The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.
Carfentanil and the rise and fall of overdose deaths in the United States
Open accessAbstract
Background and Aims: It is widely believed that the 2018 decline in overdose deaths in the United States was attributable to a range of public health interventions, however, this decline also coincided with the regulation and decline in use of potent fentanyl analogs, especially carfentanil. The aim of this study was to investigate the association between overdose deaths and carfentanil availability in the United States. Design: Secondary analysis of drug overdose deaths from the Center for Disease Control and Prevention (CDC) and carfentanil exhibit data from drug seizures submitted to drug crime labs and published by the Drug Enforcement Administration (DEA). Trends in overdose deaths were compared in states with high carfentanil exhibits with states with low or no carfentanil exhibits. Setting: United States. Participants: A total of 1 035 923 drug overdose death records in the United States from 1979 through 2019 were studied. Measurements: The outcomes studied were number of overdose deaths and mortality rates by state. Findings: Drug overdose deaths have been closely tracked along an exponential curve. The years 2016 and 2017 witnessed a hyper‐exponential surge with increases in overdose deaths of 11 228 (+21.4%) and 6605 (+10.4%), respectively. Subsequently in 2018, drug overdose deaths declined by −2870 (−4.1%). This rise and then fall coincided with a surge and then decline in carfentanil drug seizure exhibits during these same years: 0 (2015), 1292 (2016), 5857 (2017) and 804 (2018). The majority of carfentanil exhibits were localized to a few states. The 2018 decline in overdose deaths in the top five states with the greatest spike in carfentanil exhibits in 2017 (Ohio, Florida, Pennsylvania, Kentucky and Michigan) was 2848, which accounted for nearly all of the total US decline. Conclusions: The 2016–2017 acceleration and then 2018 decline in drug overdose deaths in the United States was associated with the sudden rise and then fall of carfentanil availability. Given the regional variation, carfentanil's decreased availability may have contributed to the reduction in overdose deaths in 2018.
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Prior evidence indicates that Ohio and Florida have experienced concentrated clusters of other high-potency synthetic opioids, including carfentanil.
“Consistent with this interpretation, prior evidence indicates that Ohio and Florida have experienced concentrated clusters of other high‐potency synthetic opioids, including carfentanil [39].”
From Temporal and geographical patterns of nitazene detections in drug samples and biospecimens in the United States, 2019–2024 (2026) · cites this paper as [39]
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“Consistent with this interpretation, prior evidence indicates that Ohio and Florida have experienced concentrated clusters of other high-potency synthetic opioids, including carfentanil [39].”
Metadata
- Authors
- Jalal, H., & Burke, D. S.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Jalal, Hawre
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2020-09-25
- Volume
- 116
- Issue
- 6
- Pages
- 1593-1599
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC8019064
- OpenAlex
- W3086650622
- Cited by
- 87
- References
- 17
- Citations by year
- 2026: 12 · 2025: 32 · 2024: 12 · 2023: 14 · 2022: 14 · 2021: 3
- FWCI
- 5.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (K01DA048985)
- National Cancer Institute (U01CA265750)
- 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
- carfentanil, drug overdose deaths, opioid overdose, fentanyl analogs, drug seizures, drug availability, opioid epidemic, drug policy, Ohio, Florida, Pennsylvania, Kentucky, Michigan
- MeSH terms
- Analgesics, Opioid, Crime, Fentanyl, Humans, United States, Drug Overdose
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