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Fentanyl-associated illness among substance users — Fulton County, Georgia, 2015

Published:March 20, 2018DOI:https://doi.org/10.1016/j.ajem.2018.03.041
      In early 2015, Hospital A emergency physicians subjectively noticed an increase in opioid overdoses presenting to the emergency department (ED) that corresponded with an increase in fentanyl-positive substance-related deaths documented by the Fulton County medical examiner (ME). This prompted Hospital A emergency physicians to begin selective fentanyl urine drug screening (UDS) for patients with clinical signs of opioid intoxication. After testing revealed that some patients had UDS positive for fentanyl, Hospital A began testing for fentanyl as part of all routine UDS in May 2015 and notified the Georgia Department of Public Health (DPH) of their findings. Fentanyl had not been commonly reported as associated with substance abuse and overdose in Georgia before this cluster. DPH initiated an epidemiologic investigation to characterize events and guide prevention efforts.

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