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

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

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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

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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.

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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

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

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