Noriega Ivette, Bhullar Manreet K, Gilson Thomas P, Flannery Daniel J, Deo Vaishali, Fulton Sarah
Case Western Reserve University, 10900 Euclid Ave, SOM WG-57, Cleveland, OH 44106, USA.
Cuyahoga County Medical Examiner's Office, 11001 Cedar Avenue, Cleveland, OH 44106, USA.
Drug Alcohol Depend Rep. 2023 Sep 1;8:100187. doi: 10.1016/j.dadr.2023.100187. eCollection 2023 Sep.
Fentanyl and fentanyl analogs have increased the overdose mortality rates in the United States, significantly impacting states like Ohio. We examined carfentanil overdose deaths, other contributing Cause of Death (COD) drugs, and drug seizure trends from 2016 to 2020 in Northeast Ohio.
We studied death investigation data from the Cuyahoga County, Ohio Medical Examiner's Office (CCMEO) of all fatal accidental opioid overdoses as well as drug seizure data from Cuyahoga County Regional Forensic Science Laboratory (CCRFSL). We also compared decedents' race, gender, age, residential locality, drugs contributing to the COD in opioid cases, and for carfentanil, fentanyl, and cocaine seizures in Cuyahoga County from 2016 to 2020 ( = 2948).
Decedents' had an average of three different drugs contributing to their COD. A bimodal carfentanil spike was observed in fatal accidental overdoses in Cuyahoga County for the years 2017 and 2019. Decedents in urban residency, who were Non-Hispanic, White and younger, significantly predicted the presence of carfentanil contributing to the COD. In 2020, decedents who were Black and older were significantly associated with cocaine contributing to the COD. Carfentanil and carfentanil-related overdoses were significantly correlated.
The pervasiveness of illicitly manufactured fentanyl and fentanyl analog (e.g., carfentanil) mixtures with other drugs are changing the demographics of persons who fatally overdose in Cuyahoga County, OH. Significant trending shifts can also be observed for the presence of carfentanil in decedent and seizure county data.
Local data of drug-related overdose deaths and drug seizures from a medical examiner's office and affiliated forensic laboratory lab can be used for timely public health surveillance, and informing prevention, and intervention at the county level.
芬太尼及其类似物使美国的过量用药死亡率上升，对俄亥俄州等州产生了重大影响。我们研究了2016年至2020年俄亥俄州东北部卡芬太尼过量用药死亡情况、其他导致死亡的相关药物以及毒品缉获趋势。
我们研究了俄亥俄州库亚霍加县法医办公室（CCMEO）关于所有致命意外阿片类药物过量用药的死亡调查数据，以及库亚霍加县区域法医科学实验室（CCRFSL）的毒品缉获数据。我们还比较了2016年至2020年（n = 2948）库亚霍加县死者的种族、性别、年龄、居住地点、导致阿片类药物过量用药死亡的相关药物，以及卡芬太尼、芬太尼和可卡因的缉获情况。
死者平均有三种不同药物导致其死亡。2017年和2019年，库亚霍加县致命意外过量用药中观察到双峰型卡芬太尼峰值。居住在城市、非西班牙裔、白人且较年轻的死者，显著预示了卡芬太尼是导致死亡的原因。2020年，黑人且年龄较大的死者与可卡因是导致死亡的原因显著相关。卡芬太尼及与卡芬太尼相关的过量用药显著相关。
非法制造的芬太尼及其类似物（如卡芬太尼）与其他药物的混合物的普遍存在，正在改变俄亥俄州库亚霍加县致命过量用药者的人口统计学特征。在死者和缉获县数据中，也可观察到卡芬太尼存在的显著趋势变化。
来自法医办公室和附属法医实验室的与药物相关的过量用药死亡和毒品缉获的本地数据，可用于及时的公共卫生监测，并为县级预防和干预提供信息。
