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USA. Drug overdose epidemic has been growing exponentially for decades

Death rates from drug overdoses in the US have been on an exponential growth curve that began at least 15 years before the mid-1990s surge in opioid prescribing, suggesting that overdose death rates may continue along this same historical growth trajectory for years to come. These findings suggest that, to be successful, prevention efforts must extend beyond control of specific drugs to address deeper factors driving the epidemic. (University of Pittsburgh Schools of the Health Science in: Science Daily, 20.09.2018)

https://www.sciencedaily.com/releases/2018/09/180920161028.htm

Kanada. ‘The crisis is not abating’: Opioids killing more than 11 Canadians daily

More than 11 Canadians are dying every day on average because of opioids, according to new data from the federal government.

“The crisis is not abating,” Theresa Tam, Canada’s chief public health officer, said in an interview on Tuesday.

Canada is the world’s second highest per-capita consumer of opioids, after the United States, which has led to widespread misuse, dependence and addiction. (The Globe and Mail, Kanada, 18.09.2018)

https://www.theglobeandmail.com/canada/article-the-crisis-is-not-abating-opiod-overdose-kills-more-than-1/

International Overdose Awareness Day 2018: Facts&Stats

(International Overdose Awareness Day, Juli 2018)

https://www.overdoseday.com/resources/facts-stats/

USA. Fentanyl: The Opioid Epidemic That's Killing America | Opinion

The number of bodies piling up in Florida’s 4th District morgue was so large last year, the medical examiner’s office ran out of room. In Cook County Illinois, medical officials responded to 74 overdoses in 72 hours.

(..) According to preliminary estimates recently released from the Centers for Disease Control, drug overdoses killed more than 72,000 Americans last year, the highest number on record.

(...) While opioid overdoses are driving the increase in deaths, prescription drugs are no longer the primary cause. Instead “synthetic” opioids like fentanyl and its chemical siblings, so-called fentanyl “analogues,” are fueling the death spiral. It was fentanyl that filled the Florida morgue to capacity and fentanyl-laced heroin that overwhelmed Cook County’s first responders. (Newsweek, 12.09.2018)

https://www.newsweek.com/fentanyl-opioid-epidemic-thats-killing-america-opinion-1115758

Fentanyl-contaminated drugs and non-fatal overdose among people who inject drugs in Baltimore, MD.

Park JN, Weir BW, Allen ST, Chaulk P, Sherman SG.

Harm Reduct J. 2018 Jul 5;15(1):34. doi: 10.1186/s12954-018-0240-z.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034235/

Contributions of prescribed and non-prescribed opioids to opioid related deaths: population based cohort study in Ontario, Canada.

Gomes T, Khuu W, Martins D, Tadrous M, Mamdani MM, Paterson JM, Juurlink DN.

BMJ. 2018 Aug 29;362:k3207. doi: 10.1136/bmj.k3207.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6113771/

Niederlande. Dutch cut overdose deaths by dispensing pure heroin

AMSTERDAM, the Netherlands - On a quiet alley in east Amsterdam, a security guard stands watch outside a brick office building, which 75 men and women visit twice a day to smoke or shoot up government-funded heroin.

Public-health experts in the Netherlands say free distribution is one reason that drug-related deaths are far less common than in the United States. The program also has reduced crime and improved the quality of life for many users, according to Ellen van den Hoogen, who runs the clinic. (cleveland.com, USA, 15.07.2018)

https://www.cleveland.com/metro/index.ssf/2018/07/in_amsterdam_the_government_pr.html

The toxicology of heroin-related death: estimating survival times.

Ruan X, Chiravuri S, Kaye AD.

Addiction. 2016 Dec;111(12):2261. doi: 10.1111/add.13547. Epub 2016 Sep 15. No abstract available. Erratum in: Addiction. 2017 Feb;112(2):375.

https://deepblue.lib.umich.edu/bitstream/handle/2027.42/134443/add13547.pdf

USA: Anstieg tödlicher Alkoholschäden der Leber nach der Wirtschaftskrise von 2007

Ann Arbor/Michigan – In den USA ist es nach der Finanz- und Wirtschaftskrise von 2007 zu einem Anstieg von alkoholbedingten Todesfällen an Leberzirrhose und Leberkrebs gekommen. Betroffen waren nach einer Studie im British Medical Journal(BMJ2018; 362: k2817) vor allem jüngere Erwachsene. (aerzteblatt.de, 19.07.2018)

https://www.aerzteblatt.de/nachrichten/96592/USA-Anstieg-toedlicher-Alkoholschaeden-der-Leber-nach-der-Wirtschaftskrise-von-2007

USA - Office of National Drug Control Policy. Fentanyl Safety Recommendations for First Responders

The increased prevalence of fentanyl and other synthetic opioids in the illicit drug market means that first responders need to understand how to protect themselves from exposure in the field.  Law enforcement, fire, rescue, and emergency medical services (EMS) personnel must balance safety with mobility and efficiency when responding to scenes where the presence of fentanyl is suspected.

The Fentanyl Safety Recommendations for First Responders, and the companion training video Fentanyl: The Real Deal, provide unified, scientific, evidence-based recommendations to first responders so they can protect themselves when the presence of fentanyl is suspected during the course of their daily activities such as responding to overdose calls and conducting traffic stops, arrests, and searches. (Office of National Drug Control Policy, USA, August 2018)

https://www.whitehouse.gov/ondcp/key-issues/fentanyl/

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

Opioid, Amphetamine, and Cocaine-Induced Deaths in Australia: August 2018

Roxburgh, A., Dobbins, T., Degenhardt, L., and Peacock, A. (2018). 

Sydney, National Drug and Alcohol Research Centre, University of New South Wales.

https://ndarc.med.unsw.edu.au/resource/opioid-amphetamine-and-cocaine-induced-deaths-australia-august-2018

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

Kanada. Illicit Drug Overdose Deaths in BC - January 1, 2008 – July 31, 2018

British Columbia, Coroner Service, Posting Date August 22, 2018 

https://www2.gov.bc.ca/assets/gov/public-safet-and-emergency-services/death-investigation/statistical/illicit-drug.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

Australien. Majority of opioid overdose deaths relate to pharmaceutical opioids

The number of people dying as a result of opioid use has risen markedly, says a report by the National Drug and Alcohol Research Centre at UNSW Sydney. (University of New South Wales, Australien. 20.08.2018)

http://newsroom.unsw.edu.au/news/health/majority-opioid-overdose-deaths-relate-pharmaceutical-opioids

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/

Notes from the Field: Overdose Deaths with Carfentanil and Other Fentanyl Analogs Detected — 10 States, July 2016–June 2017.

O’Donnell J, Gladden RM, Mattson CL, Kariisa M. 

MMWR Morb Mortal Wkly Rep 2018;67:767–768. doi.org/10.15585/mmwr.mm6727a4.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6727a4.htm

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

UK. Deaths from fentanyl nearly double in a year as total drug fatalities reach record levels in England and Wales

Government faces calls for drugs law reform after official statistics show overall drugs deaths have hit record levels for the fourth year in a row and reveal a marked increase in fatalities from opioid with street name 'serial killer'. (The Independent, UK, 06.08.2018)

https://www.independent.co.uk/news/uk/home-news/drug-deaths-record-high-statistics-opioids-fentanyl-carfentanyl-cocaine-spice-ons-laws-reform-a8479431.html

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. Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017 

Fentanyl is a big culprit, but there are also encouraging signs from states that have prioritized public health campaigns and addiction treatment. (New York Times, 15.08.2018)

https://www.nytimes.com/2018/08/15/upshot/opioids-overdose-deaths-rising-fentanyl.html

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

UK. Fentanyl and cocaine drug deaths rise

The number of deaths in England and Wales due to the synthetic opioid fentanyl rose by 29% in 2017, Office for National Statistics data shows. (BBC, 06.08.20118)

https://www.bbc.co.uk/news/uk-45083167

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

International Overdose Awareness Day 2018 (31.08.2018) - Downloadable Resources

https://www.overdoseday.com/resources/downloadable-resources/

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

USA. Opiatüberdosierung: Wie Ärzte aus ihren Fehlern lernen können

Los Angeles – Eine Rückmeldung vom Rechtsmediziner, dass einer ihrer Patienten an einer Opiat-Überdosierung gestorben ist, hat US-Ärzte einer randomisierten Studie in Science (2018; 361: 588–590) zufolge zu einer – etwas – zurückhaltenderen Verordnung der Opiate veranlasst. (aerzteblatt.de, 10.08.2018)

https://www.aerzteblatt.de/nachrichten/97106/Opiatueberdosierung-Wie-Aerzte-aus-ihren-Fehlern-lernen-koennen

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

Methadone maintenance treatment and mortality in people with criminal convictions: A population-based retrospective cohort study from Canada.

Russolillo A, Moniruzzaman A, Somers JM (2018) 

PLoS Med 15(7): e1002625. doi.org/10.1371/journal.pmed.1002625

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002625

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

Reducing the opioid overdose death toll in North America.

Hall WD, Farrell M (2018) 

PLoS Med 15(7): e1002626. doi.org/10.1371/journal.pmed.1002626

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002626