Table 2.
Drug Overdose Decedents’ Toxicology Reports and Substance Use History – Rhode Island, January 2012 – March 2014 (N=536)
| Total N (%) |
Drug Overdose Deaths N (%) |
Chi-Square Test (p-value) | ||
|---|---|---|---|---|
|
| ||||
| Illicit-Fentanyl (N=69) | Other-Drug (N=467) | |||
| Toxicological Reports of Substances Present in Decedent’s Body | ||||
| Illicit substances | ||||
| Cocaine (P) | 169 (31.5) | 27 (39.1) | 142 (30.4) | 0.146 |
| Heroin* | 162 (30.2) | 13 (18.8) | 149 (31.9) | 0.000 |
| 6MAM (C) | 48 (9.0) | 3 (4.4) | 45 (9.6) | 0.151 |
| Non-fentanyl-related illicit substance** | 336 (62.7) | 40 (58.0) | 296 (63.4) | 0.386 |
| Fentanyl-related substances | ||||
| Acetyl fentanyl (C) | 15 (2.8) | 14 (20.3) | 1 (0.2) | <0.000 |
| ANPP (C) | 10 (1.9) | 9 (13.0) | 1 (0.2) | <0.000 |
| Fentanyl (C) | 42 (7.8) | 35 (50.7) | 7 (1.5) | <0.000 |
| Fentanyl (P) | 79 (14.7) | 68 (98.6) | 11 (2.4) | <0.000 |
| Opiates (P) | 269 (37.7) | 26 (37.7) | 243 (52.0) | 0.026 |
| Pharmaceutical substances | ||||
| Acetaminophen (P) | 28 (5.2) | 0 (0.0) | 28 (6.0) | 0.38*** |
| Benzodiazepines (C) | 204 (38.1) | 24 (34.8) | 180 (38.5) | 0.548 |
| Carisoprodol (P) | 14 (2.6) | 0 (0.0) | 14 (3.0) | 0.234*** |
| Codeine (C) | 75 (14.0) | 3 (4.4) | 72 (15.4) | 0.013 |
| Methadone (P) | 71 (13.3) | 3 (4.4) | 68 (14.6) | 0.020 |
| Morphine (C) | 188 (35.1) | 16 (23.2) | 172 (36.8) | 0.027 |
| Oxycodone (P) | 81 (15.1) | 2 (2.9) | 79 (16.9) | 0.002 |
| Tricyclic antidepressants (P) | 66 (12.3) | 4 (5.8) | 62 (13.3) | 0.078 |
| Zolpidem (P) | 16 (3.0) | 2 (2.9) | 14 (3.0) | 0.964 |
| Reported Recent Substance Use | ||||
| Alcohol | 259 (48.3) | 26 (37.7) | 233 (49.9) | 0.058 |
| Tobacco | 239 (44.6) | 36 (52.2) | 203 (43.5) | 0.175 |
| Illicit drug use | ||||
| Any type | 256 (47.8) | 43 (62.3) | 213 (45.6) | 0.002 |
| Heroin | 166 (31.0) | 34 (49.3) | 132 (28.3) | 0.000 |
| Reported Prior Drug Overdose | 73 (13.6) | 9 (13.0) | 64 (13.7) | 1.000*** |
| Reported Past Drug Addiction Treatment | 97 (18.1) | 16 (23.2) | 81 (17.3) | 0.411*** |
| Filled ≥1 Opioid Prescriptionz (within 90 days of death) | ||||
| No | 350 (65.3) | 45 (65.2) | 305 (65.3) | 0.988 |
| Yes | 186 (34.7) | 24 (34.8) | 162 (34.7) | |
Notes: Percentages refer to the proportion of decedents represented within illicit-fentanyl and other-drug overdose deaths (i.e., column percentages). Information on recent substance use, prior overdose and past drug treatment or rehabilitation was obtained by reviewing each decedent’s medical examiner chart, which was based on 3rd party reports (e.g., family members, friends, medical records). Bold indicates that differences between illicit-fentanyl and other-drug deaths are statistically significant.
Toxicological heroin evidence was defined as the presence of morphine and at least one of the following requirements: codeine or 6MAM identified in toxicology, presence of track marks in decedent’s body, or presence of intravenous drug paraphernalia on the death scene.
Includes the following illicit substances: amphetamine, cannabinoids, cocaine, methamphetamine, 6MAM and heroin; and opiates. Excludes other licit prescription substances presented on the table (e.g., codeine, morphine) which may or may not have been consumed by decedents for legitimate medical purposes.
Fisher’s Exact Test (p-value) is presented due to small expected cell counts.
(P) = Preliminary toxicology results (i.e., ELISA)
(C) = Confirmatory toxicology results
ANPP = 4-anilino-N-phenethyl-4-piperidine
6MAM = 6-Monoacetylmorphine