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The following is a summary of “Emergency Department Patients With Para-Fluorofentanyl Overdose,” published in the November 2024 issue of Emergency Medicine by Aldy et al.
Para-fluorofentanyl (PFF) and other fentanyl analogs are increasingly present in the illicit opioid supply.
Researchers conducted a retrospective study to analyze the demographics, clinical effects, and sex differences in naloxone administration among individuals with confirmed PFF overdose compared to fentanyl in the emergency department (ED).
They performed the ToxIC Fentalog Study (2020–2023) across 10 U.S. hospitals. Adults presenting to EDs with suspected opioid overdoses were screened and included if waste serum samples were available for comprehensive toxicological analysis. The analysis focused on individuals with fentanyl, assessing the relationship between PFF and naloxone administration, with additional stratified analyses to explore sex differences.
The results showed that of 4,873 screened patients, 833 were included (694 PFF negative (PFFN) and 139 PFF positive (PFFP). The mean age was 41 years, with males predominating (73.1% PFFN vs 69.8% PFFP). Over half of patients with PFFP were presented at 2 sites: New York (29.8%) and Pennsylvania (21.3%). The most common indication for naloxone was a depressed level of consciousness (82.1% PFFN vs 79.8% PFFP). Patients with PFFP were less likely to receive naloxone doses >2 mg than PFFN (48.2% vs 60.8%, P =0.002). After adjusting for covariates, PFFP were less likely to receive out-of-hospital naloxone (adjusted odds ratio [aOR]: 0.87; 95% confidence interval [CI]: 0.81, 0.94). Male PFFP were less likely to receive naloxone doses ≥ 2mg (aOR: 0.64; 95% CI: 0.42, 0.97), but this association was insignificant for females.
Investigators concluded the PFF was present in nearly 20% of the patients admitted to ED with confirmed fentanyl overdose, with lower naloxone administration, particularly among males
Source: jem-journal.com/article/S0736-4679(24)00366-4/abstract
