Illicitly Manufactured Fentanyl-Involved Overdose Deaths with Detected Xylazine - United States, January 2019-June 2022 - PubMed (original) (raw)

FIGURE 2

Number and percentage of drug overdose deaths involving illicitly manufactured fentanyls, by xylazine detection or co-involvement — State Unintentional Drug Overdose Reporting System, 31 states and District of Columbia, January 2021–June 2022 Abbreviations: DC = District of Columbia; IMF = illicitly manufactured fentanyl; SUDORS = State Unintentional Drug Overdose Reporting System. * A drug was considered involved or co-involved if it was listed as a cause of death on the death certificate or in the medical examiner or coroner report. † Fentanyl was classified as likely illicitly manufactured using toxicology, scene, and witness evidence. For the 8% of deaths involving fentanyl that had insufficient evidence for classification as illicit or prescription, fentanyl was classified as illicit because the vast majority of fentanyl overdose deaths involve illicit fentanyl. All fentanyl analogs except alfentanil, remifentanil, and sufentanil, which have legitimate human medical use, were included as IMFs. § Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Georgia, Illinois, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, and West Virginia. Illinois, Louisiana, Pennsylvania, and Washington reported deaths from counties that accounted for ≥75% of drug overdose deaths in the state in 2017, per SUDORS funding requirements; all other jurisdictions reported deaths from the full jurisdiction. Jurisdictions were included if data were available for the full period of January 2021–June 2022, including toxicology reports for ≥75% of deaths. Analysis was restricted to decedents with an available toxicology report; or, if no toxicology report was available, deaths were also included if xylazine was listed as part of the cause of death on the death certificate. Four funded states were excluded from analyses because they were known to have not tested for xylazine during the analysis period. Toxicology report data were not available for ≥75% of all deaths in eight states with complete death certificate data for January 2021–June 2022, and they were therefore excluded from analyses, but death certificate data identified IMF-involved deaths with xylazine co-involved: Alabama (46 deaths), Florida (261), Indiana (82), Mississippi (10), Missouri (93), New York (735), South Carolina (178), and Tennessee (167).