdose surveillance must move from a reactive to a proactive mode, utilizing the infrastructure for electronic health records.<br><br>Copyright © 2017 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0955-3959
UR  - http://dx.doi.org/10.1016/j.drugpo.2017.05.051
ID  - ref1
ER  -