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FRIDAY, Oct. 27, 2017 (HealthDay News) -- Extremely powerful synthetic opioids, such as fentanyl or carfentanil, were directly responsible for more than half of thousands of opioid overdose deaths across many states in 2016, a new report finds.
Most often, fentanyl and even more potent "fentanyl analog" drugs -- such as carfentanil -- were mixed into the heroin that addicts were using, often without their knowledge, say researchers at the U.S Centers for Disease Control and Prevention.
The new report, based on data from 10 states, comes a day after President Donald Trump declared the opioid addiction epidemic a national public health emergency, potentially freeing up more funds to battle what he called a "scourge."
The study, led by CDC researcher Julie O'Donnell, looked at toxicology reports from nearly 5,200 fatal opioid overdoses occurring between July and December of 2016 in 10 states: Maine, Massachusetts, Missouri, New Hampshire, New Mexico, Ohio, Oklahoma, Rhode Island, West Virginia and Wisconsin.
O'Donnell's team reported that "fentanyl was detected in at least half of opioid overdose deaths in seven of 10 states," and other illicit drugs, such as heroin, were also involved in 57 percent of these fatalities.
In about 47 percent of ODs involving fentanyl, drugs were injected, although fatal overdoses also occurred when drugs were snorted or ingested, the research showed.
Fentanyl-linked fatal ODs occurred most frequently in the Northeast, where between 60 percent and 90 percent of fatalities were tied to fentanyl. Victims were most likely to be white (81 percent), male (71 percent) and between the ages of 25 and 44 (about 58 percent).
Often, drug abusers may not know that dealers have "cut" heroin with fentanyl or its analogs, and so "fentanyl mixed with heroin, with or without users' knowledge, is driving many fentanyl overdoses," the report said.
Both fentanyl and its analogs, such as carfentanil or furanylfentanyl, are extremely potent. According to O'Donnell's team, fentanyl is up to 100 times more potent than morphine, while carfentanil is 10,000 times more potent. Especially after injection, unconsciousness, and then death, can come quickly.
Dr. Robert Glatter works in the ER at New York City's Lenox Hill Hospital. "As an emergency physician on the front lines, I am witness to the devastating effects of opiate overdose and addiction on a daily basis, and how it rips apart relationships and families," he said.
"Carfentanil is one of the most potent analogs which is currently of major concern," he added. "Minute amounts can be deadly." In fact, he said, carfentanil is so powerful that even Narcan (naloxone), the "rescue" drug often used to reverse an opioid overdose, can prove ineffective.
The new CDC report found evidence that carfentanil and its deadly kin are making inroads in the United States. In the new study, "fentanyl analogs were present in more than 10 percent of opioid overdose deaths in four states," O'Donnell's group noted.
Carfentanil hit Ohio particularly hard, with 350 fatal overdoses there linked to the drug's use, the study found.
"The stark reality is that this crisis has been playing out on a daily basis in our nation's emergency departments and ICUs over the past several decades, affecting tens of millions of families," Glatter said.
The executive order signed Thursday by Trump pledges more federal funding to fight opioid dependency. But that money first needs to be allocated by Congress. Should it arrive, the CDC team believes it should be earmarked for interventions that are known to work.
These include a wider availability to the OD-reversal drug Narcan, but especially "increased access to medication-assisted treatment" to help wean addicts off opioids, O'Donnell's team said.
Glatter agreed, saying "approaches focusing on medication-assisted treatment along with counseling have shown recent promise."
The new report was published Oct. 27 in the CDC's Morbidity and Mortality Weekly Report.
-- E.J. Mundell
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