Synthetic opioids
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Eighty percent of synthetic opioid-related overdose deaths in 2016 were also tied to the simultaneous use of alcohol or another drug (such as another opioid, heroin or cocaine).
As opioid-related deaths rise in the United States, so has the role of synthetic opioids - primarily illicit fentanyl, mixed into heroin or made into counterfeit pills (SN Online: 3/29/18). In 2016, synthetics surged past prescription opioids and were involved in 19,413 deaths, compared with 17,087 deaths involving prescription opioids, researchers report May 1 in JAMA. The study is based on data from the National Vital Statistic System's record of all U.S. deaths.

"Synthetic opioids are much deadlier than prescription opioids," says emergency physician Leana Wen, Health Commissioner of Baltimore, who was not involved in the study. Fentanyl, for example, is about 50 to 100 times more potent than morphine. The illicit origins of many synthetic opioids make the public health response more difficult, she says. "We can track prescriptions; it's much harder to track illegally trafficked drugs."

synthetic opioid deaths USA
Citations
C. Jones et al. Changes in synthetic opioid involvement in drug overdose deaths in the United States, 2010-2016. JAMA. Vol. 319, May 1, 2108, p. 1819. (doi:10.1001/jama.2018.2844)