I rarely use sensational headlines but this one deserves the term, “deadly.”
The U.S. Centers for Disease Control and Prevention (CDC) today issued an alert on a peculiar cluster of designer drug overdose deaths that will appear in tomorrow’s August 30th issue of Morbidity and Mortality Weekly Report (MMWR).
In March and early April this year, Rhode Island public health officials noted an unusually high number of drug overdose deaths, with 21 cases in one month relative to an average of nine. Ten deaths were associated with what was originally thought to be the prescription opioid drug, fentanyl.
Fentanyl is most often used in chronic pain management in the form of transdermal patches (Duragesic), “lollipops” (Actiq) or for intravenous, outpatient anesthesia owning to its short duration of action. As a recreational street drug, fentanyl is often called, “China White.”
However, subsequent detailed analysis by the CDC and Rhode Island public health officials revealed that the drug was a chemical relative called acetyl fentanyl. Four additional cases were identified later up through May 26th, bringing the acetyl fentanyl death total to 14. Katie Mulvaney of the Providence Journal reported earlier this week on the intended guilty plea of a 20-year-old man charged with distributing the fatal doses.
Authorities called these cases a “cluster” because all but one death occurred in the same small northern Rhode Island town with no cases in the state capital of Providence. Other drugs such as cocaine, other opioids, alcohol, and benzodiazepines were found in the majority of victims, but one person died solely from acetyl fentanyl.
While first identified in Rhode Island, the Pennsylvania Department of Drug and Alcohol Programs reported on June 27th that acetyl fentanyl was implicated in 50 fatal overdoses and five non-fatal overdoses across that state this year (PDF).
Most concerning to public health officials is that acetyl fentanyl is truly a new designer drug in that no previous reports exist documenting overdose deaths with this chemical. Even the internationally-known recreational drug information site Erowid.org does not currently have any entries on this chemical.
Acetyl fentanyl is not sold as a drug anywhere in the world and is only found as a very minor impurity (0.04 in prescription fentanyl products. But it’s a highly potent drug with little room for dosing errors: Animal experiments indicate that it’s five times more potent than heroin.
The story continues: http://www.forbes.com/sites/davidkr...-on-deadly-new-designer-drug-acetyl-fentanyl/