Penn Medicine emergency department physicians are calling for more readily available testing strips to identify the presence of fentanyl in patients experiencing a drug overdose, and a rapid, coordinated response among health care providers and city agencies to help curb overdoses and identify high potency high risk drugs. Fentanyl testing strips are urine drug tests being used off-label to identify fentanyl and fentanyl analogues in the drug supply. In a letter to the editor published this week in the New England Journal of Medicine, the authors describe a recent cluster of 18 drug overdoses over a four-day period linked to crack cocaine laced with fentanyl that left three people dead.
Use of fentanyl, a synthetic and lethal opioid, has become a growing public health crisis in Philadelphia and other cities across the United States. Fentanyl—which is cheaper to produce than heroin and more addictive—has drenched much of the heroin and crack cocaine drug supply and was found in nearly 85 percent of Philadelphia’s 1,217 overdoses in 2017.
In the cluster described in the letter, all 18 patients who arrived at Penn Medicine emergency departments via EMS transport had substance-use disorders, but none had used opioids previously. Exposure to fentanyl poses risks of severe respiratory depression and death, especially among patients without opioid tolerance.
“This outbreak is indicative of a larger problem with fentanyl in the city that we need to continue to quickly act on,” said Jeanmarie Perrone, a professor of emergency medicine and director of the division of medical toxicology in the Perelman School of Medicine. “As demonstrated by this cluster, fentanyl overdoses are the leading cause of illness and death associated with opioid overdoses, which highlights the need for more testing strips that tell a user if their drug supply is tainted.”
Read more at Penn Medicine News.
