Objectives: There is a significant delay in finalization of drug overdose deaths, and a need to more quickly identify suspected overdoses to improve public health response. The objective of our study was to describe creation of a suspect overdose form and evaluate its use.
Design: Evaluation of a suspected overdose form used to record information related to death investigation with matching to state vital records. We calculated the toxicology turnaround time for matched records, and also calculated sensitivity, specificity, positive predictive value, and negative predictive value of the form compared to vital records as the gold standard.
Setting: Multnomah County, Oregon, deaths investigated by the County Medical Examiner between January 2020 and December 2021.
Main Outcome Measure: Sensitivity of the suspected overdose form.
Results: We analyzed 2818 matched death records in total during the study period. The average turnaround time for the 1673 records with toxicology results was 101 days. In 2020, sensitivity of the form was 74%, but this increased to nearly 95% in 2021.
Conclusions: Multnomah County's suspected evaluation form provides a timelier indicator of deaths suspected to be from drug overdose, has good sensitivity to detect true overdoses, and can help guide more rapid public health and public safety response activities.
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http://dx.doi.org/10.1097/PHH.0000000000001942 | DOI Listing |
Transplant Proc
January 2025
Department of Surgery, Tulane University, New Orleans, Louisiana. Electronic address:
Background: Organ procurement from brain-dead pregnant women is rare and typically occurs postfetal delivery. In this case report, we describe organ procurement from a brain-dead woman in her third trimester of pregnancy with a nonviable fetus remaining in utero.
Case Summary: We report a 33-year-old woman at 38 weeks gestation who suffered anoxic brain injury following cardiac arrest due to suspected opioid overdose.
HCA Healthc J Med
December 2024
HCA Florida Orange Park Hospital, Orange Park, FL.
Introduction: As illicit drug manufacturers find new ways to market their products and increase their profit margins, multiple contaminants have found their way into the illicit drug supply. The newest addition, xylazine, also known as "tranq," has spread through the city of Philadelphia and has recently been gaining ground across the United States, including in the state of Florida.
Case Presentation: This case describes a 37-year-old male with a significant past psychiatric history of severe polysubstance intravenous (IV) use, including fentanyl and methamphetamine.
Prehosp Emerg Care
January 2025
Department of Emergency Medicine, College of Medicine, The University of Arizona, Tucson, AZ.
Objectives: Buprenorphine is becoming a key component of prehospital management of opioid use disorder (OUD). It is unclear how many prehospital patients might be eligible for buprenorphine induction, as traditional induction requires that patients first have some degree of opioid withdrawal. The primary aim of this study was to quantify how many patients developed precipitated withdrawal after receiving prehospital naloxone for suspected overdose, as they could be candidates for prehospital buprenorphine.
View Article and Find Full Text PDFPrehosp Emerg Care
January 2025
Co-Principal Investigator, EMS Bridge, Alameda Health System - Highland Hospital, Emergency Medicine, 1141 E 31st. St, Oakland, CA, 94602.
Objectives: Opioids kill tens of thousands of patients each year. While only a fraction of people with opioid use disorder (OUD) have accessed treatment in the last year, 30% of people who died from an overdose had an Emergency Medical Services (EMS) encounter within a year of their death. Prehospital buprenorphine represents an important emerging OUD treatment, yet limited data describe barriers to this treatment.
View Article and Find Full Text PDFAm J Emerg Med
December 2024
Icahn School of Medicine at Mount Sinai, Center for Research on Emerging Substances, Poisoning, Overdose, and New Discoveries (RESPOND), NYC Health + Hospitals/Elmhurst, New York, NY, USA.
Background: Tramadol is an adulterant of illicit opioids. As it is a serotonin-norepinephrine reuptake inhibitor as well as a μ-opioid agonist, tramadol adulteration may worsen overdose signs and symptoms or affect the amount of naloxone patients receive.
Methods: This is a multicenter, prospective cohort of adult patients with suspected opioid overdoses who presented to one of eight United States emergency departments and were included in the Toxicology Investigators Consortium's Fentalog Study.
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