Fentanyl-related deaths: A 5-year retrospective study (2010–2014, 81 cases) in the department of forensic medicine, Newcastle, Forensic and Analytical Science Service

Abstract

Background: Fentanyl is a synthetic opioid developed in the 1960s and is 50–100 times more potent than morphine. Fentanyl is recognised to be abused in the community. The Department of Forensic Medicine Newcastle, Forensic and Analytical Science Service (DOFM, Newcastle) has recently experienced an increase in fentanyl related deaths. This study was carried out to characterise fentanyl related death in DOFM, Newcastle.Method: A retrospective study (5 years, 2010–2014) of deaths related to fentanyl in DOFM, Newcastle, was carried out noting the age, gender, cause of death, toxicological analysis, mode of delivery, and presumed mechanism of death.Result: There was a striking increase in death related to fentanyl from 1 case in 2010 to 38 cases in 2014 (n=81). Most of the fatal cases had a fentanyl blood level between 0.01–0.029 mg/L with the highest level being 0.08 mg/L. The most common cause of death was mixed drug toxicity. The victims were mostly middle aged males and the most common mechanism of death was respiratory depression. Other substances detected apart from fentanyl were benzodiazepine, opioids and alcohol. The most common route of administration was via extracting fentanyl from a patch and injecting it intravenously. Background: Fentanyl is a synthetic opioid developed in the 1960s and is 50–100 times more potent than morphine. Fentanyl is recognised to be abused in the community. The Department of Forensic Medicine Newcastle, Forensic and Analytical Science Service (DOFM, Newcastle) has recently experienced an increase in fentanyl related deaths. This study was carried out to characterise fentanyl related death in DOFM, Newcastle. Method: A retrospective study (5 years, 2010–2014) of deaths related to fentanyl in DOFM, Newcastle, was carried out noting the age, gender, cause of death, toxicological analysis, mode of delivery, and presumed mechanism of death. Result: There was a striking increase in death related to fentanyl from 1 case in 2010 to 38 cases in 2014 (n=81). Most of the fatal cases had a fentanyl blood level between 0.01–0.029 mg/L with the highest level being 0.08 mg/L. The most common cause of death was mixed drug toxicity. The victims were mostly middle aged males and the most common mechanism of death was respiratory depression. Other substances detected apart from fentanyl were benzodiazepine, opioids and alcohol. The most common route of administration was via extracting fentanyl from a patch and injecting it intravenously.