Steep increases in fentanyl-related mortality west of the Mississippi River: recent evidence from county and state surveillance.

Shover, Chelsea L.; Falasinnu, Titilola O.; Dwyer, Candice L.; Santos, Nayelie Benitez; Cunningham, Nicole J.; Freedman, Rohan B.; Vest, Noel A.; Humphreys, Keith

doi:10.1016/j.drugalcdep.2020.108314

Cited by 162Opioid Use Disorder TreatmentHIV, Drug Use, Sexual RiskForensic Toxicology and Drug Analysis

Steep increases in fentanyl-related mortality west of the Mississippi River: recent evidence from county and state surveillance.

Open access

Shover, Chelsea L., Falasinnu, Titilola O., Dwyer, Candice L., Santos, Nayelie Benitez, Cunningham, Nicole J., Freedman, Rohan B., Vest, Noel A., Humphreys, Keith·2020·Drug and Alcohol Dependence

DOI 10.1016/j.drugalcdep.2020.108314PMC PMC7521591

Published version of a preprint

Open this paper in CoChat — free account Open PDF

Abstract

Background Overdose deaths from synthetic opioids (e.g., fentanyl) increased 10-fold in the United States from 2013 to 2018, despite such opioids being rare in illicit drug markets west of the Mississippi River. Public health professionals have feared a “fentanyl breakthrough” in western U.S. drug markets could further accelerate overdose mortality. We evaluated the number and nature of western U.S. fentanyl deaths using the most recent data available. Methods We systematically searched jurisdictions west of the Mississippi River for publicly available data on fentanyl-related deaths since 2018, the most recent Centers for Disease Control and Prevention (CDC) statistics. Using mortality data from 2019 and 2020, we identified changes in fentanyl-related mortality rate and proportion of fatal heroin-, stimulant, and prescription pill overdoses involving fentanyl. Results Seven jurisdictions had publicly available fentanyl death data through December 2019 or later: Arizona; California; Denver County, CO; Harris County, TX; King County, WA; Los Angeles County, CA; and Dallas-Fort Worth, TX (Denton, Johnson, Parker, and Tarrant counties). All reported increased fentanyl deaths over the study period. Their collective contribution to national synthetic narcotics mortality increased 371 % from 2017 to 2019. Available 2020 data shows a 63 % growth in fentanyl-mortality over 2019. Fentanyl-involvement in heroin, stimulant, and prescription pill deaths has substantially grown. Discussion Fentanyl has spread westward, increasing deaths in the short-term and threatening to dramatically worsen the nation’s already severe opioid epidemic in the long-term. Increasing the standard dose of naloxone, expanding Medicaid, improving coverage of addiction treatment, and public health educational campaigns should be prioritized.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1016/j.drugalcdep.2020.108314

Cites

27 of 27 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Fentanyl did not saturate each state's unregulated drug market at the same time; from about 2013 onward, it spread from east to west over the course of several years.
“However, fentanyl did not saturate each state’s unregulated drug market at the same time25; from about 2013 onward, it spread from east to west over the course of several years.20,26”
From Drug Decriminalization, Fentanyl, and Fatal Overdoses in Oregon (2024) · cites this paper as [26]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

International Statistical Classification of Diseases and Related Health Problems
Eisfeld, J. (2014) · TSQ Transgender Studies Quarterly · doi:10.1215/23289252-2399740 · Cited by 3,570 · see citing works
Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018
Wilson, N., Kariisa, M., Seth, P., Smith, H., & Davis, N. L. (2020) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6911a4 · Cited by 1,123 · see citing works
The triple wave epidemic: Supply and demand drivers of the US opioid overdose crisis
Ciccarone, D. (2019) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2019.01.010 · Cited by 677 · see citing works
Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis
Sun, E. C., Dixit, A., Humphreys, K., Darnall, B. D., Baker, L. C., & Mackey, S. (2017) · BMJ · doi:10.1136/bmj.j760 · Cited by 534 · see citing works
Self-citation
Understanding Links among Opioid Use, Overdose, and Suicide
Bohnert, A. S. B., & Ilgen, M. A. (2019) · New England Journal of Medicine · doi:10.1056/nejmra1802148 · Cited by 321 · see citing works
Addressing the Fentanyl Threat to Public Health
Frank, R. G., & Pollack, H. A. (2017) · New England Journal of Medicine · doi:10.1056/nejmp1615145 · Cited by 242 · see citing works
Alcohol or Benzodiazepine Co-involvement With Opioid Overdose Deaths in the United States, 1999-2017
Tori, M. E., Larochelle, M. R., & Naimi, T. S. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.2361 · Cited by 187 · see citing works
Our other prescription drug problem
Lembke, A., Papac, J., & Humphreys, K. (2018) · New England Journal of Medicine · doi:10.1056/nejmp1715050 · Cited by 160 · see citing works
Self-citation
Fentanyl shock: The changing geography of overdose in the United States
Zoorob, M. (2019) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2019.04.010 · Cited by 160 · see citing works
The rise in non‐fatal and fatal overdoses involving stimulants with and without opioids in the United States
Hoots, B., Vivolo-Kantor, A. M., & Seth, P. (2020) · Addiction · doi:10.1111/add.14878 · Cited by 150 · see citing works
The Future of Fentanyl and Other Synthetic Opioids
Pardo, B., Taylor, J., Caulkins, J. P., Kilmer, B., Reuter, P. H., & Stein, B. D. (2019) · RAND Corporation eBooks · doi:10.7249/rr3117 · Cited by 139 · see citing works
Drug Overdose Deaths Involving Fentanyl, 2011-2016.
Spencer, M. R. T., Warner, M., Bastian, B. A., Trinidad, J. P., & Hedegaard, H. B. (2019) · PubMed · Cited by 136 · see citing works
Notes from the Field: Overdose Deaths with Carfentanil and Other Fentanyl Analogs Detected — 10 States, July 2016–June 2017
O’Donnell, J. K., Gladden, R. M., Mattson, C. L., & Kariisa, M. (2018) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6727a4 · Cited by 88 · see citing works
Regional Differences in the Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2017.
Hedegaard, H. B., Bastian, B. A., Trinidad, J. P., Spencer, M. R., & Warner, M. (2019) · PubMed · Cited by 87 · see citing works
Comparative Analysis of Suicide, Accidental, and Undetermined Cause of Death Classification
Gray, D., Coon, H. H., McGlade, E., Callor, W. B., Byrd, J., Viskochil, J., Bakian, A. V., Yurgelun-Todd, D. A., Grey, T. C., & McMahon, W. M. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12079 · Cited by 69 · see citing works
Fentanyl is used in Mexico's northern border: current challenges for drug health policies
Fleiz, C., Arredondo, J., Chavez, A., Pacheco, L., Segovia, L. A., Villatoro, J. A., Cruz, S. L., Medina‐Mora, M. E., & Fuente, J. R. D. L. (2019) · Addiction · doi:10.1111/add.14934 · Cited by 54 · see citing works
Femoral blood concentrations of flualprazolam in 33 postmortem cases
Kriikku, P., Rasanen, I., Ojanperä, I. A., Thelander, G., Kronstrand, R., & Vikingsson, S. (2019) · Forensic Science International · doi:10.1016/j.forsciint.2019.110101 · Cited by 47 · see citing works
Naloxone dosing in the era of ultra-potent opioid overdoses: a systematic review
Moe, J., Godwin, J., Purssell, R. A., O’Sullivan, F., Hau, J. P., Purssell, E., Curran, J., Doyle‐Waters, M. M., Brasher, P. M. A., Buxton, J. A., et al. (2020) · Canadian Journal of Emergency Medicine · doi:10.1017/cem.2019.471 · Cited by 47 · see citing works
Flualprazolam Blood Concentrations in 197 Forensic Investigation Cases
Papsun, D. M., Krotulski, A. J., Homan, J. W., Temporal, K.-D. H., & Logan, B. K. (2020) · Journal of Analytical Toxicology · doi:10.1093/jat/bkaa070 · Cited by 46 · see citing works
Flualprazolam: Report of an Outbreak of a New Psychoactive Substance in Adolescents
Blumenberg, A., Hughes, A., Reckers, A., Ellison, R., & Gerona, R. R. L. (2020) · PEDIATRICS · doi:10.1542/peds.2019-2953 · Cited by 32 · see citing works
Rapid Assessment of Opioid Exposure and Treatment in Cities Through Robotic Collection and Chemical Analysis of Wastewater
Endo, N., Ghaeli, N., Duvallet, C., Foppe, K. S., Erickson, T. B., Matus, M. G., & Chai, P. R. (2020) · Journal of Medical Toxicology · doi:10.1007/s13181-019-00756-5 · Cited by 31 · see citing works
Temporary population mobilities between Estonia and Finland based on mobile phone data and the emergence of a cross-border region
Silm, S., Jauhiainen, J. S., Raun, J., & Tiru, M. (2020) · European Planning Studies · doi:10.1080/09654313.2020.1774514 · Cited by 29 · see citing works
The Palgrave Handbook of American Mental Health Policy
(2019) · Springer eBooks · doi:10.1007/978-3-030-11908-9 · Cited by 28 · see citing works
Rise in Presence of Methamphetamine in Oral Fluid Toxicology Tests Among Outpatients in a Large Healthcare Setting in the Northeast
Wakeman, S. E., Flood, J. G., & Ciccarone, D. (2020) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000695 · Cited by 14 · see citing works
The fentanyl epidemic in Estonia: opportunities for a comprehensive public health response
Uusküla, A., Jarlais, D. C. D., & Vorobjov, S. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30436-5 · Cited by 9 · see citing works
Harris County Institute of Forensic Sciences
Derrick, S. M., & County, H. (2011) · Cited by 8 · see citing works
How Should the United States Respond to the Opioid Addiction and Overdose Epidemic?
Humphreys, K. N., & Pollack, H. A. (2019) · Springer eBooks · doi:10.1007/978-3-030-11908-9_10 · Cited by 4 · see citing works
Self-citation

Flagged first, then by citations

5 of the 32 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

Office of the Surgeon General Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health 2016 HHS Washington, D.C 28252892

Sorted by citations

The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis
Ciccarone, D. (2021) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000717 · Cited by 987 · see citing works
Responding to the opioid crisis in North America and beyond: recommendations of the Stanford–Lancet Commission
Humphreys, K. N., Shover, C. L., Andrews, C. M., Bohnert, A. S. B., Brandeau, M. L., Caulkins, J. P., Chen, J. H., Cuéllar, M.-F., Hurd, Y. L., Juurlink, D. N., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02252-2 · Cited by 463 · see citing works
Self-citation
Xylazine Spreads Across the US: A Growing Component of the Increasingly Synthetic and Polysubstance Overdose Crisis
Friedman, J. R., Montero, F., Bourgois, P., Wahbi, R., Dye, D. W., Goodman‐Meza, D., & Shover, C. L. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109380 · Cited by 366 · see citing works
Self-citation
Charting the fourth wave: Geographic, temporal, race/ethnicity and demographic trends in polysubstance fentanyl overdose deaths in the United States, 2010–2021
Friedman, J. R., & Shover, C. L. (2023) · Addiction · doi:10.1111/add.16318 · Cited by 327 · see citing works
Self-citation
Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls — United States, 2019–2020
O’Donnell, J. K., Tanz, L. J., Gladden, R. M., Davis, N. L., & Bitting, J. (2021) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7050e3 · Cited by 236 · see citing works
COVID-19 and the Drug Overdose Crisis: Uncovering the Deadliest Months in the United States, January‒July 2020
Friedman, J. R., & Akre, S. (2021) · American Journal of Public Health · doi:10.2105/ajph.2021.306256 · Cited by 168 · see citing works
High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder
Herring, A. A., Vosooghi, A., Luftig, J., Anderson, E. S., Zhao, X., Dziura, J. D., Hawk, K. F., McCormack, R. P., Saxon, A. J., & D’Onofrio, G. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.17128 · Cited by 161 · see citing works
Evidence of Buprenorphine-precipitated Withdrawal in Persons Who Use Fentanyl
Varshneya, N. B., Thakrar, A. P., Hobelmann, J. G., Dunn, K. E., & Huhn, A. S. (2021) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000922 · Cited by 150 · see citing works
Treatment of overdose in the synthetic opioid era
Skolnick, P. (2021) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2021.108019 · Cited by 123 · see citing works
Rapid Adoption of Low-Threshold Buprenorphine Treatment at California Emergency Departments Participating in the CA Bridge Program
Snyder, H. R., Kalmin, M. M., Moulin, A. K., Campbell, A., Goodman‐Meza, D., Padwa, H., Clayton, S., Speener, M., SHOPTAW, S. J., & Herring, A. A. (2021) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2021.05.024 · Cited by 94 · see citing works
Racial/ethnic differences in prescription opioid misuse and heroin use among a national sample, 1999–2018
Schuler, M. S., Schell, T. L., & Wong, E. C. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108588 · Cited by 91 · see citing works
Overdose mortality rates for opioids and stimulant drugs are substantially higher in men than in women: state-level analysis
Butelman, E. R., Huang, Y., Epstein, D. H., Shaham, Y., Goldstein, R. Z., Volkow, N. D., & Nelly Alia-klein, A. (2023) · Neuropsychopharmacology · doi:10.1038/s41386-023-01601-8 · Cited by 91 · see citing works
Surging Racial Disparities in the U.S. Overdose Crisis
Friedman, J. R., Beletsky, L. A., & Jordan, A. (2022) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2021.21040381 · Cited by 84 · see citing works
Elevated Mortality Among People Experiencing Homelessness With COVID-19
Leifheit, K. M., Chaisson, L. H., Medina, J., Wahbi, R., & Shover, C. L. (2021) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofab301 · Cited by 80 · see citing works
Self-citation
Racial/Ethnic, Social, and Geographic Trends in Overdose-Associated Cardiac Arrests Observed by US Emergency Medical Services During the COVID-19 Pandemic
Friedman, J. R., Mann, N. C., Hansen, H., Bourgois, P. I., Braslow, J. T., Bui, A. A. T., Beletsky, L. A., & Schriger, D. L. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0967 · Cited by 78 · see citing works
Low Dose Initiation of Buprenorphine: A Narrative Review and Practical Approach
Cohen, S. M., Weimer, M. B., Levander, X. A., Peckham, A. M., Tetrault, J. M., & Morford, K. L. (2021) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000945 · Cited by 76 · see citing works
Effectiveness of Policies for Addressing the US Opioid Epidemic: A Model-Based Analysis from the Stanford-Lancet Commission on the North American Opioid Crisis
Rao, I. J., Humphreys, K. N., & Brandeau, M. L. (2021) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2021.100031 · Cited by 75 · see citing works
Self-citation
Fatal and nonfatal opioid overdose risk following release from prison: A retrospective cohort study using linked administrative data
Hartung, D. M., McCracken, C. M., Nguyen, T. D., Kempany, K. G., & Waddell, E. N. (2023) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2023.208971 · Cited by 75 · see citing works
Low-dose Buprenorphine Initiation in Hospitalized Adults With Opioid Use Disorder: A Retrospective Cohort Analysis
Button, D. A., Hartley, J., Robbins, J. L., Levander, X. A., Smith, N., & Englander, H. L. (2021) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000864 · Cited by 73 · see citing works
Health risks associated with smoking versus injecting fentanyl among people who use drugs in California
Megerian, C. E., Bair, L., Smith, J., Browne, E. N., Wenger, L. D., Guzman, L., Kral, A. H., & Lambdin, B. H. (2023) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2023.111053 · Cited by 68 · see citing works
Legality of drug checking equipment in the United States: A systematic legal analysis
Davis, C. S., Lieberman, A. J., & O’Kelley-Bangsberg, M. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109425 · Cited by 64 · see citing works
Innovation and adaptation: The rise of a fentanyl smoking culture in San Francisco
Ciccarone, D., Holm, N., Ondocsin, J., Schlosser, A. V., Fessel, J. N., Cowan, A., & Mars, S. G. (2024) · PLoS ONE · doi:10.1371/journal.pone.0303403 · Cited by 56 · see citing works
Drug Decriminalization, Fentanyl, and Fatal Overdoses in Oregon
Zoorob, M. J., Park, J. N., Kral, A. H., Lambdin, B. H., & del Pozo, B. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.31612 · Cited by 52 · see citing works
Growing racial/ethnic disparities in overdose mortality before and during the COVID-19 pandemic in California
Friedman, J. R., Hansen, H., Bluthenthal, R. N., Harawa, N. T., Jordan, A., & Beletsky, L. A. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106845 · Cited by 52 · see citing works
Collateral Damage: A Narrative Review on Epidemics of Substance Use Disorders and Their Relationships to Sexually Transmitted Infections in the United States
Strathdee, S. A., Bristow, C., Gaines, T. L., & SHOPTAW, S. J. (2020) · Sexually Transmitted Diseases · doi:10.1097/olq.0000000000001341 · Cited by 50 · see citing works
Potency-Enhancing Synthetics in the Drug Overdose Epidemic: Xylazine (“Tranq”), Fentanyl, Methamphetamine, and the Displacement of Heroin in Philadelphia and Tijuana
Montero, F., Bourgois, P. I., & Friedman, J. R. (2022) · Journal of Illicit Economies and Development · doi:10.31389/jied.122 · Cited by 48 · see citing works
“They say it’s fentanyl, but they honestly look like Perc 30s”: Initiation and use of counterfeit fentanyl pills
Daniulaityte, R., Sweeney, K. R., Ki, S., Doebbeling, B. N., & Mendoza, N. S. (2022) · Harm Reduction Journal · doi:10.1186/s12954-022-00634-4 · Cited by 47 · see citing works
Project ECHO and Primary Care Buprenorphine Treatment for Opioid use Disorder: Implementation and Clinical Outcomes
Anderson, J., Martin, S. A., Gadomski, A., Krupa, N. L., Mullin, D. J., Cahill, A., & Jenkins, P. (2021) · Substance Abuse · doi:10.1080/08897077.2021.1931633 · Cited by 47 · see citing works
Testing the test strips: laboratory performance of fentanyl test strips
Halifax, J. C., Lim, L., Ciccarone, D., & Lynch, K. L. (2024) · Harm Reduction Journal · doi:10.1186/s12954-023-00921-8 · Cited by 45 · see citing works
Decriminalization of drug possession in Oregon: Analysis and early lessons
Russoniello, K., Vakharia, S. P., Netherland, J., Naidoo, T., Wheelock, H., Hurst, T., & Rouhani, S. (2023) · Drug Science, Policy and Law · doi:10.1177/20503245231167407 · Cited by 44 · see citing works
“Notice of major cleaning”: A qualitative study of the negative impact of encampment sweeps on the ontological security of unhoused people who use drugs
Goldshear, J. L., Kitonga, N., Angelo, N., Cowan, A., Henwood, B. F., & Bluthenthal, R. N. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116408 · Cited by 43 · see citing works
The introduction of fentanyl on the US–Mexico border: An ethnographic account triangulated with drug checking data from Tijuana
Friedman, J. R., Bourgois, P. I., Godvin, M., Chavez, A., Pacheco, L., Segovia, L. A., Beletsky, L. A., & Arredondo, J. (2022) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2022.103678 · Cited by 43 · see citing works
Fentanyl, heroin, and methamphetamine-based counterfeit pills sold at tourist-oriented pharmacies in Mexico: An ethnographic and drug checking study
Friedman, J. R., Godvin, M., Molina, C. A., Romero, R., Bórquez, A., Avra, T. D., Goodman‐Meza, D., Strathdee, S. A., Bourgois, P. I., & Shover, C. L. (2023) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2023.110819 · Cited by 42 · see citing works
Self-citation
Decrease in injection and rise in smoking and snorting of heroin and synthetic opioids, 2000–2021
Karandinos, G., Unick, J., Ondocsin, J., Holm, N., Mars, S. G., Montero, F., Rosenblum, D., & Ciccarone, D. (2024) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2024.111419 · Cited by 42 · see citing works
Identifying counties at risk of high overdose mortality burden during the emerging fentanyl epidemic in the USA: a predictive statistical modelling study
Marks, C., Abramovitz, D. A., Donnelly, C. A., Carrasco‐Escobar, G., Carrasco-Hernández, R., Ciccarone, D., González-Izquierdo, A., Martin, N. K., Strathdee, S. A., Smith, D. M., et al. (2021) · The Lancet Public Health · doi:10.1016/s2468-2667(21)00080-3 · Cited by 42 · see citing works
National and regional trends in fentanyl seizures in the United States, 2017–2023
Palamar, J. J., Fitzgerald, N. D., Carr, T. H., Cottler, L. B., & Ciccarone, D. (2024) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2024.104417 · Cited by 41 · see citing works
Emerging Characteristics of Isotonitazene-Involved Overdose Deaths: A Case-Control Study
Shover, C. L., Falasinnu, T., Freedman, R. B., & Humphreys, K. N. (2020) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000775 · Cited by 39 · see citing works
Self-citation
Mortality among people who inject drugs: a prospective cohort followed over three decades in Baltimore, MD, USA
Sun, J., Mehta, S. H., Astemborski, J. A., Piggott, D. A., Genberg, B. L., Woodson‐Adu, T., Benson, E., Thomas, D. L., Celentano, D. D., Vlahov, D., et al. (2021) · Addiction · doi:10.1111/add.15659 · Cited by 38 · see citing works
The opioid epidemic among the Latino population in California
Valdez, A., Cepeda, A., Frankeberger, J., & Nowotny, K. M. (2022) · Drug and Alcohol Dependence Reports · doi:10.1016/j.dadr.2022.100029 · Cited by 32 · see citing works
Using death scene and toxicology evidence to define involvement of heroin, pharmaceutical morphine, illicitly manufactured fentanyl and pharmaceutical fentanyl in opioid overdose deaths, 38 states and the District of Columbia, January 2018–December 2019
O’Donnell, J. K., Gladden, R. M., Kariisa, M., & Mattson, C. L. (2021) · Addiction · doi:10.1111/add.15768 · Cited by 32 · see citing works
Advancing humanized monoclonal antibody for counteracting fentanyl toxicity towards clinical development
Hicks, D. M., Baehr, C., Silva-Ortiz, P., Khaimraj, A., Luengas, D., Hamid, F. A. A. A., & Pravetoni, M. (2022) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2022.2122507 · Cited by 31 · see citing works
Fentanyl epidemic hits the U.S. West Coast: Opioid-related deaths in San Francisco from 2009–2019
West, K. L., Lindquist, K. J., & Rodda, L. N. (2021) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2021.103402 · Cited by 30 · see citing works
“It wasn’t here, and now it is. It’s everywhere”: fentanyl’s rising presence in Oregon’s drug supply.
Shin, S. S., LaForge, K., Stack, E., Pope, J., Leichtling, G., Larsen, J. E., Leahy, J. M., Seaman, A., Hoover, D., Chisholm, L., et al. (2022) · Harm Reduction Journal · doi:10.1186/s12954-022-00659-9 · Cited by 25 · see citing works
Preventing Overdose Using Information and Data from the Environment (PROVIDENT): protocol for a randomized, population‐based, community intervention trial
Marshall, B. D. L., Alexander-Scott, N. E., Yedinak, J. L., Hallowell, B. D., Goedel, W. C., Allen, B., Schell, R. C., Li, Y., Krieger, M. S., Pratty, C., et al. (2021) · Addiction · doi:10.1111/add.15731 · Cited by 25 · see citing works
Knowledge, attitudes, and behaviors related to the fentanyl-adulterated drug supply among people who use drugs in Oregon
LaForge, K., Stack, E., Shin, S. S., Pope, J., Larsen, J. E., Leichtling, G. J., Leahy, J. M., Seaman, A., Hoover, D., Byers, M., et al. (2022) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2022.108849 · Cited by 25 · see citing works
Endogenous opiates and behavior: 2020
Bodnar, R. J. (2022) · Peptides · doi:10.1016/j.peptides.2022.170752 · Cited by 24 · see citing works
Trends in mortality from alcohol, opioid, and combined alcohol and opioid poisonings by sex, educational attainment, and race and ethnicity for the United States 2000–2019
Buckley, C. M., Ye, Y., Kerr, W. C., Mulia, N., Puka, K., Rehm, J. T., & Probst, C. (2022) · BMC Medicine · doi:10.1186/s12916-022-02590-z · Cited by 24 · see citing works
A National Study of Homelessness, Social Determinants of Health, and Treatment Engagement Among Outpatient Medication for Opioid Use Disorder-Seeking Individuals in the United States
Gazzola, M. G., Carmichael, I. D., Christian, N. J., Zheng, X., Madden, L. M., & Barry, D. T. (2023) · Substance Abuse · doi:10.1177/08897077231167291 · Cited by 23 · see citing works
UV Stabilizer BTMPS in the Illicit Fentanyl Supply in 9 US Locations
Shover, C. L., Godvin, M., Appley, M. G., Pyfrom, E. M., Montero, F., Hochstatter, K. R., Nadel, T., Garg, N. K., Koncsol, A. J., Friedman, J. R., et al. (2025) · JAMA · doi:10.1001/jama.2024.27550 · Cited by 22 · see citing works
Self-citation
Covalently Loaded Naloxone Nanoparticles as a Long-Acting Medical Countermeasure to Opioid Poisoning
Kassick, A. J., Wu, M. M., Luengas, D., Ebqa’ai, M., Nirmani, L. P. T., Tomycz, N. D., Nelson, T. L., Pravetoni, M., Raleigh, M. D., & Averick, S. E. (2021) · ACS Pharmacology & Translational Science · doi:10.1021/acsptsci.1c00168 · Cited by 22 · see citing works
Sociodemographic and geographic disparities in excess fatal drug overdoses during the COVID-19 pandemic in California: A population-based study
Kiang, M. V., Acosta, R. J., Chen, Y., Matthay, E. C., Tsai, A. C., Basu, S., Glymour, M. M., Bibbins-Domingo, K. B., Humphreys, K. N., & Arthur, K. N. (2022) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2022.100237 · Cited by 22 · see citing works
Self-citation
Behavior change after fentanyl testing at a safe consumption space for women in Northern Mexico: A pilot study
Goodman‐Meza, D., Arredondo, J., Slim, S., Angulo, L., Gonzalez-Nieto, P., de Loera, A. G., SHOPTAW, S. J., Cambou, M. C., & Pitpitan, E. V. (2022) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2022.103745 · Cited by 22 · see citing works
Brief History of Opioids in Perioperative and Periprocedural Medicine to Inform the Future
Boysen, P. G., Patel, J. H., & King, A. N. (2022) · Ochsner Journal · doi:10.31486/toj.22.0065 · Cited by 22 · see citing works
Opioid-related deaths before and after COVID-19 stay-at-home orders in Los Angeles County
Kelley, M. A., Lucas, J. R., Stewart, E. A., Goldman, D. P., & Doctor, J. N. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.109028 · Cited by 21 · see citing works
Predictors of having naloxone in urban and rural Oregon findings from NHBS and the OR-HOPE study
Lipira, L. E., Leichtling, G. J., Cook, R., Leahy, J. M., Orellana, E. R., Korthuis, P. T., & Menza, T. W. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108912 · Cited by 21 · see citing works
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease
Cook, R., Torralva, R., King, C., Lum, P. J., Tookes, H. E., Foot, C. A., Vergara‐Rodriguez, P., Rodriguez, A. E., Fanucchi, L. C., Lucas, G. M., et al. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.109077 · Cited by 20 · see citing works
Voting with their feet: Social factors linked with treatment for opioid use disorder using same-day buprenorphine delivered in California hospitals
Kalmin, M. M., Goodman‐Meza, D., Anderson, E. S., Abid, A., Speener, M., Snyder, H. R., Campbell, A., Moulin, A. K., SHOPTAW, S. J., & Herring, A. A. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108673 · Cited by 18 · see citing works
Estimating the impact of stimulant use on initiation of buprenorphine and extended-release naltrexone in two clinical trials and real-world populations
Cook, R., Foot, C. A., Arah, O. A., Humphreys, K. N., Rudolph, K. E., Luo, S. X., Tsui, J. I., Levander, X. A., & Korthuis, P. T. (2023) · Addiction Science & Clinical Practice · doi:10.1186/s13722-023-00364-3 · Cited by 18 · see citing works
Self-citation
Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants
Cano, M., Timmons, P., Hooten, M., & Sweeney, K. (2023) · Drug and Alcohol Dependence Reports · doi:10.1016/j.dadr.2023.100197 · Cited by 17 · see citing works
Covid-19-related changes to drug-selling networks and their effects on people who use illicit opioids
Frank, D. A., Krawczyk, N., Arshonsky, J., Bragg, M. A., Friedman, S. R., & Bunting, A. M. (2022) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.21-00438 · Cited by 17 · see citing works
High variation in purity of consumer-level illicit fentanyl samples in Los Angeles, September 2023–April 2025
Shover, C. L., Koncsol, A. J., Godvin, M., Goodman‐Meza, D., Pardo, B., Poimboeuf, M., Molina, C. A., Romero, R., Feng, J., & Friedman, J. R. (2025) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2025.104977 · Cited by 15 · see citing works
Self-citation
Cost-effectiveness of office-based buprenorphine treatment for opioid use disorder
Qian, G. L., Rao, I. J., Humphreys, K. N., Owens, D. K., & Brandeau, M. L. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109762 · Cited by 15 · see citing works
Self-citation
Recent Drug Overdose Mortality Decline Compared With Pre–COVID-19 Trend
Kiang, M. V., & Humphreys, K. N. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.58090 · Cited by 15 · see citing works
Self-citation
Development and Validation of Machine Models Using Natural Language Processing to Classify Substances Involved in Overdose Deaths
Goodman‐Meza, D., Shover, C. L., Medina, J., Tang, A. B., SHOPTAW, S. J., & Bui, A. A. T. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.25593 · Cited by 15 · see citing works
Self-citation
Opioid Use Disorder: Pernicious and Persistent
Bergeria, C. L., & Strain, E. C. (2022) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20220699 · Cited by 15 · see citing works
Overdose deaths involving synthetic opioids: Racial/ethnic and educational disparities in the eastern and western US
Cano, M. N., Mendoza, N. S., Ignacio, M., Rahman, A., & Daniulaityte, R. (2023) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2023.110955 · Cited by 15 · see citing works
Healthcare Utilization of Patients with Opioid Use Disorder in US Hospitals from 2016 to 2019: Focusing on Racial and Regional Variances
Kim, S. J., Medina, M., & Chang, J. (2022) · Clinical Drug Investigation · doi:10.1007/s40261-022-01192-0 · Cited by 14 · see citing works
Xylazine Complicating Opioid Ingestions in Young Children
Deutsch, S. A., & Jong, A. R. D. (2022) · PEDIATRICS · doi:10.1542/peds.2022-058684 · Cited by 14 · see citing works
Real-World Study of Multiple Naloxone Administrations for Opioid Overdose Reversal among Emergency Medical Service Providers
Abdelal, R., Banerjee, A. R., Carlberg-Racich, S., Cebollero, C., Darwaza, N., Kim, C., Ito, D., & Epstein, J. (2022) · Substance Abuse · doi:10.1080/08897077.2022.2060433 · Cited by 14 · see citing works
Global burden, socioeconomic disparities, and spatiotemporal dynamics of opioid use disorder mortality and disability: a comprehensive analysis from the global burden of disease study 2017-2021
Zhang, J., Liu, R., Wang, X., Zhang, L., Pei, W., Hou, J., & Li, S. (2025) · BMC Public Health · doi:10.1186/s12889-025-24541-y · Cited by 13 · see citing works
“It's my frenemy”: A qualitative exploration of knowledge and perceptions of fentanyl use during the COVID-19 pandemic in people who use drugs at a syringe services program in Philadelphia, PA
Bass, S. B., Kelly, P. J. A., Pandit-Kerr, S., Pilla, J., Morris, K., Larsen, E., Wisdom, J. P., & Torralva, P. R. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.882421 · Cited by 13 · see citing works
Has the United States Reached a Plateau in Overdoses Caused by Synthetic Opioids After the Onset of the COVID-19 Pandemic? Examination of Centers for Disease Control and Prevention Data to November 2021
Brown, K. G., Chen, C. Y., Dong, D., Lake, K. J., & Butelman, E. R. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.947603 · Cited by 12 · see citing works
The Evolution of Excess Deaths in the United States During the First 2 Years of the COVID-19 Pandemic
Ruhm, C. J. (2023) · American Journal of Epidemiology · doi:10.1093/aje/kwad127 · Cited by 12 · see citing works
A Two-Year Review of Fentanyl in Driving under the Influence and Postmortem Cases in Orange County, CA, USA
Havro, V., Casassa, N., Andera, K. M., & Mata, D. C. (2022) · Journal of Analytical Toxicology · doi:10.1093/jat/bkac030 · Cited by 11 · see citing works
An electroencephalogram biomarker of fentanyl drug effects
Balanza, G. A., Bharadwaj, K. M., Mullen, A. C., Beck, A. M., Work, E. C., McGovern, F. J., Houle, T. T., Eric, T., & Purdon, P. L. (2022) · PNAS Nexus · doi:10.1093/pnasnexus/pgac158 · Cited by 11 · see citing works
Buprenorphine discontinuation in telehealth-only treatment for opioid use disorder: A longitudinal cohort analysis
Chan, B. L., Cook, R., Levander, X. A., Wiest, K. L., Hoffman, K. A., Pertl, K., Petluri, R., McCarty, D. W., Korthuis, P. T., & Martin, S. A. (2024) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2024.209511 · Cited by 11 · see citing works
Hospital policies for opioid use disorder treatment: A policy content analysis and environmental scan checklist
Priest, K. C., Englander, H. L., & McCarty, D. W. (2021) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2021.02.007 · Cited by 11 · see citing works
A qualitative exploration of unintentional versus intentional exposure to fentanyl among people who use drugs in Austin, TX
Cance, J. D., Bingaman, A., Kane, H., Hairgrove, S., Torrez, S. B., Buck, A., Zagorski, C. M., Loera, L. J., & Hill, L. G. (2022) · Journal of the American Pharmacists Association · doi:10.1016/j.japh.2022.10.005 · Cited by 11 · see citing works
Low-dose Initiation of Buprenorphine in Hospitalized Patients Using Buccal Buprenorphine: A Case Series
Adams, K. K., Cohen, S. M., Guerra, M. E., & Weimer, M. B. (2023) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000001146 · Cited by 11 · see citing works
Drug-related deaths among housed and homeless individuals in the UK and the USA: comparative retrospective cohort study
Roberts, E., Copeland, C. S., Humphreys, K. N., & Shover, C. L. (2023) · The British Journal of Psychiatry · doi:10.1192/bjp.2023.111 · Cited by 11 · see citing works
Self-citation
Generating Timely Estimates of Overdose Deaths for the US Using Urine Drug Test Data
Myers, J. V., Marks, C., Kim, J. H., Fareed, N., Thomas, N. A., Whitley, P., & Fernández, S. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.14402 · Cited by 10 · see citing works
URINE TOXICOLOGY PROFILES OF EMERGENCY DEPARTMENT PATIENTS WITH UNTREATED OPIOID USE DISORDER: A MULTI-SITE VIEW
Cowan, E. A., Perrone, J., Dziura, J. D., Edelman, E. J., Hawk, K. F., Herring, A. A., McCormack, R. P., Murphy, A., Phadke, M. A., Fiellin, D. A., et al. (2023) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2023.06.007 · Cited by 10 · see citing works
Policy Responses to the Addiction Crisis
Frank, R. G., Humphreys, K. N., & Pollack, H. A. (2021) · Journal of Health Politics Policy and Law · doi:10.1215/03616878-8970796 · Cited by 10 · see citing works
Self-citation
Hospital-Based Methadone and Buprenorphine Initiation Practices by Addiction Consult Services
Cohen, S. M., Straus, E. R., Fiellin, D. A., Pomeranz, J. L., Suzuki, J., Tetrault, J. M., Weimer, M. B., Edelman, E. J., & Joudrey, P. J. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.26077 · Cited by 9 · see citing works
Barriers to Buprenorphine Initiation in Patients Using Fentanyl
Kawasaki, S. S., Liebschutz, J. M., Murray-Krezan, C. M., Switzer, G. E., Nash, S., Jeong, K., & Winstanley, E. L. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.52136 · Cited by 9 · see citing works
Chronic low back pain comorbidity count and its impact on exacerbating opioid and non‐opioid prescribing behavior
Moses-Hampton, M., Povieng, B., Ghorayeb, J. H., Zhang, Y., & Wu, H. (2022) · Pain Practice · doi:10.1111/papr.13185 · Cited by 9 · see citing works
Longitudinal changes in co-involved drugs, comorbidities, and demographics of methamphetamine-related deaths in Los Angeles County
Shover, C. L., Friedman, J. R., Romero, R., Buhr, R. G., Chu, B., Tang, A. B., Medina, J., Wisk, L. E., Lucas, J., & Goodman‐Meza, D. (2023) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2023.209101 · Cited by 9 · see citing works
Self-citation
“Just another thing for me to stress off of”: Responses to unintentional fentanyl use in a community-based study of people who use opioids
Lorvick, J., Hemberg, J., George, M. J., Piontak, J. R., & Comfort, M. L. (2023) · Harm Reduction Journal · doi:10.1186/s12954-023-00863-1 · Cited by 9 · see citing works
Leveraging pooled medical examiner records to surveil complex and emerging patterns of polysubstance use in the United States
Shover, C. L., Friedman, J. R., Romero, R., Jiménez, S. A., Beltran, J., Garcia, C., & Goodman‐Meza, D. (2024) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2024.104397 · Cited by 9 · see citing works
Self-citation
Fluorofentanyl and novel synthetic opioids in accidental overdose deaths
Yu, J., Diekhans, K., Tsang, A., & Rodda, L. N. (2024) · Journal of Analytical Toxicology · doi:10.1093/jat/bkae062 · Cited by 9 · see citing works
Simulating the impact of Addiction Consult Services in the context of drug supply contamination, hospitalizations, and drug-related mortality
King, C. A., Cook, R., Wheelock, H., Korthuis, P. T., Leahy, J. M., Goff, A., Morris, C. D., & Englander, H. L. (2021) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2021.103525 · Cited by 9 · see citing works
Enumerating contributions of fentanyls and other factors to the unprecedented 2020 rise in opioid overdose deaths: model-based analysis
Stringfellow, E. J., Lim, T. Y., DiGennaro, C., Hasgül, Z., & Jalali, M. S. (2023) · PNAS Nexus · doi:10.1093/pnasnexus/pgad064 · Cited by 9 · see citing works
Charting the decline of the fourth wave: US overdose deaths by race, ethnicity and substance involvement
Friedman, J. R., Palamar, J. J., Ciccarone, D., Gaines, T. L., Bórquez, A., Shover, C. L., & Strathdee, S. A. (2026) · Addiction · doi:10.1111/add.70472 · Cited by 8 · see citing works
Self-citation
Medical examiner response to the drug overdose epidemic in King County Washington: “Real‐time” surveillance, data science, and applied forensic epidemiology
Harruff, R. C., Yarid, N. A., Barbour, W. L., & Martin, Y. H. (2023) · Journal of Forensic Sciences · doi:10.1111/1556-4029.15329 · Cited by 8 · see citing works
Association of medications for opioid use disorder with reduced risk of repeat opioid overdose in Medicaid: A cohort study
Tipping, A. D., Nowels, M., Moore, C., Samples, H., Crystal, S., Olfson, M., Williams, A. R., & Heaps‐Woodruff, J. M. (2023) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2023.209218 · Cited by 8 · see citing works
Utilising an access to care integrated framework to explore the perceptions of hepatitis C treatment of hospital-based interventions among people who use drugs
Levander, X. A., Vega, T. A., Seaman, A., Korthuis, P. T., & Englander, H. L. (2021) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2021.103356 · Cited by 8 · see citing works
Hepatitis C mortality trends in San Francisco: can we reach elimination targets?
Mirzazadeh, A., Facente, S. N., Burk, K., Kahn, J. G., & Morris, M. D. (2021) · Annals of Epidemiology · doi:10.1016/j.annepidem.2021.10.004 · Cited by 8 · see citing works
The Community-Based Medication-First program for opioid use disorder: a hybrid implementation study protocol of a rapid access to buprenorphine program in Washington State
Banta‐Green, C. J., Owens, M. D., Williams, J. R., Sears, J. M., Floyd, A. S., Williams‐Gilbert, W., & Kingston, S. (2022) · Addiction Science & Clinical Practice · doi:10.1186/s13722-022-00315-4 · Cited by 8 · see citing works
Evaluation of “Real-Time” Fatal Drug Overdose Surveillance by King County Medical Examiner's Office, Seattle, Washington
Harruff, R. C., Simpson, C. M., Gifford, A. L., Yarid, N. A., Barbour, W. L., & Heidere, C. (2022) · American Journal of Forensic Medicine & Pathology · doi:10.1097/paf.0000000000000798 · Cited by 8 · see citing works
Heroin injection to fentanyl smoking: Examining temporal trends in substance type and route of administration among people who inject drugs in Los Angeles, CA and Denver, CO, USA between 2021–2022
Ganesh, S. S., Smeltzer, R. P., Goldshear, J. L., Shah, P., Corsi, K. F., Huh, J., & Bluthenthal, R. N. (2025) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2025.104864 · Cited by 7 · see citing works

Fentanyl epidemic hits the U.S. West Coast: Opioid-related deaths in San Francisco from 2009–2019
West, K. L., Lindquist, K. J., & Rodda, L. N. (2021) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2021.103402 · Cited by 30 · see citing works
Our Response to Opioid Overdose Deaths Must Be as Nimble as Illicit Opioid Markets
Palacios, W. R. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.14634 · Cited by 1 · see citing works
Deaths From Synthetic Opioids Surge in Northeast, Ohio River Valley
D’Arrigo, T. (2019) · Psychiatric News · doi:10.1176/appi.pn.2019.4a2
Synthetic Opioid Overdose Deaths Soar
D’Arrigo, T. (2021) · Psychiatric News · doi:10.1176/appi.pn.2021.4.18
Fentanyl Market Diffusion and the Rise, Plateau, and Decline in Us Opioid Overdose MortalityPreprint
Sibley, A. L., Dasgupta, N., & Carroll, J. J. (2026) · SSRN Electronic Journal · doi:10.2139/ssrn.7401628

Authors: Shover, C. L., Falasinnu, T. O., Dwyer, C. L., Santos, N. B., Cunningham, N. J., Freedman, R. B., Vest, N. A., & Humphreys, K.
Affiliations: Stanford Medicine (US)
VA Palo Alto Health Care System (US)
University of California, Los Angeles (US)
Los Angeles LGBT Center (US)
Brown University (US)
Corresponding author: Shover, Chelsea L.
ORCID: Shover, Chelsea L.
Falasinnu, Titilola O.
Cunningham, Nicole J.
Freedman, Rohan B.
Vest, Noel A.
Humphreys, Keith
Venue: Drug and Alcohol Dependence
Publisher: Elsevier BV
Published: 2020-11
Volume: 216
Pages: 108314
ISSN: 0376-8716 (ISSN-L)
DOI: 10.1016/j.drugalcdep.2020.108314
PMC: PMC7521591
OpenAlex: W3090555497
Semantic Scholar: 14ab5e310f56292fe3ca12fc9baea747bfd402e5
Cited by: 162
References: 32
Citations by year: 2026: 16 · 2025: 20 · 2024: 24 · 2023: 31 · 2022: 36 · 2021: 32 · 2020: 3
FWCI: 19.09
Type: journal article
Language: en
Open access: green
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Drug and Alcohol Dependence (publishedVersion)
medRxiv (acceptedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
Wu Tsai Neurosciences Institute, Stanford University
National Institute on Drug Abuse
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Keywords: fentanyl, opioid overdose deaths, synthetic opioids, opioid epidemic, American West, heroin overdose, stimulant overdose, naloxone, access to addiction treatment, Medicaid expansion, public health education
MeSH terms: Analgesics, Opioid, Heroin, Female, Fentanyl, Humans, Longitudinal Studies, Male, Local Government, Opioid-Related Disorders, Population Surveillance, State Government, Illicit Drugs, United States, Drug Overdose

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Steep increases in fentanyl-related mortality west of the Mississippi River: recent evidence from county and state surveillance.

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks