ArticleAddiction (Abingdon, England)2022
Using death scene and toxicology evidence to define involvement of heroin, pharmaceutical morphine, illicitly manufactured fentanyl and pharmaceutical fentanyl in opioid overdose deaths, 38 states and the District of Columbia, January 2018-December 2019.
Article in Addiction (Abingdon, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Multinational appraisal of the epidemiological distribution of opioid fatalities: a systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- Comparison of persons who died of drug overdoses with and without evidence of hepatitis C, United States, 2019-2024.Drug and alcohol dependence · 2026Article
- Fentanyl in forensic autopsies: Trends, circumstances, and toxicological findings.International journal of legal medicine · 2026Article
- Astrocytes and Astrocyte-Derived Extracellular Conduits in Opiate-Mediated Neurological Disorders.Cells · 2025Review
- Missouri naloxone distribution 2017-2023: Evaluation and implications of applying a naloxone saturation model.Journal of substance use and addiction treatment · 2025Article
- Misclassification of opioid-involvement in drug-related overdose deaths in the United States: A scoping review.Annals of epidemiology · 2025Article
- Review
- Routes of Drug Use Among Drug Overdose Deaths - United States, 2020-2022.MMWR. Morbidity and mortality weekly report · 2024Article
- Comparing the effects of decreasing prescription opioid shipments and the release of an abuse deterrent OxyContin formulation on opioid overdose fatalities in WV: an interrupted time series study.Substance abuse treatment, prevention, and policy · 2024Article
- Associations between opioid overdose deaths and drugs confiscated by law enforcement and submitted to crime laboratories for analysis, United States, 2014-2019: an observational study.Lancet regional health. Americas · 2023Article
- Methods for jurisdictional vulnerability assessment of opioid-related outcomes.Preventive medicine · 2023Article
- Trends and Characteristics of Buprenorphine-Involved Overdose Deaths Prior to and During the COVID-19 Pandemic.JAMA network open · 2023Article
- Drug Overdose Deaths Among Persons Aged 10-19 Years - United States, July 2019-December 2021.MMWR. Morbidity and mortality weekly report · 2022Article
- Misinterpretation of the "Overdose Crisis" Continues to Fuel Misunderstanding of the Role of Prescription Opioids.Journal of pain research · 2022Article
- Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls - United States, 2019-2020.MMWR. Morbidity and mortality weekly report · 2021Article
- Clarifying CDC's Efforts to Quantify Overdose Deaths.Public health reports (Washington, D.C. : 1974)Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND AND
aimsTracking specific drugs contributing to drug overdose deaths is limited when relying on death certificate (DC) data alone. This study aimed to determine whether integrating DC data with medical examiner/coroner reports, including postmortem toxicology and death investigation findings, would enhance identification of (1) heroin and pharmaceutical morphine involvement in overdose deaths and (2) fentanyl source (illicitly manufactured versus pharmaceutical).
designRetrospective analysis of heroin, pharmaceutical morphine, illicitly manufactured fentanyl (IMF) and pharmaceutical fentanyl involvement in fatal overdoses. DC and toxicology data were compared with enhanced definitions integrating overdose scene, witness and toxicology evidence.
settingUnited States: 38 states and the District of Columbia, participating in Centers for Disease Control and Prevention (CDC)-funded opioid overdose death surveillance. CASES: Opioid overdose decedents from funded jurisdictions; deaths during 1 January 2018-31 December 2019. MEASUREMENTS: Using medical examiner/coroner report data, deaths with 6-acetylmorphine and/or morphine detected by postmortem toxicology were defined as confirmed, probable or suspected heroin deaths, or probable pharmaceutical morphine deaths. Fentanyl was defined as probable or suspected IMF or probable pharmaceutical fentanyl.
findingsThe enhanced definition defined 18 393 deaths as confirmed, probable, or suspected heroin deaths (including 2678 with morphine listed as cause of death on the DC) and 404 as probable pharmaceutical morphine deaths. Among deaths with fentanyl detected, 89.3% were defined as probable or suspected IMF and 1.0% as probable pharmaceutical fentanyl. Fentanyl source could not be determined for 9.7% of deaths.
conclusionsIntegrating drug overdose scene, witness and toxicology findings can improve identification of specific drugs contributing to overdose deaths and enhance overdose intervention targeting.
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