Fentanyl linked to 50% of overdose deaths in 10 states

[drusso]

Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 ...

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[lobelsteve]

Yay. The government's and media's attack on Rx drugs is working.

 

[Aether2000]

Interesting data. Of those with fentanyl overdose, only 39% also had heroin on board. I would have thought it would be 100%. This suggests in the majority of cases involving fentanyl OD, the public is overdosing on either pure prescription fentanyl or illicit fentanyl from other sources. Perhaps physicians can help by stopping prescribing fentanyl to anyone except those with active cancer..... There are many alternatives.

 

[DrCommonSense]

Interesting data. Of those with fentanyl overdose, only 39% also had heroin on board. I would have thought it would be 100%. This suggests in the majority of cases involving fentanyl OD, the public is overdosing on either pure prescription fentanyl or illicit fentanyl from other sources. Perhaps physicians can help by stopping prescribing fentanyl to anyone except those with active cancer..... There are many alternatives.

its illegal fentanyl not prescription.

Prescription would be listed separately under prescription drugs

 

[DrCommonSense]

Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 ...

That was expected. People with problems related to opioids will not magically just become normal after they can't get prescription narcotics (which is often mostly stolen from other people with legit prescriptions).

The opioid crisis will just worsen with fentanyl/heroin overdoses while we restrict Tramadol from older patients with zero addiction risk or history.

 

[Aether2000]

Coroners cannot tell the difference between prescription fentanyl and illicit source fentanyl.

 

[DrCommonSense]

Coroners cannot tell the difference between prescription fentanyl and illicit source fentanyl.

Then how do they differentiate between prescription drugs vs non prescription drug OD rates when making the diagnosis? The numbers are reported as prescription drugs somehow right? Maybe they have access to their prescription drug history and the meds they have been prescribed then compare it to the metabolites on the tox report? Nah couldn't be.

CDC: Painkillers No Longer Driving Opioid Epidemic

Deaths from opioid overdoses have jumped — and one age group is being affected at stark rates

Of note: "
The study was carried out by the University of Florida and the Ohio Department of Public Health, in collaboration with the CDC, and was written by Alexis B. Peterson, PhD, Epidemic Intelligence Service and the National Center for Injury Prevention and Control, CDC, and colleagues.


Investigators found that from 2013 to 2014, fentanyl submissions increased 494% in Florida and 1043% in Ohio. This, they note, was "concurrent" with a 115% increase in fentanyl deaths in Florida and a 526% increase in Ohio. They also saw a "sharp increase" in fentanyl submissions and fentanyl deaths in Florida from December 2014 to February 2015.

In contrast, fentanyl prescription rates (per 1000 population) for the full year (2013-2014) increased only 5% in Florida and declined 7% in Ohio."

or

"
More specifically:

• 
  
  
  • In 2010, 29% of fatal overdoses involved so-called "natural" and "semisynthetic" opioids (morphine, oxycodone), while only about 12% involved methadone, a "synthetic" opioid. Five years later, the percentage of fatal overdoses involving these drugs fell to 24% and 6%, respectively.
  • In contrast, fatal overdoses involving heroin skyrocketed from 8% in 2010 to 25% in 2015 — essentially tripling."

Prescriptions are trending downwards while deaths are way up. Hmm but I guess its those legal scripts doing it right?

 

[lobelsteve]

its illegal fentanyl not prescription.

Prescription would be listed separately under prescription drugs

Your post is disingenuous and the respect you command dwindles when nonsense like this is presented. You know better.

 

[DrCommonSense]

Your post is disingenuous and the respect you command dwindles when nonsense like this is presented. You know better.

I have already linked further points in establishment of my argument and updated that post to confirm it further.

Fentanyl scripts were down 7% in Ohio but Fentanyl overdose rates jumped >100% as per CDC/Ohio Department of Health study in 2015. This has gotten even more dramatic over the last few years.

Also, they are able to link tox reports to listed prescription drugs to make the diagnosis.

Clearly, its illegal Fentanyl that is driving the trend. Furthermore, heroin is often laced with Fentanyl making the diagnosis even easier.


Hell, even the CDC just stated this in the last few months that the increasing overdose deaths are driven by illegal Fent/Heroin.

Even the LINK provided in the ORIGINAL post confirms how they determine this:

"This report describes opioid overdose deaths during July–December 2016 that tested positive for fentanyl, fentanyl analogs, or U-47700, an illicit synthetic opioid, in 10 states participating in CDC’s Enhanced State Opioid Overdose Surveillance (ESOOS) program.* Fentanyl analogs are similar in chemical structure to fentanyl but not routinely detected because specialized toxicology testing is required. Fentanyl was detected in at least half of opioid overdose deaths in seven of 10 states, and 57% of fentanyl-involved deaths also tested positive for other illicit drugs, such as heroin. Fentanyl analogs were present in >10% of opioid overdose deaths in four states, with carfentanil, furanylfentanyl, and acetylfentanyl identified most frequently. Expanded surveillance for opioid overdoses, including testing for fentanyl and fentanyl analogs, assists in tracking the rapidly changing illicit opioid market and informing innovative interventions designed to reduce opioid overdose deaths."

Many of the analogs are only produced by illegal sources.

 

[emd123]

The vast majority of the fentanyl being abused in the US is being made by illegal or unregulated labs in China, and illegally imported and sold on the black market to the US, per the DEA. All the regulating of doctors, prescribing, PMP checks and dose limits in the world aren't going to do a damn thing about this.

https://www.uscc.gov/sites/default/... Deadly Export to the United States020117.pdf

DEA: Made-in-China Lethal Opioid Fueling U.S. Drug Epidemic

Where does fentanyl come from? China is primary source in U.S., and much is ending up in Ohio

Chinese suppliers flood US and Canada with deadly fentanyl

"The DEA says the China-U.S. supply is further fueling the country’s drug epidemic.
'This stuff is unbelievably potent. It is so powerful that even a tiny amount can kill you,' says DEA spokesman Rusty Payne. 'China is by far the most significant manufacturer of illicit designer synthetic drugs. There is so much manufacturing of new drugs, [it’s] amazing what is coming out of China. Hundreds of [versions], including synthetic fentanyl and fentanyl-based compounds.'"

 

[Ducttape]

but whats driving people to go towards illegal fentanyl and heroin in the first place?

its another diversionary type argument by drcommon... point excitedly that most of the deaths are due to illicit/illegal fentanyl and use that as the basis that opioid prescriptions are not the problem, while ignoring the fact that what drives people to turn to illegal drugs in the first place is exposure to legal fentanyl (and hydrocodone and oxycodone) via prescriptions.

 

[DOctorJay]

https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

• Four in five new heroin users started out misusing prescription painkillers.

• 94% of respondents in a 2014 survey of people in treatment for opioid addiction said theychose to use heroin because prescription opioids were “far more expensive and harder to obtain."



Sent from my iPhone using SDN mobile

 

[Aether2000]

I agree as of the past few years, illicit fentanyl is driving the overdoses from synthetics, but physicians also prescribe fentanyl. The issue is coroners in general DO NOT differentiate illicit from prescribed because of the multiple sources of fentanyl: powder from China, prescription fentanyl that has been diverted (transbuccal, transdermal), fentanyl IV that is diverted from hospitals/surgery center/doctor's offices, etc. Those suffering overdoses may have multiple sources used simultaneously. But even if not, my concern is that if a physician has prescribed fentanyl to a person at any point in the past year for chronic non-malignant pain (esp. if it is Fentora, Subsys, or other transbuccal) and they die of a subsequent China source fentanyl OD, then the physician will be culpable because the coroner cannot tell the difference. Physicians who prescribe fentanyl for any purpose will unfortunately be caught up in this massive escalation of deaths just as they were from other prescription drug overdoses, and will be charged with murder and manslaughter.

 

[Orin]

Prescriptions drugs were easy to obtain and abuse. The drug itself though isn't the issue, anymore than the guns are the issue with gun deaths. Our society sucks for way too many people and this stuff helps folks not care/deal. Opium has been used/abused since BC times, but we've made it stronger, easier to get, subsidized delivery via insurance, and are now forcing drug dependent folks/addicts into a less safe and deadlier alternative.

It sucks and I'm getting frustrated of telling folks I don't have anything that can safely help their pain the same as their Oxy 15s.

We've got to find a middle ground for the millions of drug dependent folks we've created and some effective treatments, or there's just going to be a bolus of deaths over the next 5 years from folks turning to the streets followed by hopefully a slow decline as we stop creating new addicts.

I guess that's one way to take care of health care costs though.

With that said, very few folks should be on systemic Fentanyl and almost none on TIRFs unless their life expectancy can be reasonable measured in months.

 

[DrCommonSense]

but whats driving people to go towards illegal fentanyl and heroin in the first place?

its another diversionary type argument by drcommon... point excitedly that most of the deaths are due to illicit/illegal fentanyl and use that as the basis that opioid prescriptions are not the problem, while ignoring the fact that what drives people to turn to illegal drugs in the first place is exposure to legal fentanyl (and hydrocodone and oxycodone) via prescriptions.

How do we explain how the percentage of people STARTING with heroin rather than prescription narcotics has dramatically increased in the last few years?

How come so many are just starting straight with heroin now and ignoring prescription drugs with ZERO decrease in death rates?



The Terrifying New Trend in Heroin Addiction

 

[DrCommonSense]

https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

• Four in five new heroin users started out misusing prescription painkillers.

• 94% of respondents in a 2014 survey of people in treatment for opioid addiction said theychose to use heroin because prescription opioids were “far more expensive and harder to obtain."



Sent from my iPhone using SDN mobile

Yeah except now addicts are literally just starting with heroin again rather than trying to con some doctor into writing a prescription.

The Terrifying New Trend in Heroin Addiction

 

[DOctorJay]

well in that case I agree with the title, terrifying indeed

 

[Ducttape]

its because you miss the entire point of the original premise.

you have to read the trail, which you didn't. the article links to another article which then links to this: Results from the 2014 National Survey on Drug Use and Health: Detailed Tables, SAMHSA, CBHSQ

this article suggests that most people are first being exposed to opioids via prescription narcotics that were not prescribed for them. the "last" author - who incorrectly assumes from the previous one - made a assumption that results in a fatal flaw in his article.

the availability and social acceptability of opioid therapy is what is the problem.

 

[lobelsteve]

Jackpot. Collected and destroyed by pharmacist today.

 

[DrCommonSense]

its because you miss the entire point of the original premise.

you have to read the trail, which you didn't. the article links to another article which then links to this: Results from the 2014 National Survey on Drug Use and Health: Detailed Tables, SAMHSA, CBHSQ

this article suggests that most people are first being exposed to opioids via prescription narcotics that were not prescribed for them. the "last" author - who incorrectly assumes from the previous one - made a assumption that results in a fatal flaw in his article.

the availability and social acceptability of opioid therapy is what is the problem.

How do you explain that since restricting opioid prescriptions there has been a tripling of heroin usage by people who have NOT been exposed to prescription narcotics with zero decrease in death rates? All that is happening is that people who were already going to become addicts due to depression, mental health issues, broken families, money issues, etc are just taking heroin rather than using prescription drugs as their source to get high.

You aren't saving any lives by restricting narcotic medications to this segment because they are just going right to heroin/illicit fentanyl as show in the newest studies cited in this article.

You have confused cause and effect

 

[Ducttape]

one, your first statement contains a lie that I clearly pointed out was incorrect from the article you quoted. (to wit:" a tripling of heroin usage by people who have NOT been exposed")

two, people have been depressed, had mental health issues, broken families and money issues for all of humankind.

we have iatrogenically "primed the pump" by making opioids so readily available to the average consumer and got many addicted, that would never have turned to heroin in previous generations.

a main reason to restrict opioids is not to prevent those who are already addicted from using heroin or, sadly, even trying to save them.

imo, its to restrict opioids so as to
1. not kill them directly - obviously, if they go out and score some heroin, they are doing it themselves instead of via prescription;
2. reduce the risk that opioid naïve people (and kids) will become addicts;
3. change the mindset of the social norm of acceptability towards narcotics.

 

[DrCommonSense]

one, your first statement contains a lie that I clearly pointed out was incorrect from the article you quoted. (to wit:" a tripling of heroin usage by people who have NOT been exposed")

two, people have been depressed, had mental health issues, broken families and money issues for all of humankind.

we have iatrogenically "primed the pump" by making opioids so readily available to the average consumer and got many addicted, that would never have turned to heroin in previous generations.

a main reason to restrict opioids is not to prevent those who are already addicted from using heroin or, sadly, even trying to save them.

imo, its to restrict opioids so as to
1. not kill them directly - obviously, if they go out and score some heroin, they are doing it themselves instead of via prescription;
2. reduce the risk that opioid naïve people (and kids) will become addicts;
3. change the mindset of the social norm of acceptability towards narcotics.

First statement comes DIRECTLY from the article. Sorry if you misunderstood the study but you need to reread it.

The rest of your arguments are leaps of faith that have NOT been proven to occur when restricting narcotics as per Florida experience and that VICE article discussion.

 

[Ducttape]

First statement comes DIRECTLY from the article. Sorry if you misunderstood the study but you need to reread it.

The rest of your arguments are leaps of faith that have NOT been proven to occur when restricting narcotics as per Florida experience and that VICE article discussion.

To spell it out as simply as possible, “your” article contains the lie that it got from misreading another article, which quoted the data.

The tripling of addicts who “initially” started with heroin actually is traced back to article that state that these addicts started with nonprescription opioids -prescription opioids of family and friends most commonly.

 

[DrCommonSense]

To spell it out as simply as possible, “your” article contains the lie that it got from misreading another article, which quoted the data.

The tripling of addicts who “initially” started with heroin actually is traced back to article that state that these addicts started with nonprescription opioids -prescription opioids of family and friends most commonly.

cool story bro