Report Details States Hit Hardest by Fentanyl, Highlights Their Responses

A report released this week by Drug Strategies, a not-for-profit research institute, and Shatterproof, a not-for-profit addiction treatment advocacy group, identifies the 11 states hit hardest by a surge in fentanyl-related overdose deaths and outlines interventions being implemented in response to the crisis.

Overall across the U.S., fentanyl overdose deaths increased by more than 14%, from 28,000 in 2017 to 32,000 in 2018, according to preliminary data released by the Centers for Disease Control and Prevention in July. Nine states—Ohio, New York, Florida, Massachusetts, Pennsylvania, Maryland, Michigan, North Carolina and Illinois—accounted for 60% of U.S. fentanyl-related deaths alone. The report issued by Drug Strategies and Shatterproof, titled The Fentanyl Epidemic: State Initiatives to Reduce Overdose Deaths, covers these states, as well as West Virginia and New Hampshire, which reported the highest numbers of fentanyl-related deaths relative to their respective population size.

“This report is the first to take a close look at the states that have been devastated by fentanyl,” Drug Strategies President Mathea Falco said in a news release. “We highlight what states have done to reduce fentanyl overdose deaths and we provide seven recommendations that can have an immediate impact in curbing this epidemic. Effective strategies are urgently needed to save lives from this highly lethal, powerful drug.”

Current initiatives and future recommendations

The report highlights effective initiatives currently being implemented by the states hit hardest by the fentanyl epidemic, and offers a series of related recommendations:

• Overdose data collection and information sharing, which includes the collection of death certification information, mandatory reporting of non-fatal overdoses to state health departments, and the establishment of overdose monitoring and mapping systems. The report recommends that data collection, analysis and information sharing should be standardized to facilitate development of timely and accurate strategies.
• Use of fentanyl testing strips. Despite their effectiveness in detecting the presence of fentanyl in street drugs, the test strips are illegal under drug paraphernalia laws in all of the states study, except for Maryland and New York. The report recommends that fentanyl strips be made legal.
• Naloxone opioid overdose reversal kits. The report notes that given its potency, a fentanyl overdose can require five to 10 doses of the overdose reversal medication. Naloxone access and administration initiatives in Massachusetts, Ohio and New Hampshire are among those detailed in the report.
• The report compares 911 Good Samaritan Laws, and recommends the adoption of robust Good Samaritan Laws to encourage residents to call 911 to avert overdoses
• Lastly, the report compares fentanyl-specific public education campaigns by state and encourages the launch and expansion of such campaigns to educate, reduce stigma and spark policy change.

“This report illustrates that the reach of the third wave of this crisis, fentanyl, has only just begun to be felt,” Shatterproof founder and CEO Gary Mendell said in the release. “Good policy helped mitigate the effects of the first two waves, prescription opioids and illicit heroin. Several of these states were on the forefront of addressing the earlier phases of the opioid crisis and we need to harness this experience to reverse the course of the fentanyl wave.”