2017-2018 Acetyl Fentanyl Trends In Southwest Michigan: Is There A Larger Pattern?
BACKGROUND: Acetyl fentanyl is a synthetic fentanyl analog with no approved medical use and 16 times the potency of morphine. It was first reported in 2013, with outbreaks being reported across the United States and Europe at varying concentrations.
OBJECTIVE: This paper explores current trends of acetyl fentanyl in southwest Michigan.
MATERIALS AND METHODS: A study was conducted using WMed Swift Toxicology of Opioid-Related Mortalities (STORM) data on southwest Michigan decedents with acetyl fentanyl (9/1/2017- 9/30/2018). External laboratory results were used to ascertain quantitative levels of those drugs. Subset analysis was performed comparing before (group A) and after (group B) the midpoint of study.
RESULTS AND DISCUSSION: 38 patients fit the method criteria, but two did not have quantifiable levels of fentanyl. In group A (n=13), the mean acetyl fentanyl was 1.67 ng/mL (range 0.05- 6.00 ng/mL median: 1.5ng/mL). In group B (n=25), the mean acetyl fentanyl was 7.66 ng/mL (range 0.14 - 21.57 ng/mL median: 6.72ng/mL). Group B had significantly higher acetyl fentanyl levels with an odds ratio of 6.87 (3.87-9.87) p < 0.01. There was no difference in fentanyl levels (mean 16.28 ng/mL ± 19.34), which is similar to that reported in a 2015-2017 study done in Wayne County, MI (5.61 ng/mL ± 6.05).
CONCLUSION: The data suggest an increasing trend in the occurrence and concentration of acetyl fentanyl in Southwest Michigan, which is concerning because of its high potency. Longer studies are needed to look at acetyl fentanyl trends over time.