WV medical examiner predicts spike in fentanyl ODs

CHARLESTON, W.Va. — During the Appalachian Addiction and Prescription Drug Abuse Conference this weekend, West Virginia’s Chief Medical Examiner Dr. Allen Mock predicted that fentanyl will be the No. 1 cause of overdose deaths next year.

Between 2001-2014, the average number of fentanyl-related deaths was 42. But in 2015, the death toll quadrupled to 168.

“I’ll go on the record saying fentanyl will be our problem next year,” Mock told the group of physicians, nurses and addiction specialists who gathered Saturday in Charleston for the conference. “Fentanyl and the analogs will be our next killer.”

 Fentanyl, a synthetic opioid analgesic, is up to 50 times more potent than heroin. Last year, heroin took the lives of 193 West Virginians.

National Institute on Drug Abuse (NIDA) reports fentanyl is up to 100 times more potent than morphine, and is typically prescribed to patients after surgery or to treat severe pain.

When prescribed, the painkiller can be administered via injection, transdermal patch or in lozenges. But NIDA reports fentanyl and fentanyl analogs (similar in chemical structure) responsible for recent overdoses are produced in clandestine laboratories and are sold as a power or as a tablet that mimics other less potent drugs.

Fentanyl, like other opioid drugs, drives up dopamine levels in the brain, producing a euphoric state. Because of the drug’s high potency, NIDA says the risk of overdose is greatly increased.

Although the numbers of fentanyl-related deaths are expected to rise in coming years, Mock reported the number of oxycodone-, methadone-, and hydrocodone-related overdose deaths have declined.

Oxycodone-related overdose deaths peaked in West Virginia in 2010 and 2011 with 223 deaths each year. Those numbers have declined for the past three years, with 174 oxycodone-related deaths in 2015.

Methadone-related deaths peaked in 2005 and have been declining every since. Only 31 deaths last year were attributed to methadone overdose.

Hydrocodone-related deaths have fallen consistently since 2011, when the overdoes deaths peaked at 171. Last year, that number was down to 108.

An increasing number of overdose deaths have been attributed to gabapentin (name brand Neurontin) since 2011. The drug is an anti-epileptic medication, according to Drugs.com, but can also be used to treat nerve pain. Ninety-eight people died in 2015 due to gabapentin-related overdose.

 Clonazepam (brand name Klonopin), a drug used to treat seizures and anxiety, has also been attributing to a rising number of deaths in the past five years. Last year, 84 people died due to clonazepam-related overdose.

In all, West Virginia saw 686 overdose deaths in 2015. The numbers have steadily increased each year, according to the West Virginia Statistics Center, with a slight decline in 2009 with 479 deaths, and a peak in 2011 with 656 deaths.

Mock attributed the 2011 spike to the street sales of oxymorphone.

Southern West Virginia counties consistently had a higher overdose death rates than other parts of the state. In 2001, McDowell County had the highest rate, with 38 deaths per 100,000 residents. McDowell ranked No. 1 again in 2013 with a rate of 76.7.

Last year, Wyoming County jumped to No. 1, with a staggering overdose death rate of 90.3.

Mock also noted that more men than women in West Virginia die of overdose deaths, and the average age for men is 41.8 and for women is 43.3.

— Email: [email protected] and follow on Twitter @WendyHoldren

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