Heroin & Other Illicit Drugs
Starting in 2013, the production of illicitly manufactured fentanyl increased to unprecedented levels. Using drug products obtained by law enforcement testing positive for fentanyl (fentanyl submissions) as a proxy for the increase in fentanyl, data have shown a corresponding increase in fatal overdoses involving synthetic opioids other than methadone due to the greater lethality of fentanyl compared to heroin. However, the effect of this shift in drug supply on nonfatal overdoses has not been well described.
This session will include data on nonfatal overdoses in emergency departments (EDs), taken from the Centers for Disease Control and Prevention’s (CDC’s) Enhanced State Opioid Overdose Surveillance System (ESOOS). The Drug Enforcement Administration’s National Forensic Laboratory Information System performs testing of law enforcement drug products. Trends in fentanyl and heroin submissions and opioid- and heroin-involved overdoses treated in EDs from 2016–2017 will be examined to document changes in nonfatal overdoses that may be influenced by drug supply changes. National Vital Statistics System data on fatal overdoses will be used for comparison. Findings are expected to show increases in fentanyl submissions and decreases in heroin submissions from 2016–2017. In states with more fentanyl submissions, it is expected that opioid-involved overdoses treated in EDs will decrease because of an increase in fatal overdoses occurring prior to possible transport to an ED. The presenter will conclude that decreases in opioid-involved ED visits may appear encouraging, but may be attributable to the greater lethality of fentanyl compared to heroin. Public health and law enforcement need to continue to collaborate to facilitate faster identification and response to spikes in fentanyl overdoses.
This session is accredited for the following accreditation types: CME, CNE, CPE, APA, AAFP, AAHCPAD*, NAADAC*, ASWB*
*State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit.