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Illicit Fentanyl-Related Fatalities in Florida: Toxicological Findings.
J Anal Toxicol. 2016 Oct; 40(8):588-594.JA

Abstract

Fentanyl induces pharmacological effects and abuse liability comparable to other prescription opioids and heroin. A surge in fentanyl-related fatalities has been periodically reported throughout the USA. The University of Florida Forensic Toxicology Laboratory observed a significant increase in fentanyl-related deaths starting in mid-2014. The present report evaluated toxicological findings, demographics of the decedents and circumstances of death in the postmortem cases that were submitted to the laboratory for toxicological analysis from July 2014 to January 2015 and that were tested for fentanyl in biological specimens. The cases originated from 6 of the 24 Florida Medical Examiner Districts, with the majority from District 12 (Desoto, Manatee and Sarasota counties). The specimens were analyzed for fentanyl by gas chromatography-mass spectrometry; the limit of detection (LOD) was 0.62 ng/mL and the limit of quantification (LOQ) was 2.5 ng/mL. During the 7-month period, the laboratory tested 143 postmortem cases for fentanyl and 50% had quantifiable fentanyl in postmortem blood. Fentanyl concentrations ranged from 2.5 to 68 ng/mL (n = 66; median: 9.8 ng/mL); six cases were positive for fentanyl >LOD but <LOQ. The majority of the cases (85%) had indications of possible drug abuse with heroin use being the most often suspected. Concurrent detection of 6-acetylmorphine, morphine and cocaine along with other opioids and benzodiazepines was common. Of the 59 deaths from District 12, the cause of death was accidental drug intoxication with fentanyl as a sole or contributing factor for 57 cases (two non-drug intoxication deaths). The median age of the 57 decedents was 35 (range: 19-63) years. Males represented 87% of the deaths and 96% were Whites. Most of the decedents (n = 53) had no prescription for fentanyl. Considering fentanyl's high potency and abuse liability, the recent rise in fentanyl-related deaths is a serious public health concern and signifies the urgent need to establish prevention and treatment efforts.

Authors+Show Affiliations

Forensic Toxicology Laboratory, Division of Forensic Medicine, Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA Houston Forensic Science Center, Houston, TX, USA.Forensic Toxicology Laboratory, Division of Forensic Medicine, Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.District Twelfth Medical Examiner's Office, Sarasota, FL, USA.District Twelfth Medical Examiner's Office, Sarasota, FL, USA.District Twelfth Medical Examiner's Office, Sarasota, FL, USA.District Twelfth Medical Examiner's Office, Sarasota, FL, USA.Forensic Toxicology Laboratory, Division of Forensic Medicine, Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA bruce-goldberger@ufl.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27702938

Citation

Lee, Dayong, et al. "Illicit Fentanyl-Related Fatalities in Florida: Toxicological Findings." Journal of Analytical Toxicology, vol. 40, no. 8, 2016, pp. 588-594.
Lee D, Chronister CW, Broussard WA, et al. Illicit Fentanyl-Related Fatalities in Florida: Toxicological Findings. J Anal Toxicol. 2016;40(8):588-594.
Lee, D., Chronister, C. W., Broussard, W. A., Utley-Bobak, S. R., Schultz, D. L., Vega, R. S., & Goldberger, B. A. (2016). Illicit Fentanyl-Related Fatalities in Florida: Toxicological Findings. Journal of Analytical Toxicology, 40(8), 588-594.
Lee D, et al. Illicit Fentanyl-Related Fatalities in Florida: Toxicological Findings. J Anal Toxicol. 2016;40(8):588-594. PubMed PMID: 27702938.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Illicit Fentanyl-Related Fatalities in Florida: Toxicological Findings. AU - Lee,Dayong, AU - Chronister,Chris W, AU - Broussard,Wilson A, AU - Utley-Bobak,Suzanne R, AU - Schultz,Daniel L, AU - Vega,Russell S, AU - Goldberger,Bruce A, PY - 2016/07/27/received PY - 2016/07/26/accepted PY - 2016/10/6/entrez PY - 2016/10/6/pubmed PY - 2017/4/1/medline SP - 588 EP - 594 JF - Journal of analytical toxicology JO - J Anal Toxicol VL - 40 IS - 8 N2 - Fentanyl induces pharmacological effects and abuse liability comparable to other prescription opioids and heroin. A surge in fentanyl-related fatalities has been periodically reported throughout the USA. The University of Florida Forensic Toxicology Laboratory observed a significant increase in fentanyl-related deaths starting in mid-2014. The present report evaluated toxicological findings, demographics of the decedents and circumstances of death in the postmortem cases that were submitted to the laboratory for toxicological analysis from July 2014 to January 2015 and that were tested for fentanyl in biological specimens. The cases originated from 6 of the 24 Florida Medical Examiner Districts, with the majority from District 12 (Desoto, Manatee and Sarasota counties). The specimens were analyzed for fentanyl by gas chromatography-mass spectrometry; the limit of detection (LOD) was 0.62 ng/mL and the limit of quantification (LOQ) was 2.5 ng/mL. During the 7-month period, the laboratory tested 143 postmortem cases for fentanyl and 50% had quantifiable fentanyl in postmortem blood. Fentanyl concentrations ranged from 2.5 to 68 ng/mL (n = 66; median: 9.8 ng/mL); six cases were positive for fentanyl >LOD but <LOQ. The majority of the cases (85%) had indications of possible drug abuse with heroin use being the most often suspected. Concurrent detection of 6-acetylmorphine, morphine and cocaine along with other opioids and benzodiazepines was common. Of the 59 deaths from District 12, the cause of death was accidental drug intoxication with fentanyl as a sole or contributing factor for 57 cases (two non-drug intoxication deaths). The median age of the 57 decedents was 35 (range: 19-63) years. Males represented 87% of the deaths and 96% were Whites. Most of the decedents (n = 53) had no prescription for fentanyl. Considering fentanyl's high potency and abuse liability, the recent rise in fentanyl-related deaths is a serious public health concern and signifies the urgent need to establish prevention and treatment efforts. SN - 1945-2403 UR - https://www.unboundmedicine.com/medline/citation/27702938/Illicit_Fentanyl_Related_Fatalities_in_Florida:_Toxicological_Findings_ L2 - https://academic.oup.com/jat/article-lookup/doi/10.1093/jat/bkw087 DB - PRIME DP - Unbound Medicine ER -