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Fentanyl and fentanyl analogs in the illicit stimulant supply: results from U.S. drug seizure data, 2011-2016.

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Park, Ju Nyeong, Rashidi, Emaan, Foti, Kathryn, Zoorob, Michael, Sherman, Susan, Alexander, G. Caleb·2021·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2020.108416PMC PMC7751390
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Abstract

Background. U.S. research examining the illicit drug supply remain rare even though the information could help reduce overdoses. Relatively little is known regarding how often opioids are found in stimulants and whether temporal and geographic trends exist. We examined trends in fentanyl-cocaine and fentanyl-methampheatmine combinations in the national illicit drug supply. Methods. We analysed serial cross-sectional data from the National Forensic Laboratory Information System (NFLIS) collected between January 2011 and December 2016. We restricted the analysis to cocaine (N=1,389,968) and methamphetamine (n=1,407,474) samples and calculated proportions containing fentanyl (including 23 related analogs) over time. Results. The combined presence of fentanyl and cocaine steadily increased nationally between 2012-2016 (p=0.01), and the number of such samples tripled from 2015-2016 (n=423 to n=1,325). Similarly, the combined presence of fentanyl and methamphetamine increased 179% from 2015-2016 (n=82 to n=272). Patterns varied widely by state; in2016, fentanyl-cocaine samples were most common in New Hampshire (7.2%), Connecticut (5.4%), Ohio (2.6%) and Massachusetts (2.1%), whereas fentanyl-methamphetamine samples were most often in New Hampshire (6.1%), Massachusetts (5.6%), Vermont (2.4%) and Maine (1.2%). Conclusions. Although relatively uncommon, the presence of fentanyl in the stimulant supply increased significantly between 2011 and 2016, with the greatest increases occuring between 2015 to 2016; the presence of these products were concentrated in the U.S. Northeast. Given these trends, strengthening community-based drug checking programs and surveillance within the public health infrastructure could help promote timely responses to novel threats posed by rapid shifts in the drug supply that may lead to inadvertent exposures.

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  • Absolute counts of nitazene reports are correlated with overdose rates and are widely used proxies for street-level drug availability.

    “Absolute counts have been used in prior studies, are correlated with overdose rates and are widely used proxies for street‐level drug availability [21, 22, 23, 24].”

    From Temporal and geographical patterns of nitazene detections in drug samples and biospecimens in the United States, 2019–2024 (2026) · cites this paper as [21]

    The Methods and Results (pages unavailable) show that the paper used seizure-sample counts and found a state-level correlation between the proportion of stimulant samples containing fentanyl or its analogs and opioid overdose mortality rates. It does not establish a correlation for absolute counts of nitazene reports, or say that such counts are widely used proxies for street-level availability. The Discussion also cautions that seizure data may give a biased picture of the drug supply. (LLM, conf=0.85)

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Research works printed but not linked: 2

  1. Barratt MJ, Kowalski M, Maier LJ, Ritter A, 2018 Global review of drug checking services operating in 2017, Drug Policy Modelling Program Bulletin. National Drug and Alcohol Research Center, UNSW, Sydney, Australia.
  2. Park JN, Rouhani S, Beletsky L, Vincent L, Saloner B, Sherman SG, 2020b Situating the Continuum of Overdose Risk in the Social Determinants of Health: A New Conceptual Framework. Milbank Q 98(3), 700– 746. 32808709 PMC7482387

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Authors
Park, J. N., Rashidi, E., Foti, K., Zoorob, M., Sherman, S., & Alexander, G. C.
Affiliations
  • Johns Hopkins University (US)
  • Harvard University (US)
Corresponding author
Park, Ju Nyeong
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2021-01
Volume
218
Pages
108416
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2020.108416
PMC
PMC7751390
OpenAlex
W3106839464
Semantic Scholar
9c60a91c24ac33d2437826abfa4e1f7fb335d5c2
Cited by
128
References
42
Citations by year
2026: 16 · 2025: 17 · 2024: 23 · 2023: 33 · 2022: 24 · 2021: 14 · 2020: 1
FWCI
13.47
Type
journal article
Language
en
Open access
Licence
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Allergy and Infectious Diseases
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
fentanyl, fentanyl analogs, illicit drug supply, cocaine, methamphetamine, drug seizures, temporal trends, regional variation, northeastern United States, pharmacovigilance, opioid overdose
MeSH terms
Central Nervous System Stimulants, Analgesics, Opioid, Cocaine, Connecticut, Cross-Sectional Studies, Female, Fentanyl, Humans, Maine, Massachusetts, Methamphetamine, New Hampshire, Ohio, Public Health, Illicit Drugs, United States, Drug Overdose

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