Chelsea L Shover1, Titilola O Falasinnu, Rohan B Freedman, Keith Humphreys. 1. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA (CLS); Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (TOF); Brown University, Providence, RI (RBF); Veterans Affairs Palo Alto Health Care System, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA (KH).
Abstract
OBJECTIVES: Case reports of fatal overdoses involving the novel synthetic opioid isotonitazene have prompted the U.S. Drug Enforcement Administration to consider an emergency scheduling of the drug in June 2020. We aimed to epidemiologically characterize deaths involving isotonitazene. METHODS: We conducted a case control study using publicly available mortality records from January 1, 2020 to July 31, 2020 in Cook County, IL and Milwaukee County, WI. Cases (all deaths involving isotonitazene) and controls (all deaths involving other synthetic opioids) were compared on demographic characteristics, number of substances involved in fatal overdose, and co-involvement of other substances. RESULTS: We identified 40 fatal overdoses involving isotonitazene and 981 fatal overdoses involving other synthetic opioids. Isotonitazene deaths involved a significantly greater number of substances, and were significantly more likely to involve the designer benzodiazepine flualprazolam. DISCUSSION: Isotonitazene was involved in a substantial minority of synthetic opioid overdose deaths in the first 7 months of 2020. Future studies characterizing its prevalence in other markets are warranted. Emergence of highly potent novel synthetic opioids underscore the need for comprehensive health services for people with opioid use disorder.
OBJECTIVES: Case reports of fatal overdoses involving the novel synthetic opioid isotonitazene have prompted the U.S. Drug Enforcement Administration to consider an emergency scheduling of the drug in June 2020. We aimed to epidemiologically characterize deaths involving isotonitazene. METHODS: We conducted a case control study using publicly available mortality records from January 1, 2020 to July 31, 2020 in Cook County, IL and Milwaukee County, WI. Cases (all deaths involving isotonitazene) and controls (all deaths involving other synthetic opioids) were compared on demographic characteristics, number of substances involved in fatal overdose, and co-involvement of other substances. RESULTS: We identified 40 fatal overdoses involving isotonitazene and 981 fatal overdoses involving other synthetic opioids. Isotonitazene deaths involved a significantly greater number of substances, and were significantly more likely to involve the designer benzodiazepine flualprazolam. DISCUSSION: Isotonitazene was involved in a substantial minority of synthetic opioid overdose deaths in the first 7 months of 2020. Future studies characterizing its prevalence in other markets are warranted. Emergence of highly potent novel synthetic opioids underscore the need for comprehensive health services for people with opioid use disorder.
Authors: Peter Blanckaert; Annelies Cannaert; Katleen Van Uytfanghe; Fabian Hulpia; Eric Deconinck; Serge Van Calenbergh; Christophe Stove Journal: Drug Test Anal Date: 2020-01-08 Impact factor: 3.345
Authors: Chelsea L Shover; Titilola O Falasinnu; Candice L Dwyer; Nayelie Benitez Santos; Nicole J Cunningham; Rohan B Freedman; Noel A Vest; Keith Humphreys Journal: Drug Alcohol Depend Date: 2020-09-28 Impact factor: 4.492
Authors: Keith Humphreys; Chelsea L Shover; Christina M Andrews; Amy S B Bohnert; Margaret L Brandeau; Jonathan P Caulkins; Jonathan H Chen; Mariano-Florentino Cuéllar; Yasmin L Hurd; David N Juurlink; Howard K Koh; Erin E Krebs; Anna Lembke; Sean C Mackey; Lisa Larrimore Ouellette; Brian Suffoletto; Christine Timko Journal: Lancet Date: 2022-02-02 Impact factor: 202.731
Authors: Amanda L A Mohr; Barry K Logan; Melissa F Fogarty; Alex J Krotulski; Donna M Papsun; Sherri L Kacinko; Marilyn A Huestis; Jeri D Ropero-Miller Journal: J Anal Toxicol Date: 2022-07-14 Impact factor: 3.220