The nation’s expanding opioid epidemic has many ramifications for healthcare facilities, including the threat of violence by addicts seeking care, exposure of healthcare workers to powerful narcotics, and the potential for street opioids to exacerbate the longstanding problem of drug diversion by healthcare workers.

The CDC recently estimated that 60,000 overdose deaths occurred last year in the U.S., with the toll driven by a five-fold increase in overdose deaths involving synthetic opioids.1

“Illicitly manufactured fentanyl, a synthetic opioid 50-100 times more potent than morphine, is primarily responsible for this rapid increase,” the CDC noted. “In addition, fentanyl analogs such as acetylfentanyl, furanylfentanyl, and carfentanil are being detected increasingly in overdose deaths and the illicit opioid drug supply.”

In particular, carfentanil is estimated to be 10,000 times more potent than morphine, and healthcare workers have had to be revived with an emergency antidote after coming into contact with these patients. (For more information, see stories in the October 2017 issue of Hospital Employee Health.) The toll estimated for 2016 was extrapolated from surveillance data from 10 states. The overdose deaths estimated for 2016 almost double the 33,000 deaths the CDC previously estimated for 2015.2

“Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths in multiple states, with a variety of fentanyl analogs increasingly involved, if not solely implicated, in these deaths,” the CDC concluded. “This finding raises concern that in the near future, fentanyl analog overdose deaths might mirror the rapidly rising trajectory of fentanyl overdose deaths that began in 2013 and become a major factor in opioid overdose deaths.”

The CDC had expanded its drug and overdose surveillance to 32 states this year.

REFERENCES

1. CDC. O’Donnell JK, Halpin J, Mattson CL, et al. Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 — 10 States, July-December 2016. MMWR ePub: 27 October 2017. Available at: http://bit.ly/2idBfPT. Accessed Oct. 30, 2017.

2. CDC. Trends in Deaths Involving Heroin and Synthetic Opioids Excluding Methadone, and Law Enforcement Drug Product Reports, by Census Region — United States, 2006–2015. MMWR 2017;66(34):897-908.