New Report Reveals More Than 1000 People Died in Illegal Fentanyl Epidemic of 2005-2007

New Report Reveals More Than 1000 People Died in Illegal Fentanyl Epidemic of 2005-2007

Report highlights the successes of public health responses to this epidemic, but also warns of sharp rise in all drug overdose deaths

A new report provides an unprecedented look at the scope and nature of an epidemic of overdoses related to illegally produced (non-pharmaceutical) fentanyl -- an epidemic that ultimately killed at least 1,013 people within less than two years. Published in the July 25 issue of the Centers for Disease Control and Prevention’s (CDC) Mortality and Morbidity Weekly Report (MMWR), Non-Pharmaceutical Fentanyl-related Deaths, Multiple States chronicles the steps public health and law enforcement authorities at the federal, state and local level took in identifying and responding to the problem, and notes how these measures could be applied to public health threats.

Fentanyl is a synthetic opioid medication that when properly manufactured and administered is an effective treatment for severe or chronic pain. It is a very potent drug; however (30-50 times more potent than heroin), and can be extraordinarily dangerous when produced illicitly or used non-medically. Non-pharmaceutical versions of fentanyl have not only been sold directly as street drugs, but have also been mixed in with other street drugs such as heroin and cocaine –sometimes with fatal consequences.

An April 2006 spike in the number of drug overdoses in Camden, N.J., was reported to the Epidemic Information Exchange (EpiX), a communications network developed by the U.S. Centers for Disease Control and Prevention. Similar reports of sudden increases in overdoses and deaths from other parts of the country led the CDC, the Office of National Drug Control Policy, the Substance Abuse and Mental Health Services Administration, the Drug Enforcement Administration, and other public health and law enforcement officials to launch a government-wide effort to investigate the problem and protect the public health.

Working closely with state and local authorities, experts from these agencies were able to determine that what were initially suspected to be heroin overdoses were actually overdoses related to illicit drugs containing non-pharmaceutical fentanyl. Federal authorities immediately undertook a wide range of efforts to determine the source and extent of the problem – including epidemiologic studies to assess its origins.

Federal, state and local authorities simultaneously launched intensive outreach efforts throughout the medical and substance abuse treatment communities to alert people of the dangers. Practical information and measures were also provided for helping prevent exposure to illicit fentanyl drugs and for treating those who had been exposed. Thanks in large part to these efforts, the epidemic, which was determined to have begun around April of 2005, ended by March 2007.

“This MMWR report details the effective measures CDC, ONDCP, DEA, SAMHSA and others implemented to stem this epidemic, save countless lives and help address possible future outbreaks,” said SAMHSA Administrator Terry Cline, Ph.D. “It also highlights the very disturbing rise in overdose deaths related to both the abuse of street and prescription drugs, and the continuing need to address this dire problem.”

The report’s editorial notes point out that the non-pharmaceutical epidemic occurred against a backdrop of dramatic rises in deaths from drug overdoses. For example, unintentional drug poisoning (primarily drug overdoses) deaths rose from 11,155 in 1999 to 22,448 in 2005 – an increase of more than 100 percent. The editorial notes that many of these fatal overdoses involved the use of opioid prescription drugs. In light of this public health problem, the report recommends building upon many of the measures put in place to address the non-pharmaceutical fentanyl epidemic, including enhancing mechanisms for identifying and reporting drug-related deaths, establishing national standards for guiding the toxicological testing and analysis of these deaths and maintaining outreach programs for effectively providing vital information to potentially affected communities.

A copy of the full report and accompanying editorial can be obtained at www.cdc.gov/mmwr.