ArticleClinical toxicology (Philadelphia, Pa.)2018
Self-identification of nonpharmaceutical fentanyl exposure following heroin overdose.
Article in Clinical toxicology (Philadelphia, Pa.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 46 citations in OpenAlex.
- Article
- Attitudes and experiences with fentanyl contamination of methamphetamine: exploring self-reports and urine toxicology among persons who use methamphetamine and other drugs.Harm reduction journal · 2023Article
- Comparison of the effects of fentanyls and otherFrontiers in pharmacology · 2023Article
- Consuming illicit opioids during a drug overdose epidemic: Illicit fentanyls, drug discernment, and the radical transformation of the illicit opioid market.The International journal on drug policy · 2022Article
- Characteristics of adults reporting illicitly manufactured fentanyl or heroin use or prescription opioid misuse in the United States, 2019.Drug and alcohol dependence · 2021Article
- Elevated prevalence of self-reported unintentional exposure to fentanyl among women who use drugs in a Canadian setting: A cross-sectional analysis.The International journal on drug policy · 2020Article
- Understanding the increase in opioid overdoses in New Hampshire: A rapid epidemiologic assessment.Drug and alcohol dependence · 2020Article
- Fentanyl depression of respiration: Comparison with heroin and morphine.British journal of pharmacology · 2020Article
- Associations between perceived illicit fentanyl use and infectious disease risks among people who inject drugs.The International journal on drug policy · 2019Article
- Street fentanyl use: Experiences, preferences, and concordance between self-reports and urine toxicology.The International journal on drug policy · 2019Article
- Potential uses of naltrexone in emergency department patients with opioid use disorder.Clinical toxicology (Philadelphia, Pa.) · 2019Review
- Agreement between self-reported psychoactive substance use and urine toxicology results for adults with opioid use disorder admitted to hospital.Toxicology communications · 2019Article
- Testing hair for fentanyl exposure: a method to inform harm reduction behavior among individuals who use heroin.The American journal of drug and alcohol abuse · 2019Article
- Fentanyl exposure among patients seeking opioid treatment.Journal of substance abuse treatment · 2019Article
- Fatalities caused by novel opioids: a review.Forensic sciences research · 2019Review
- Estimating the Risk of Exposure to Fentanyl in New York City: Testing Drug Residue in Used Syringes.American journal of public health · 2018Article
- Use of rapid fentanyl test strips among young adults who use drugs.The International journal on drug policy · 2018Article
- Prevalence and drug use correlates of inadvertent fentanyl exposure among individuals misusing drugs in seven U.S. states.Journal of addictive diseasesArticle
- "They Don't Give You No Note If It's Got Fentanyl": Using Cognitive Interviews to Understand Self-report and Urine Drug Screen Discrepancies.Substance use : research and treatmentArticle
Corrections and comments
- Erratum issuedCorrection.2018
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo compare user self-identification of nonpharmaceutical fentanyl exposure with confirmatory urine drug testing in emergency department (ED) patients presenting after heroin overdose.
methodsThis was a cross-sectional study of adult ED patients who presented after a heroin overdose requiring naloxone administration. Participants provided verbal consent after which they were asked a series of questions regarding their knowledge, attitudes and beliefs toward heroin and nonpharmaceutical fentanyl. Participants also provided urine samples, which were analyzed using liquid chromatography coupled to quadrupole time-of-flight mass spectrometry to identify the presence of fentanyl, heroin metabolites, other clandestine opioids, common pharmaceuticals and drugs of abuse.
resultsThirty participants were enrolled in the study period. Ten participants (33%) had never required naloxone for an overdose in the past, 20 participants (67%) reported recent abstinence, and 12 participants (40%) reported concomitant cocaine use. Naloxone was detected in all urine drug screens. Heroin or its metabolites were detected in almost all samples (93.3%), as were fentanyl (96.7%) and its metabolite, norfentanyl (93.3%). Acetylfentanyl was identified in nine samples (30%) while U-47700 was present in two samples (6.7%). Sixteen participants self-identified fentanyl in their heroin (sensitivity 55%); participants were inconsistent in their qualitative ability to identify fentanyl in heroin.
conclusionsHeroin users presenting to the ED after heroin overdose requiring naloxone are unable to accurately identify the presence of nonpharmaceutical fentanyl in heroin. Additionally, cutting edge drug testing methodologies identified fentanyl exposures in 96.7% of our patients, as well as unexpected clandestine opioids (like acetylfentanyl and U-47700).
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