Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants

Background: Illicitly-manufactured fentanyl and stimulants have replaced prescription opioids as the primary contributors to fatal overdoses in the United States (US), yet the street supply of these substances is challenging to quantify. Building on the foundation of prior research on law enforcemen...

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Main Authors: Manuel Cano, Patricia Timmons, Madeline Hooten, Kaylin Sweeney
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:Drug and Alcohol Dependence Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772724623000677
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author Manuel Cano
Patricia Timmons
Madeline Hooten
Kaylin Sweeney
author_facet Manuel Cano
Patricia Timmons
Madeline Hooten
Kaylin Sweeney
author_sort Manuel Cano
collection DOAJ
description Background: Illicitly-manufactured fentanyl and stimulants have replaced prescription opioids as the primary contributors to fatal overdoses in the United States (US), yet the street supply of these substances is challenging to quantify. Building on the foundation of prior research on law enforcement drug reports, the present study compares publicly available forensic laboratory drug report measures to identify which measures account for the most variation in drug overdose mortality between states, within states over time, and in various demographic groups. Methods: Drug reports from the National Forensic Laboratory Information System and drug overdose mortality rates from the Centers for Disease Control and Prevention were examined for all US states and the District of Columbia, 2013–2021 (459 state-years). State- and year- fixed effects models regressed drug overdose mortality rates (in the overall population and subpopulations by sex, age, and race/ethnicity) on various drug report measures, including rates per population and proportional shares of drug reports positive for fentanyl/fentanyl-related compounds, heroin, cocaine, methamphetamine, and xylazine. Results: For drug overdose death rates in the overall population and nearly all subpopulations examined by sex, race/ethnicity, and age, the model including all drug report proportional measures represented the best-performing model (as identified via the lowest Akaike Information Criterion and highest within R-squared value), followed by the model including only the fentanyl/fentanyl-related compounds proportion. Conclusions: Findings support the utility of publicly available drug report composition measures, particularly the proportion of fentanyl/fentanyl-related compounds, as predictors of drug overdose mortality in the US and in various subpopulations.
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spelling doaj.art-efb1dbcb20a44aca9ead035194428c462023-12-17T06:43:40ZengElsevierDrug and Alcohol Dependence Reports2772-72462023-12-019100197Drug supply measures and drug overdose mortality in the era of fentanyl and stimulantsManuel Cano0Patricia Timmons1Madeline Hooten2Kaylin Sweeney3School of Social Work, Arizona State University, 411N, Central Ave Suite 863, Phoenix, AZ 85004, USA; Corresponding author.College of Health Solutions, Arizona State University, USACollege of Health Solutions, Arizona State University, USACollege of Health Solutions, Arizona State University, USABackground: Illicitly-manufactured fentanyl and stimulants have replaced prescription opioids as the primary contributors to fatal overdoses in the United States (US), yet the street supply of these substances is challenging to quantify. Building on the foundation of prior research on law enforcement drug reports, the present study compares publicly available forensic laboratory drug report measures to identify which measures account for the most variation in drug overdose mortality between states, within states over time, and in various demographic groups. Methods: Drug reports from the National Forensic Laboratory Information System and drug overdose mortality rates from the Centers for Disease Control and Prevention were examined for all US states and the District of Columbia, 2013–2021 (459 state-years). State- and year- fixed effects models regressed drug overdose mortality rates (in the overall population and subpopulations by sex, age, and race/ethnicity) on various drug report measures, including rates per population and proportional shares of drug reports positive for fentanyl/fentanyl-related compounds, heroin, cocaine, methamphetamine, and xylazine. Results: For drug overdose death rates in the overall population and nearly all subpopulations examined by sex, race/ethnicity, and age, the model including all drug report proportional measures represented the best-performing model (as identified via the lowest Akaike Information Criterion and highest within R-squared value), followed by the model including only the fentanyl/fentanyl-related compounds proportion. Conclusions: Findings support the utility of publicly available drug report composition measures, particularly the proportion of fentanyl/fentanyl-related compounds, as predictors of drug overdose mortality in the US and in various subpopulations.http://www.sciencedirect.com/science/article/pii/S2772724623000677Drug overdose mortalityLaw enforcement drug seizuresNational forensic laboratory information systemFentanylCarfentanilXylazine
spellingShingle Manuel Cano
Patricia Timmons
Madeline Hooten
Kaylin Sweeney
Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants
Drug and Alcohol Dependence Reports
Drug overdose mortality
Law enforcement drug seizures
National forensic laboratory information system
Fentanyl
Carfentanil
Xylazine
title Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants
title_full Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants
title_fullStr Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants
title_full_unstemmed Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants
title_short Drug supply measures and drug overdose mortality in the era of fentanyl and stimulants
title_sort drug supply measures and drug overdose mortality in the era of fentanyl and stimulants
topic Drug overdose mortality
Law enforcement drug seizures
National forensic laboratory information system
Fentanyl
Carfentanil
Xylazine
url http://www.sciencedirect.com/science/article/pii/S2772724623000677
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