Using Surveillance With Near-Real-Time Alerts During a Cluster of Overdoses From Fentanyl-Contaminated Crack Cocaine, Connecticut, June 2019 - PubMed (original) (raw)

. 2021 Nov-Dec;136(1_suppl):18S-23S.

doi: 10.1177/00333549211015662.

Suzanne Doyon 2, Sarah Ali 3, Susan B Logan 4, Aliese Alter 5, Katherine Hart 2, Raffaella Coler 6, Richard Kamin 6 7, Steven C Wolf 8 9 10, Kristin Soto 11, Lauren Whiteman 5, Mark Jenkins 12

Affiliations

Using Surveillance With Near-Real-Time Alerts During a Cluster of Overdoses From Fentanyl-Contaminated Crack Cocaine, Connecticut, June 2019

Peter Canning et al. Public Health Rep. 2021 Nov-Dec.

Abstract

In 2019, Connecticut launched an opioid overdose-monitoring program to provide rapid intervention and limit opioid overdose-related harms. The Connecticut Statewide Opioid Response Directive (SWORD)-a collaboration among the Connecticut State Department of Public Health, Connecticut Poison Control Center (CPCC), emergency medical services (EMS), New England High Intensity Drug Trafficking Area (HIDTA), and local harm reduction groups-required EMS providers to call in all suspected opioid overdoses to the CPCC. A centralized data collection system and the HIDTA overdose mapping tool were used to identify outbreaks and direct interventions. We describe the successful identification of a cluster of fentanyl-contaminated crack cocaine overdoses leading to a rapid public health response. On June 1, 2019, paramedics called in to the CPCC 2 people with suspected opioid overdose who reported exclusive use of crack cocaine after being resuscitated with naloxone. When CPCC specialists in poison information followed up on the patients' status with the emergency department, they learned of 2 similar cases, raising suspicion that a batch of crack cocaine was mixed with an opioid, possibly fentanyl. The overdose mapping tool pinpointed the overdose nexus to a neighborhood in Hartford, Connecticut; the CPCC supervisor alerted the Connecticut State Department of Public Health, which in turn notified local health departments, public safety officials, and harm reduction groups. Harm reduction groups distributed fentanyl test strips and naloxone to crack cocaine users and warned them of the dangers of using alone. The outbreak lasted 5 days and tallied at least 22 overdoses, including 6 deaths. SWORD's near-real-time EMS reporting combined with the overdose mapping tool enabled rapid recognition of this overdose cluster, and the public health response likely prevented additional overdoses and loss of life.

Keywords: opioid overdose; public health surveillance.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1

Figure 1

Question card for the Connecticut Statewide Opioid Response Directive (SWORD) emergency medical services (EMS). EMS responders use the card when reporting overdoses to the Connecticut Poison Control Center. Abbreviations: CT, Connecticut; DOB, date of birth; EMT, emergency medical technician; EMTP, emergency medical technician–paramedic; FD, fire department; IM, intramuscular; IN, intranasal; IV, intravenous; PD, police department; PO, by mouth; PT, patient.

Figure 2

Figure 2

Number of emergency medical services–suspected opioid overdoses called into the Connecticut Poison Control Center, by time of call, Hartford, Connecticut, June 1-5, 2019.

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