The fentanyl phase of the opioid epidemic in Cuyahoga County, Ohio, United States. Issue 3 (4th January 2021)

• Record Type: Journal Article
• Authors: Deo, Vaishali S.; Gilson, Thomas P.; Kaspar, Claire; Singer, Mendel E.
• Is Part Of: Journal of forensic sciences. Volume 66:Issue 3(2021)
• Page Start: 926
• Page End: 933
• Publication Date: 2021-01-04
• Subjects: autopsy -- fentanyl -- forensic pathology -- forensic toxicology -- heroin -- mortality -- Ohio -- opioid -- overdose -- prescription data -- United States; Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; 363.2505
• DOI: 10.1111/1556-4029.14665
• Languages: English
• ISSNs: 0022-1198

Abstract

Abstract: Since late 2014, fentanyl has become the major driver of opioid mortality in the United States. However, a descriptive analysis of fentanyl victims is limited. We studied the 2016 fentanyl and heroin overdose deaths and compared them to previously studied heroin‐associated fatalities from 2012 over a wide range of demographic and investigative variables, including overdose scene findings, toxicology results, and prescription drug history. We observed a significant increase in fentanyl‐related deaths ( n = 421, 2016) versus heroin deaths ( n = 160, 2012) but the baseline demographics between both cohorts remained similar. Victims were predominantly of ages 35–64 years (60%–64%), White (83%–85%), and male (73%–76%). 2016 fentanyl decedents were more likely to have naloxone administered upon overdose, and the majority still had a positive prescription history for a controlled substance. Toxicology data showed a decrease in mean morphine and 6‐monoacetylmorphine concentrations when cointoxication with fentanyl occurred. Our study emphasizes the medical examiner's role as a public health data source and bridge between different stakeholders combating the opioid epidemic.