ArticleDrug and alcohol dependence2020
Steep increases in fentanyl-related mortality west of the Mississippi River: Recent evidence from county and state surveillance.
Article in Drug and alcohol dependence, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
98 citing papers in PubMed, 167 citations in OpenAlex.
- Estimating the impact of stimulant use on initiation of buprenorphine and extended-release naltrexone in two clinical trials and real-world populations.Addiction science & clinical practice · 2023Trial
- Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.Drug and alcohol dependence · 2021Trial
- A novel community mobilization framework to scale youth opioid prevention education in Texas.Preventive medicine reports · 2026Article
- Estimating the Daily Milligrams of Morphine Equivalent of Illicit Fentanyl Use in Los Angeles: Clinical and Epidemiological Implications.medRxiv : the preprint server for health sciences · 2026Article
- The 2025 Drug Overdose Spike That Wasn't: Neither Politics nor Data Errors Explain the Anomaly.American journal of public health · 2026Article
- Patterns of polysubstance use among people who use drugs on an American Indian reservation of a southern plains Tribal Nation.Harm reduction journal · 2026Article
- Examining Ethnic and Racial Variations in Opioid-related Hospitalizations Using Western U.S. Electronic Health Records.Journal of racial and ethnic health disparities · 2026Review
- Fentanyl use among people who inject drugs in two large Pacific Northwest metropolitan areas.Harm reduction journal · 2026Article
- Infectious disease complications associated with opioid use disorder at a southern county hospital: a retrospective chart review.BMC infectious diseases · 2026Article
- Barriers to Buprenorphine Initiation in Patients Using Fentanyl.JAMA network open · 2026Article
- Article
- Stability or versatility: transitions in fentanyl routes of administration.Harm reduction journal · 2025Article
- Review
- Geographic Trends in Opioid and Polysubstance Overdose Deaths in the US, 2014-2023.Journal of general internal medicine · 2025Article
- High variation in purity of consumer-level illicit fentanyl samples in Los Angeles, September 2023-April 2025.The International journal on drug policy · 2025Article
- Medicaid Expansion Boosted Specialty Treatment Episodes For Substance Use Disorder In Expansion States, 2010-22.Health affairs (Project Hope) · 2025Article
- 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.BMC public health · 2025Article
- Trends of all opioid-, heroin-, and fentanyl-involved nonfatal overdoses in the United States, October 2020 - April 2025.Drug and alcohol dependence · 2025Article
- "All it's gonna tell you is if it has fentanyl or not:" Perceptions of fentanyl and drug checking among first responders and people who use drugs.Journal of substance use and addiction treatment · 2025Article
- Hospital-Based Methadone and Buprenorphine Initiation Practices by Addiction Consult Services.JAMA network open · 2025Article
38 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundOverdose 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.
methodsWe 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.
resultsSeven 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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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.