Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Center for Substance Abuse Research (CESAR), University of Maryland, College Park, MD, USA.
Clin Toxicol (Phila). 2020 Jan;58(1):59-61. doi: 10.1080/15563650.2019.1605078. Epub 2019 Apr 22.
Fentanyl-associated deaths have risen in Maryland, but the prevalence of illicit fentanyl use is unknown. Our objective was to measure whether fentanyl is present among emergency department (ED) patients seeking care for a drug overdose. The prevalence of fentanyl use was determined using a cross-sectional study of a convenience sample of adult ED patients with complaints of apparent opioid overdose, withdrawal from opioids, and/or requesting treatment for their substance use disorder (SUD) between February and April, 2018. Subjects were consented, interviewed, and underwent urine point-of-care (POC) fentanyl testing. A total of 102 patients met inclusion criteria and were approached, 76 consented, 63 (83%) of whom tested positive for recent fentanyl use. 60 (80%) were male, 26 (34%) had overdosed, 41 (54%) were seeking SUD treatment, and 13 (17%) were in withdrawal (4 had multiple complaints). Of those who underwent both standard hospital urine drug screen and POC fentanyl testing, 56% (22/39) were positive for fentanyl and negative for opiates. Only 5% (4/76) reported knowledge of using fentanyl. Fentanyl use was common and frequently missed among these ED patients. Hospitals who treat patients taking illicit fentanyl should consider adding fentanyl to their urine drugs of abuse panel.
马里兰州的芬太尼相关死亡人数有所上升，但非法芬太尼使用的流行程度尚不清楚。我们的目的是衡量在因药物过量寻求治疗的急诊科（ED）患者中是否存在芬太尼。使用横断面研究方法，对 2018 年 2 月至 4 月期间因明显阿片类药物过量、阿片类药物戒断和/或要求治疗物质使用障碍（SUD）而到急诊科就诊的成年 ED 患者进行了便利样本调查，以确定芬太尼的使用情况。对患者进行了同意、访谈和尿液即时检测（POC）芬太尼检测。共有 102 名符合纳入标准的患者被纳入研究，其中 76 名同意参加，63 名（83%）最近有芬太尼使用阳性检测结果。60 名（80%）为男性，26 名（34%）发生过药物过量，41 名（54%）正在接受 SUD 治疗，13 名（17%）处于戒断状态（4 名有多种症状）。在接受标准医院尿液毒品筛查和 POC 芬太尼检测的患者中，56%（22/39）芬太尼检测阳性且阿片类药物检测阴性。仅有 5%（4/76）的患者报告曾使用过芬太尼。在这些急诊科患者中，芬太尼的使用很常见且常常被漏诊。治疗使用非法芬太尼的患者的医院应考虑将芬太尼纳入尿液药物滥用检测项目。
