Acetyl Fentanyl, a Novel Fentanyl Analog, Causes 14 Overdose Deaths in Rhode Island, March–May 2013

Journal of Medical Toxicology

Volumn 11, Issue 2, 2015, Pages 208-217

  Lozier, Matthew J ^a,b   Boyd, Molly ^c   Stanley, Christina ^d   Ogilvie, Laurie ^d   King, Ewa ^d   Martin, Colleen ^b   Lewis, Lauren ^b  

^a CENTERS FOR DISEASE CONTROL AND PREVENTION   (United States)

^b NATIONAL CENTER FOR ENVIRONMENTAL HEALTH   (United States)

^c AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY   (United States)

^d RHODE ISLAND DEPARTMENT OF HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYL FENTANYL; ALCOHOL; BENZODIAZEPINE; COCAINE; DIAMORPHINE; FENTANYL DERIVATIVE; ILLICIT DRUG; MORPHINE; UNCLASSIFIED DRUG; FENTANYL; N-(1-PHENETHYLPIPERIDIN-4-YL)-N-PHENYLACETAMIDE; NARCOTIC ANALGESIC AGENT;

ADULT; ARTICLE; DEATH; DRUG INTOXICATION; DRUG OVERDOSE; DRUG SELF ADMINISTRATION; ENZYME LINKED IMMUNOSORBENT ASSAY; HUMAN; LAW ENFORCEMENT; MIDDLE AGED; TOXICOLOGY; AGED; ANALOGS AND DERIVATIVES; FACTUAL DATABASE; FEMALE; MALE; MASS FRAGMENTOGRAPHY; NEEDLE; RHODE ISLAND; RISK FACTOR; SOCIOECONOMICS; YOUNG ADULT;

ADULT; AGED; ANALGESICS, OPIOID; DATABASES, FACTUAL; DRUG OVERDOSE; ENZYME-LINKED IMMUNOSORBENT ASSAY; FEMALE; FENTANYL; GAS CHROMATOGRAPHY-MASS SPECTROMETRY; HUMANS; MALE; MIDDLE AGED; NEEDLES; RHODE ISLAND; RISK FACTORS; SOCIOECONOMIC FACTORS; YOUNG ADULT;

EID: 84931568859     PISSN: 15569039     EISSN: 19376995     Source Type: Journal    
DOI: 10.1007/s13181-015-0477-9     Document Type: Article

References (44)

1. Centers for Disease Control and Prevention NCHS. Underlying cause of death 1999–2011 on CDC WONDER online database, released 2014. Data are from the Multiple Cause of Death Files, 1999–2011, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. 2011.
2. Levi J, Segal L, Fuchs Miller A. Prescription drug abuse: strategies to stop the epidemic 2013; 2013:64.
3. Jones CM, Mack KA, Paulozzi LJ. Pharmaceutical overdose deaths, United States, 2010. J Am Med Assoc. 2013;309(7):657–9. doi:10.1001/jama.2013.272.
4. SAMHSA. Results from the 2012 National Survey on Drug Use and Health: summary of national findings. Rockville, MD: Substance Abuse and Mental Health Services Administration 2013 Contract No.: HHS Publication No. (SMA) 13-4795.
5. Centers for Disease Control and Prevention. Rates of drug poisoning deaths involving heroin,* by selected age and racial/ethnic groups—United States, 2002 and 2011. MMWR Morb Mortal Wkly Rep. 2014;63(27):595.
6. Rhode Island Department of Health. Fatal drug overdoses. http://www.health.ri.gov/data/death/drugoverdoses/2013.
7. Ayres WA, Starsiak MJ, Sokolay P. The bogus drug: three methyl & alpha methyl fentanyl sold as “China White”. J Psychoactive Drugs. 1981;13(1):91–3.
8. Higashikawa Y, Suzuki S. Studies on 1-(2-phenethyl)-4-(N-propionylanilino)piperidine (fentanyl) and its related compounds. VI. Structure-analgesic activity relationship for fentanyl, methyl-substituted fentanyls and other analogues. Forensic Toxicol. 2008;26(1):1–5. doi:10.1007/s11419-007-0039-1.
9. Baum RM. New variety of street drugs poses growing problem. Chem Eng News. 1985;63(36):7–16. doi:10.1021/cen-v063n036.p007.
10. Stogner JM. The potential threat of acetyl fentanyl: legal issues, contaminated heroin, and acetyl fentanyl “disguised” as other opioids. Ann Emerg Med. 2014;64(6):637–9. doi:10.1016/j.annemergmed.2014.07.017.
11. Kram TC, Cooper DA, Allen AC. Behind the identification of China White. Anal Chem. 1981;53(12):1379A–86.
12. Hibbs J, Perper J, Winek CL. An outbreak of designer drug-related deaths in Pennsylvania. J Am Med Assoc. 1991;265(8):1011–3.
13. Martin M, Hecker J, Clark R, Frye J, Jehle D, Lucid EJ, et al. China White epidemic: an eastern United States emergency department experience. Ann Emerg Med. 1991;20(2):158–64.
14. Nieves E. Toxic heroin has killed 12, officials say. The New York Times. 1991 February 4, 1991.
15. Centers for Disease Control and Prevention. Nonpharmaceutical fentanyl-related deaths—multiple states, April 2005–March 2007. MMWR Morb Mortal Wkly Rep. 2008;57(29):793–6.
16. Foerster EH, Mason MF. Preliminary studies on the use of n-butyl chloride as an extractant in a drug screening procedure. J Forensic Sci. 1974;19(1):155–62.
17. Rhode Island Department of Health. Agencies licensed to provide substance abuse treatment services. 2014. http://www.bhddh.ri.gov/serviceproviders/BH_ProviderSubAbuseList.pdf?7. Accessed 8 Aug 2014.
18. Patton AL, Seely KA, Pulla S, Rusch NJ, Moran CL, Fantegrossi WE, et al. Quantitative measurement of acetyl fentanyl and acetyl norfentanyl in human urine by LC-MS/MS. Anal Chem. 2014;86(3):1760–6. doi:10.1021/ac4036197.
19. Pennsylvania Department of Drug and Alcohol Programs. Department of Drug and Alcohol Programs warns about acetyl fentanyl. 2013.
20. Robin N. New street drug kills 5 in Jefferson Parish. 2013.
21. McDonald T. NC health officials warn of new street drug that killed 3 this year. News Observer 2014.
22. Manchikanti L, Helm 2nd S, Fellows B, Janata JW, Pampati V, Grider JS, et al. Opioid epidemic in the United States. Pain Phys. 2012;15(3 Suppl):ES9–38.
23. Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics in the United States, 1999–2006. NCHS data brief. 2009. 22:1–8.
24. Centers for Disease Control and Prevention. Vital signs: overdoses of prescription opioid pain relievers—United States, 1999–2008. MMWR Morb Mortal Wkly Rep. 2011;60(43):1487–92.
25. Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers—United States, 2002–2004 and 2008–2010. Drug Alcohol Depend. 2013;132(1–2):95–100. doi:10.1016/j.drugalcdep.2013.01.007.
26. Owens D. Deadly heroin-fentanyl mix on streets prompts police warnings. The Courant 2014.
27. Press A. Md. has 37 deaths from heroin, fentanyl overdoses. 2014.
28. Conlon LFK. Cancer painkiller mixed with heroin blamed for 22 Pennsylvania deaths. 2014.
29. Freyer FJ. RI overdose deaths rise to 69 for 2014; illicit drugs and fentanyl key factors. Providence J. 2014.
30. Soine WH. Clandestine drug synthesis. Med Res Rev. 1986;6(1):41–74.
31. Centers for Disease Control and Prevention. Acetyl fentanyl overdose fatalities—Rhode Island, March–May 2013. MMWR Morb Mortal Wkly Rep. 2013;62(34):703–4.
32. Fernando D. Fentanyl-laced heroin. J Am Med Assoc. 1991;265(22):2962.
33. Preble ECJ. Taking care of business: the heroin users life on the street. Int J Addict. 1969;4:1–24.
34. Rhode Island Department of Health. HEALTH Investigating New Synthetic Drug. 2013. http://www.health.ri.gov/news/.
35. Rhode Island Department of Health. HEALTH identifies new synthetic drug as acetyl fentanyl. online 2013.
36. Seal KH, Thawley R, Gee L, Bamberger J, Kral AH, Ciccarone D, et al. Naloxone distribution and cardiopulmonary resuscitation training for injection drug users to prevent heroin overdose death: a pilot intervention study. J Urban Health Bull N Y Acad Med. 2005;82(2):303–11. doi:10.1093/jurban/jti053.
37. Walley AY, Xuan Z, Hackman HH, Quinn E, Doe-Simkins M, Sorensen-Alawad A, et al. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. BMJ. 2013;346:f174. doi:10.1136/bmj.f174.
38. Green TC, Heimer R, Grau LE. Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States. Addiction. 2008;103(6):979–89. doi:10.1111/j.1360-0443.2008.02182.x.
39. Yokell MA, Green TC, Bowman S, McKenzie M, Rich JD. Opioid overdose prevention and naloxone distribution in Rhode Island. Med Health Rhode Island. 2011;94(8):240–2.
40. Davis C. Legal interventions to reduce overdose mortality: naloxone access and overdose good samaritan laws: The Network for Public Health Law2014 December 2014.
41. Niedowski E. Rhode Island takes emergency steps on overdoses. 2014.
42. Wood P. Arundel police officers to carry drug to counteract heroin overdose. The Baltimore Sun 2014.
43. Tobin KE, Davey MA, Latkin CA. Calling emergency medical services during drug overdose: an examination of individual, social and setting correlates. Addiction. 2005;100(3):397–404. doi:10.1111/j.1360-0443.2005.00975.x.
44. Tracy M, Piper TM, Ompad D, Bucciarelli A, Coffin PO, Vlahov D, et al. Circumstances of witnessed drug overdose in New York City: implications for intervention. Drug Alcohol Depend. 2005;79(2):181–90. doi:10.1016/j.drugalcdep.2005.01.010.