Research highlights growing, dangerous trend, particularly for people new to drug use —

Regulation enforcement seizures of tablets containing illicit fentanyl elevated dramatically between January 2018 and December 2021, in accordance with a brand new examine. The variety of particular person tablets seized by regulation enforcement elevated practically 50-fold from the primary quarter of 2018 to the final quarter of 2021 and the proportion of tablets to complete seizures greater than doubled, with tablets representing over 1 / 4 of illicit fentanyl seizures by the top of 2021. The examine additionally discovered a rise within the variety of fentanyl-containing powder seizures throughout this time.

This examine was printed at present in Drug and Alcohol Dependence and funded by the Nationwide Institute on Drug Abuse (NIDA), a part of the Nationwide Institutes of Well being. In line with the newest Facilities for Illness Management and Prevention information, america hit a file excessive within the variety of overdose deaths ever recorded, estimating that just about 106,000 individuals died from drug overdoses within the 12-month interval ending in October 2021. This rise is essentially pushed by illicit fentanyl and different artificial opioids.

Illicit fentanyl is extremely potent, cheaply made and simply transported, making it a worthwhile narcotic. Whereas individuals could search out illicit fentanyl deliberately, many individuals usually are not conscious that the drug they’re utilizing — together with heroin, cocaine, methamphetamine, or benzodiazepines — may very well be fentanyl, or has been adulterated or contaminated with fentanyl. As a result of fentanyl is about 50 instances stronger than heroin and a deadly dose could also be as small as two milligrams, utilizing a drug that has been laced with fentanyl can significantly improve overdose threat.

“A rise in illicit tablets containing fentanyl factors to a brand new and more and more harmful interval in america,” mentioned NIDA Director Nora D. Volkow, M.D. “Tablets are sometimes taken or snorted by people who find themselves extra na├»ve to drug use, and who’ve decrease tolerances. When a capsule is contaminated with fentanyl, as is now typically the case, poisoning can simply happen.”

Illicitly manufactured powder fentanyl has been a recognized adulterant in medicine since 2013, however the extent that fentanyl is present in counterfeit tablets has been largely unknown. To deal with this query, a group led by Joseph J. Palamar, Ph.D., M.P.H., affiliate professor on the NYU Grossman Faculty of Medication and co-investigator on the NIDA-funded Nationwide Drug Early Warning System (NDEWS), analyzed information on drug seizures by regulation enforcement. The information have been collected between January of 2018 and December of 2021 from the Excessive Depth Drug Trafficking Areas (HIDTA) program, a grant program aimed toward decreasing drug trafficking and misuse administered by the Workplace of Nationwide Drug Management Coverage wherein the Drug Enforcement Administration and the CDC play an energetic function.

Evaluating information from the primary quarter of 2018 with the final quarter of 2021, the group discovered that the variety of seizures of tablets containing fentanyl elevated from 68 to 635, and the overall variety of particular person tablets seized by regulation enforcement elevated from 42,202 to 2,089,186. Seizures of powder containing fentanyl additionally elevated from 424 to 1,539, and the overall weight of powder seized elevated from 298.2 kg to 2,416.0 kg.

In contrast to most survey information and surveillance techniques which may be lagged for a 12 months or extra, HIDTA information are made accessible quarterly, permitting analysis in nearly actual time. HIDTA additionally distinguish between the presence of fentanyl in capsule or powder kind. Analyzing these information can subsequently assist determine traits in availability of illicit substances and act as a sort of early warning system to shift public well being schooling or interventional sources extra shortly.

HIDTA information doesn’t differentiate between fentanyl and its analogs, nor estimate the quantity of fentanyl current in seized substances; nevertheless, given the small quantity vital for an overdose, the authors notice that the presence of any fentanyl is a vital indicator of overdose threat. Individuals who buy counterfeit medicine, corresponding to illicit oxycodone, hydrocodone, or benzodiazepines could also be in danger for unintentional publicity to fentanyl, which is related to elevated threat of overdose dying. Additional, individuals who use a majority of these tablets are much less more likely to have a tolerance constructed to opioids, and when coupled with the sedative results of non-fentanyl opioids or benzodiazepines, could additional improve threat of overdose and dying.

“For the primary time we will see this fast rise in tablets adulterated with fentanyl, which raises pink flags for rising threat of hurt in a inhabitants that’s presumably much less skilled with opioids,” mentioned Dr. Palamar. “We completely want extra hurt discount methods, corresponding to naloxone distribution and fentanyl check strips, in addition to widespread schooling concerning the threat of tablets that aren’t coming from a pharmacy. The quick message right here is that tablets illegally obtained can comprise fentanyl.”

The researchers emphasize that drug seizure charges usually are not direct measures of precise drug availability. Nonetheless, the rise in fentanyl-related drug seizures coincides with rising artificial opioid-related overdose dying charges. These information additionally corroborate information from the DEA Nationwide Forensic Laboratory Data System exhibiting a gradual improve in fentanyl seizures in recent times, even throughout the sooner elements of the COVID-19 pandemic. For added NDEWS analysis and reviews, go to:

“To deal with the overdose disaster, you want real-time, high-quality drug surveillance information to tell the general public well being response,” mentioned Linda B. Cottler, Ph.D., M.P.H, principal investigator of NDEWS, and final creator on the paper. “By gathering and sharing information on drug use traits as we do by our NIDA-funded NDEWS, we intention to information methods to curb the overdose disaster of at present, whereas additionally maintaining our eye on the horizon to arrange for the issues of tomorrow.”