Faculty of Medicine, Mansoura University, Mansoura, Egypt.
VA Connecticut Healthcare System, West Haven, Connecticut.
Am J Addict. 2021 Jan;30(1):92-95. doi: 10.1111/ajad.13087. Epub 2020 Aug 10.
Opioid overdose-related deaths increased from approximately 18 000 deaths in 2007 to 46 802 deaths in 2018. Fentanyl is primarily responsible for the increase in opioid overdose deaths from 2011 through 2017. The primary aim of this study is to determine the rates of fentanyl in the urine drug screens of all patients who presented to the psychiatric emergency room at VA Connecticut, over 7 months in 2018.
Data were collected for all patient presentations between June 2018 and December 2018. There were 746 total patient presentations, with 497 being unique. Collected data included basic demographic information, psychiatric diagnosis, and urine drug screen for various illicit substances, including fentanyl.
Over 15% of patients screened positive for fentanyl. Patients who tested positive for fentanyl were further classified based on positive urine drug screening results for other opioids, cocaine, or both. Twenty percent of patients who screened positive for fentanyl and cocaine tested negative for other opioids. This category suggests that some veterans might be consuming fentanyl with cocaine.
Fentanyl was found at a high rate, even in the absence of other opioids, which suggests that some veterans might be consuming fentanyl with cocaine. Consequently, harm reduction strategies should be broadened to include all patients at risk of fentanyl overdose, including patients who use substances (eg, cocaine) that are potentially adulterated with fentanyl.
This study is the first one of its kind that looked at rates of fentanyl use in all presentations to a psychiatric emergency room. While it is well-known that fentanyl is highly prevalent, these findings extend the current state of knowledge by replication in a psychiatric emergency population. (Am J Addict 2021;30:92-95).
阿片类药物过量相关死亡人数从 2007 年的约 18000 人增加到 2018 年的 46802 人。芬太尼是导致 2011 年至 2017 年阿片类药物过量死亡人数增加的主要原因。本研究的主要目的是确定 2018 年 7 个月内在弗吉尼亚州康涅狄格州退伍军人事务部精神病急诊室就诊的所有患者的尿液药物检测中芬太尼的检出率。
收集 2018 年 6 月至 2018 年 12 月期间所有患者就诊的数据。共有 746 名患者就诊，其中 497 名是唯一的。收集的数据包括基本人口统计学信息、精神科诊断以及各种非法药物的尿液药物检测，包括芬太尼。
超过 15%的患者芬太尼检测呈阳性。根据其他阿片类药物、可卡因或两者的尿液药物检测结果，对芬太尼检测呈阳性的患者进行了进一步分类。20%芬太尼和可卡因检测呈阳性的患者其他阿片类药物检测呈阴性。这一类别表明，一些退伍军人可能在吸食芬太尼的同时也在吸食可卡因。
即使没有其他阿片类药物，芬太尼的检出率也很高，这表明一些退伍军人可能在吸食芬太尼的同时也在吸食可卡因。因此，减少伤害的策略应该扩大到包括所有有芬太尼过量风险的患者，包括使用可能掺有芬太尼的物质（如可卡因）的患者。
这项研究是首例观察到所有精神病急诊就诊患者中使用芬太尼的情况。虽然芬太尼的高流行率是众所周知的，但这些发现通过在精神病急诊人群中的复制，扩展了当前的知识状态。
