Emergency rooms rarely screen fentanyl overdose patients, study finds

  • Overdose patients are rarely tested for fentanyl exposure in emergency rooms.
  • A new study shows that most overdose patients receive outdated toxicology screening.
  • Fentanyl is a dangerous designer drug found in most illegally purchased narcotics.

When patients present to the emergency room with a drug overdose, they often undergo toxicology screening to determine which narcotic is responsible.

But the tests used rarely detect fentanyl – a synthetic opiate found in many illicit drugs. The drug is responsible for a rise in overdose deaths nationwide, revealed a recent study by Epic Research and the Center for Substance Abuse Research.

“Between 45 and 50 percent of patients who come in with a generic overdose diagnosis end up being tested with standard toxicology screening, but most of those were created in the 1980s when drug testing became commonplace,” Epic researcher David Little said. says Insider. “It includes traditional opioids – natural opioids, like morphine – but it doesn’t include synthetic opioids like fentanyl.”

In order to find out if fentanyl was in the patient’s system, the doctor would have to order a second screening specifically for this drug.

In an emergency department, the doctor’s primary goal is to keep his patient alive – usually by giving him an overdose reversal drug, naloxone – and to determine exactly which drug caused the overdose is secondary, a said Little.

“As a doctor in the emergency department, you can care for six, eight, or 10 patients at a time,” Little said. “And when a patient comes in with an overdose, you give them naloxone, and they get better. There’s not a compelling, immediate need to say, okay, was that hydrocodone? Was that- Was it oxycodone? Was it fentanyl?

But determining whether fentanyl is present in a patient’s system is important for their safety because fentanyl is particularly dangerous, Little said.

Fentanyl is 50 to 100 times more potent than morphine and is often mixed with other narcotics, such as heroin, to make them more potent, according to the United States. Drug Enforcement Administration.

The synthetic drug is much cheaper to produce and lighter to transport, so it is economically advantageous for those producing the drug, several drug experts told Insider.

While the presence of fentanyl in other opioids, such as heroin or illicit painkillers, has been a well-known threat in some parts of the country for the past five years, it is now beginning to appear in illicit drugs such as cocaine and cannabis. .

In 2020, more than 56,000 deaths in the United States involved a synthetic opioid – such as fentanyl, according to the Centers for Disease Control and Prevention.

Letting a patient know that fentanyl was in their system during their overdose could protect them from future harm because they will know how to avoid that dealer, Little said.

“It’s important for law enforcement to know if we’re seeing clusters of unexpected fentanyl exposures in any given hospital or neighborhood at any given time,” he said.

Little said the study conducted by Epic and the Center for Substance Abuse Research at the University of Maryland included data from 170 organizations and 315,000 emergency room visits.

He hopes awareness of the results will spur more doctors to consider offering additional fentanyl testing to overdose patients in emergency rooms, and potentially the development of a more effective drug test that will include fentanyl.

Denise W. Whigham