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Rapid Response to Fentanyl Overdose is Critical

Fentanyl overdoses share many characteristics with heroin overdoses – with some important differences, according to an addiction specialist at Boston Medical Center’s Grayken Center for Addiction.

“Fentanyl is faster acting and more potent than heroin, so overdoses evolve in seconds to minutes, instead of minutes to hours, as we see with heroin overdoses,” says Alexander Walley, M.D., Director of the Boston University Addiction Medicine Fellowship Program and the Inpatient Addiction Medicine Consult Service at Boston Medical Center. “The window during which a bystander can respond shrinks substantially with fentanyl,” said Dr. Walley, who spoke about fentanyl overdoses at the recent annual meeting of the College on Problems of Drug Dependence. He noted that people may not know they are using fentanyl. In addition to being mixed into heroin, fentanyl can be sold as cocaine or counterfeit prescription opioids. (drugfree.org, USA, 12.07.2018)

https://drugfree.org/learn/drug-and-alcohol-news/featured-news-rapid-response-fentanyl-overdose-critical

Characteristics of Fentanyl Overdose — Massachusetts, 2014–2016 

Morbidity and Mortality Weekly Report (MMWR),Weekly/ April 14, 2017 / 66(14);382–386 

https://www.cdc.gov/mmwr/volumes/66/wr/mm6614a2.htm

Schweiz. Mortalität in substitutionsgestützten Behandlungen im Kanton Zürich, 1992-2016

CARLOS NORDT & MARCUS HERDENER 

(RESULTATE AUS DER BEGLEITEVALUATION DER METHADONBEHANDLUNGEN IM KANTON ZÜRICH NR. 22; Mai 2018)

http://www.dppp.uzh.ch/dam/jcr:4cbfe9c0-2b99-4caf-ac03-30473bf13cf5/MethiInfo22.pdf

Characteristics of Fentanyl Overdose — Massachusetts, 2014–2016 

Morbidity and Mortality Weekly Report (MMWR),Weekly/ April 14, 2017 / 66(14);382–386 

https://www.cdc.gov/mmwr/volumes/66/wr/mm6614a2.htm

NIDA. Method to identify undetected drug suicides wins top NIDA Addiction Science Award

A project that identified and tested a bioinformatics program that can help identify underreported suicides linked to drug overdoses was awarded the first-place distinction at the 2018 Intel International Science and Engineering Fair (ISEF)—the world’s largest science competition for high school students. The awards are coordinated by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, and Friends of NIDA, a coalition that supports NIDA’s mission. The Intel ISEF Addiction Science Awards were presented at a ceremony Thursday night at the David L. Lawrence Convention Center in Pittsburgh. (NIDA – National Institute on Drug Abuse, USA, 18.05.2018)

https://www.drugabuse.gov/news-events/news-releases/2018/05/method-to-identify-undetected-drug-suicides-wins-top-nida-addiction-science-award

Activity-Based Detection and Bioanalytical Confirmation of a Fatal Carfentanil Intoxication.

Cannaert A, Ambach L, Blanckaert P, Stove CP.

Front Pharmacol. 2018 May 15;9:486. doi: 10.3389/fphar.2018.00486.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962730/

Deutschland. Die meisten Drogentoten sterben an Überdosierung von Opioiden

Berlin – Die Zahl der an illegalen Drogen verstorbenen Menschen ist 2017 im Vergleich zum Vorjahr leicht rückläufig: sie sank von 1.333 auf 1.272. In den Jahren 2012 bis 2016 waren die Zahlen noch angestiegen. (aerzteblatt.de, 15.05.2018)

https://www.aerzteblatt.de/nachrichten/95204/Die-meisten-Drogentoten-sterben-an-Ueberdosierung-von-Opioiden

Study analyzes opioid overdose risk during and after pregnancy among Massachusetts women 

Overdose risk drops during pregnancy but rises after delivery, when fewer resources are available to mothers with substance use disorder. (Massachusetts General Hospital, 11.07.2018)

https://www.eurekalert.org/pub_releases/2018-07/mgh-sao071118.php

Deutschland. Analyse drogeninduzierter Todesfälle

Ludwig Kraus & Nicki-Nils Seitz 

Institut für Therapieforschung München, Mai 2018

https://www.drogenbeauftragte.de/fileadmin/dateien-dba/Drogenbeauftragte/4_Presse/1_Pressemitteilungen/2018/2018_II.Q/18-05-15_DT_Pressegespraech_finfin.pdf

Fatal case of poisoning with a new cathinone derivative: α-propylaminopentiophenone (N-PP).

Majchrzak M, Celiński R, Kowalska T, Sajewicz M.

Forensic Toxicol. 2018;36(2):525-533. doi: 10.1007/s11419-018-0417-x.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002430/

USA. Opioid Prevalence in Suicide Victims Skyrockets

NEW YORK — The prevalence of opioids in the blood of suicide victims has more than doubled in the past decade, new research shows.

A study conducted by investigators at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, showed that the number of people who died by suicide who had opioids in their system increased from 8.8% in 2006 to 17% in 2017. (Medscape Medical News, 08.05.2018)

https://www.medscape.com/viewarticle/896334

Schottland. Why are drug-related deaths among women increasing in Scotland?

A scoping of possible explanations Emily Tweed, with Rebekah Miller and Catriona Matheson

Scottish Government, 2018

http://fileserver.idpc.net/library/WomeninScotlandreport.pdf

DeutschlandRauchen tötet - vor allem einen Teil unserer Gesellschaft

In Deutschland sterben arme Bürger mit schlechter Bildung viel früher als Wohlhabende und Gebildete. Eine neue Studie zeigt: Rauchen trägt erheblich dazu bei. Die Forscher machen die Politik für das Gefälle verantwortlich. (spiegel online, 06.04.2018)

http://www.spiegel.de/gesundheit/diagnose/rauchen-toetet-in-deutschland-vor-allem-die-sozial-schwachen-a-1201327.html

USA. Methadone and buprenorphine reduce risk of death after opioid overdose - NIH research confirms effective treatments for opioid use disorder are underutilized. 

A National Institutes of Health-funded study found that treatment of opioid use disorder with either methadone or buprenorphine following a nonfatal opioid overdose is associated with significant reductions in opioid related mortality. The research, published today  in the Annals of Internal Medicine, was co-funded by the National Institute on Drug Abuse (NIDA) and the National Center for Advancing Translational Sciences, both parts of NIH. (NIH-NIDA, 19.06.2018)

https://www.nih.gov/news-events/news-releases/methadone-buprenorphine-reduce-risk-death-after-opioid-overdose

Physician Prescribing of Opioids to Patients at Increased Risk of Overdose From Benzodiazepine Use in the United States. 

Ladapo JA, Larochelle MR, Chen A, et al. 

JAMA Psychiatry.Published online April 12, 2018. doi:10.1001/jamapsychiatry.2018.0544

Abstract

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2678181

Opioid Overdose Prevention Toolkit

This toolkit offers strategies to health care providers, communities, and local governments for developing practices and policies to help prevent opioid-related overdoses and deaths. Access reports for community members, prescribers, patients and families, and those recovering from opioid overdose. (SAMHSA, 11.06.2018)

https://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/All-New-Products/SMA18-4742

Guidance: Fentanyl: preparing for a future threat - Incident planning for potent opioids arriving into the illicit drug market. 

Guidance for local areas on planning to deal with fentanyl or another potent opioid

Ref: PHE publications gateway number 2017860, PHE – Public Health England, 08.05.2018

https://www.gov.uk/government/publications/fentanyl-preparing-for-a-future-threat/guidance-for-local-areas-on-planning-to-deal-with-fentanyl-or-another-potent-opioid

The Effect of Incomplete Death Certificates on Estimates of Unintentional Opioid-Related Overdose Deaths in the United States, 1999-2015 

Jeanine M. Buchanich, PhD, MEd, Lauren C. Balmert, PhD, Karl E. Williams, MD, MPH, and Donald S. Burke, MD 

Public Health Reports, First Published June 27, 2018, doi.org/10.1177/0033354918774330

http://journals.sagepub.com/doi/10.1177/0033354918774330

Mapping Drug Overdose Demographic and Socioeconomic Characteristics in the Community.

Rooney BL, Voter MT, Eberlein CM, Schossow AJ, Fischer CL.

WMJ. 2018 Mar;117(1):18-23.

http://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/117/1/18.pdf

Causes of Death After Nonfatal Opioid Overdose. 

Olfson M, Crystal S, Wall M, Wang S, Liu S, Blanco C. 

JAMA Psychiatry.Published online June 20, 2018. doi:10.1001/jamapsychiatry.2018.1471

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2685326

Accurate identification of opioid overdose deaths using coronial data.

Roxburgh A, Pilgrim JL, Hall WD, Burns L, Degenhardt L.

Forensic Sci Int. 2018 Mar 26;287:40-46. doi: 10.1016/j.forsciint.2018.03.032.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/29627712

Ageing opioid users’ increased risk of methadone-specific death in the UK

Pierce, Matthias et al.

International Journal of Drug Policy , Volume 55 , 121 - 127

https://www.ijdp.org/article/S0955-3959(18)30040-9/fulltext

Changes in Synthetic Opioid Involvement in Drug Overdose Deaths in the United States, 2010-2016. 

Jones CM, Einstein EB, Compton WM. 

JAMA.2018;319(17):1819–1821. doi:10.1001/jama.2018.2844

https://jamanetwork.com/journals/jama/article-abstract/2679931

USA. Notes from the Field: Acute Poisonings from a Synthetic Cannabinoid Sold as Cannabidiol — Utah, 2017–2018. 

Horth RZ, Crouch B, Horowitz BZ, et al. 

MMWR Morb Mortal Wkly Rep 2018;67:587–588. doi.org/10.15585/mmwr.mm6720a5

https://www.cdc.gov/mmwr/volumes/67/wr/mm6720a5.htm

Suicide: A Silent Contributor to Opioid-Overdose Deaths

Maria A. Oquendo, M.D., Ph.D., and Nora D. Volkow, M.D.

N Engl J Med 2018; 378:1567-1569, DOI: 10.1056/NEJMp1801417

https://www.nejm.org/doi/full/10.1056/NEJMp1801417

The Burden of Opioid-Related Mortality in the United States

Tara Gomes, PhD; Mina Tadrous, PharmD, PhD; Muhammad M. Mamdani, PharmD, MA, MPH; et alJ. Michael Paterson, MSc; David N. Juurlink, MD, PhD

JAMA Network Open. 2018;1(2):e180217. doi:10.1001/jamanetworkopen.2018.0217

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2682878