A new report from the U.S. Centers for Disease Control and Prevention (CDC) looks at an investigation by public health and law enforcement agencies at the federal, state and local level to identify and respond to several drug overdoses that stemmed from illegally produced (non-pharmaceutical) fentanyl, between April 2005 and March 2007. The report highlights the successes of public health responses to this epidemic, but also warns of sharp rise in all drug overdose deaths

The report, published in the CDC’s July 25 issue of Mortality and Morbidity Weekly Report, follows a government-wide effort to investigate the problem and protect the public from a spike in drug overdoses across the country, which resulted in more than 1,013 deaths in less than two years. 

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 – 30 to 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.  

Following several reports of sudden increases in overdoses and deaths from various parts of the country, 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 launched an investigation. 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, which included providing practical information and measures for helping prevent exposure to illicit fentanyl drugs, and for treating those who had been exposed. 

“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.”

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 epidemic, as well as marked increases in fatal overdoses involving the use of opioid prescription drugs, 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.

For a copy of the full report, visit www.cdc.gov/mmwr.  

- SAMHSA

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