Fentanyl-Related Deaths Has Increased. Every week, the Centers for Disease Control and Prevention (CDC) releases the Morbidity and Mortality Weekly Report (MMWR). In the November 3, 2017, edition, the authors discuss the opioid epidemic.
Since 2013, the number of deaths caused by opioid overdoses has increased dramatically. According to the CDC, many experts have noted that, once illegally manufactured fentanyl crept into the heroin market, the number of overdoses rose. Many fake prescription pills are in drug markets. These fake pills contain fentanyl and fentanyl analogs. Fentanyl analogs, which have a chemical structure that is similar to fentanyl, may also be responsible for the increase in opioid deaths. Carfentanil, which is a fentanyl analog, is reportedly 10,000 times more powerful than morphine. Carfentanil is used to sedate large animals, making it an extremely dangerous substance for humans to take. It is difficult to detect the presence of fentanyl analogs because a special type of toxicology testing is needed.
Fentanyl analogs are mostly illegally manufactured, primarily because no legitimate medical use for these substances has been supported.
Fentanyl and fentanyl analogs are extremely potent and act quickly once they are administered. These drugs are most commonly injected by users, which increases the dangers associated with them since injection results in rapid absorption. However, roughly 20 percent of opioid-related deaths resulted from other routes of administration, such as ingestion, smoking, or snorting. Loss of consciousness and death can happen within a short period of time. In some cases, naloxone is used to stop an opioid overdose.
In 2016, the number of Opioid drug overdose deaths surpassed 60,000. From 2013 to 2016, the number of overdose deaths that involved synthetic opioids increased by five times-from 3,105 to 20,000.
Ten states have participated in the CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) program. In more than half of the opioid-related deaths in seven of these states, the deceased tested positive for fentanyl. Additionally, 57 percent of those who died from fentanyl-related causes also had other illegal drugs in their systems, such as heroin. In over 10 percent of opioid overdose deaths in four of the states in the program, fentanyl analogs were detected. Furanyl fentanyl, acetyl fentanyl, and carfentanil were most commonly detected.
The surveillance program has provided additional insight into opioid overdoses. For example, testing for fentanyl and its analogs offers new information on the ever-changing illicit opioid market. With this information, medical professionals, members of law enforcement, and others will be able to implement interventions to reduce the number of opioid-related deaths.
Across the ten states, 2,903 individuals suffered fentanyl-positive deaths. This group comprised 56.3 percent of the total number of opioid deaths. In the 2,903 fentanyl-positive fatalities, coroners or medical examiners concluded that fentanyl was a cause of death in almost all of the deaths-97.1 percent cited the drug as a cause of death.
In Maine, Massachusetts, Missouri, Rhode Island, and New Hampshire, the highest amounts of opioid overdose deaths were recorded. Between 60 and 90 percent of opioid overdose deaths were found in these states. Midwestern and Southern states followed, with 30 to 55 percent of fentanyl-related deaths occurring in West Virginia, Ohio, and Wisconsin. Oklahoma and New Mexico saw the lowest amounts of fentanyl-related deaths, at between 15 and 25 percent.
States that identified the presence of any fentanyl analogs in more than 10 percent of opioid-related deaths were located primarily in the Northeast, followed by the Midwest and the South.
The report shows that fentanyl analogs had been consumed in 14 percent of the overdose deaths. Carfentanil was the most popular fentanyl analog; it was identified in 7.6 percent of the overdoses.
Most individuals who overdosed on fentanyl and fentanyl analogs were white males between the ages of 25 and 44.
The most common illegal drugs identified in many of these deaths were cocaine and heroin.
What do these findings tell us?
Earlier reports found that mixing illegally manufactured fentanyl with heroin is responsible for many overdoses. Some users are unaware that illicitly manufactured fentanyl was present in the heroin. This situation seemed to occur frequently east of the Mississippi River. In six of the seven states located east of the Mississippi in this study, at least half of the decedents tested positive for fentanyl. In more than half of the Opioid overdose deaths that involved fentanyl and fentanyl analogs, methamphetamine, cocaine, or heroin were also detected. This finding supports the conclusion that fentanyl and its analogs are frequently used with, or either mixed with, cocaine or heroin. However, it is important to see that in close to half of the overdose deaths, other illegal opioids were not detected. Therefore, fentanyl and fentanyl analogs could be developing as unique drugs of choice for many users.
Since this data only comes from 10 states, there are, of course, limitations as to how this information may be used. Still, the data provides valuable information into a growing problem in the United States. By learning about the patterns associated with opioid-related deaths, professionals may be able to save at-risk individuals from succumbing to overdoses.
Opioid lawsuits are being filed by states and other jurisdictions against pharmaceutical companies
Many states have filed lawsuits against the pharmaceutical companies that manufacture fentanyl and other opioids, arguing that these companies concealed the addictive, harmful nature of these substances and pressured physicians to prescribe them. In some cases, the claimants allege that representatives from pharmaceutical companies even called insurance companies and pretended to be representatives from medical offices so that prescriptions for opioids would be approved.
Some of these Opioid claims have been settled for millions and millions of dollars. Other lawsuits are still pending, but also seek millions in damages.
The states that have filed these lawsuits are attempting to recoup the damages they have sustained due to the opioid epidemic. For example, many states have implemented expensive drug rehabilitation programs in an attempt to curb the effects of opioid addiction. Others have filed claims for a loss of productivity. It is estimated that in 2016, the opioid epidemic resulted in $504 billion in economic costs.
Most of these lawsuits proceed under products liability principles. Pharmaceutical companies have a duty to provide products that are safe for consumption. If they do not provide safe products, and especially if they conceal the dangerous nature of these products, they should be held accountable for the harm they cause.
Even though fentanyl can be legally prescribed, misuse of a prescription is a common problem. In fact, the Department of Health and Human Services estimates that in 2016, 11.5 million people misused prescription opioids. Around 2.1 million people misused prescription opioids for the very first time in 2016 as well. Tragically, 116 people died every day from opioid-related deaths.
Though the opioid crisis is a growing problem, continuing research will help reduce the number of deaths and injuries that occur due to drug overdoses.
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