MMWR Morb Mortal Wkly Rep. 2008 Jul 25;57(29):793-6.
On April 21, 2006, increases in overdoses were reported among illicit drug users in Camden, New Jersey, via the CDC Epidemic Information Exchange (Epi-X). This alert elicited reports of similar increases in overdoses in other parts of New Jersey, and in Maryland; Chicago, Illinois; Detroit, Michigan; and Philadelphia, Pennsylvania. The increases in Chicago and Detroit had been recognized several months earlier but attributed to heroin overdoses until fentanyl was detected in the blood or urine of some decedents. Illicitly manufactured nonpharmaceutical fentanyl (NPF), a synthetic opioid 30-50 times more potent than heroin, also was found by law enforcement personnel and medical examiner staffs at the scene of some overdoses. In May 2006, to identify NPF-related deaths in six state and local jurisdictions, CDC implemented an ad hoc case-finding and surveillance system, later managed by the Drug Enforcement Administration (DEA). This report summarizes the results of that effort, which identified 1,013 NPF-related deaths that occurred during April 4, 2005-March 28, 2007. As a result, on April 23, 2007, DEA began regulating access to N-phenethyl-4-piperidone, a chemical used to make illicit NPF. Increased public health efforts are needed to improve epidemiologic data collection on drug overdoses, enable early detection of increases in drug overdoses, educate illicit drug users regarding the risks for overdose, and help users obtain treatment for their addictions.
2006年4月21日，通过美国疾病控制与预防中心疫情信息交换平台（Epi-X）报告称，新泽西州卡姆登的非法药物使用者过量用药情况有所增加。这一警报引发了新泽西州其他地区、马里兰州、伊利诺伊州芝加哥市、密歇根州底特律市以及宾夕法尼亚州费城类似过量用药增加情况的报告。芝加哥和底特律的增加情况在几个月前就已被发现，但此前一直归因于海洛因过量用药，直到在一些死者的血液或尿液中检测出芬太尼。在一些过量用药现场，执法人员和法医工作人员还发现了非法制造的非药用芬太尼（NPF），这是一种比海洛因效力强30至50倍的合成阿片类药物。2006年5月，为确定六个州和地方辖区内与NPF相关的死亡情况，美国疾病控制与预防中心实施了一个临时病例发现和监测系统，该系统后来由美国缉毒局（DEA）管理。本报告总结了该项工作的结果，该工作确定了2005年4月4日至2007年3月28日期间发生的1013例与NPF相关的死亡。因此，2007年4月23日，美国缉毒局开始对用于制造非法NPF的化学物质N-苯乙基-4-哌啶酮的获取进行管制。需要加大公共卫生工作力度，以改善药物过量用药的流行病学数据收集，实现对药物过量用药增加情况的早期发现，就过量用药风险对非法药物使用者进行教育，并帮助使用者获得成瘾治疗。
