References
Rudd RA, Seth P, David F, Scholl L. Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR Morb Mortal Wkly Rep. 2016;65(5051):1445–52.
Miller JM, Stogner JM, Miller BL, Blough S. Exploring synthetic heroin: accounts of acetyl fentanyl use from a sample of dually diagnosed drug offenders. Drug and Alcohol Review 2017.
Diaz Bode A, Singh M, Andrews J, Kapur GB, Baez A. Fentanyl laced heroin and its contribution to a spike in heroin overdose in Miami-Dade County. Am J Emerg Med 2017.
Drug Enforcement Agency. DEA Intelligence Brief. Counterfeit prescription pills containing fentanyls: a global threat. 2016. https://www.dea.gov/docs/Counterfeit%20Prescription%20Pills.pdf. Accessed May 6 2017.
Higashikawa Y, Suzuki S. Studies on 1-(2-phenethyl)-4-(N-propionylanilino)piperidine (fentanyl) and its related compounds. VI. Structure-analgesic activity relationship for fentanyl, methyl-substituted fentanyls and other analogues. Forensic Toxicology. 2008;26:1–5.
Janssen PA. Potent, new analgesics, tailor-made for different purposes. Acta Anaesthesiol Scand. 1982;26(3):262–8.
Mather LE. Clinical pharmacokinetics of fentanyl and its newer derivatives. Clin Pharmacokinet. 1983;8(5):422–46.
Volpe DA, Mcmahon Tobin GA, Mellon RD, Katki AG, Parker RJ, Colatsky T et al. Uniform assessment and ranking of opioid Mu receptor binding constants for selected opioid drugs. 2011.
Wax PM, Becker CE, Curry SC. Unexpected “gas” casualties in Moscow: a medical toxicology perspective. Ann Emerg Med. 2003;41(5):700–5.
Drug Enforcement Agency. DEA warning to police and public: fentanyl exposure kills. 2016. https://www.dea.gov/divisions/hq/2016/hq061016.shtml. Accessed May 6 2016.
National Institute for Occupational Safety and Health. Fentanyl: preventing occupational exposure to emergency responders. 2016. https://www.cdc.gov/niosh/topics/fentanyl/risk.html. Accessed May 6 2017.
McDaniels A. Deputy, two EMS providers treated for overdose symptoms responding to call. The Baltimore Sun, Baltimore, MD. 2017. http://www.baltimoresun.com/health/bs-md-harford-opioid-exposure-20170523-story.html. Accessed May 27 2017.
Greenslade B. 3 Winnipeg police officers possibly exposed to fentanyl, self-administer naloxone. Global News 2017.
Hung OR, Whynot SC, Varvel JR, Shafer SL, Mezei M. Pharmacokinetics of inhaled liposome-encapsulated fentanyl. Anesthesiology. 1995;83:277–84.
Mather LE, Woodhouse A, Ward ME, Farr SJ, Rubsamen RA, Eltherington LG. Pulmonary administration of aerosolised fentanyl: pharmacokinetic analysis of systemic delivery. Br J Clin Pharmacol. 1998;46:37–43.
Riches JR, Read RW, Black RM, Cooper NJ, Timperley CM. Analysis of clothing and urine from Moscow theatre siege casualties reveals carfentanil and remifentanil use. J Anal Toxicol. 2012;36(9):647–56.
Van Nimmen NFJ, Poels KLC, Veulemans HAF. Identification of exposure pathways for opioid narcotic analgesics in pharmaceutical production workers. Ann Occup Hyg. 2006;50:665–77.
Gupta PK, Ganesan K, Gutch PK, Manral L, Dubey DK. Vapor pressure and enthalpy of vaporization of fentanyl. J Chem Eng Data. 2008;53(3):841–5.
Pastore MN, Kalia YN, Horstmann M, Roberts MS. Transdermal patches: history, development and pharmacology. Br J Pharmacol. 2015;172(9):2179–209.
Nelson L, Schwaner R. Transdermal fentanyl: pharmacology and toxicology. J Med Toxicol. 2009;5(4):230–41.
Duthie DJ, Rowbotham DJ, Wyld R, Henderson PD, Nimmo WS. Plasma fentanyl concentrations during transdermal delivery of fentanyl to surgical patients. Br J Anaesth. 1988;60:614–8.
Gourlay GK, Kowalski SR, Plummer JL, Cherry DA, Gaukroger P, Cousins MJ. The transdermal administration of fentanyl in the treatment of postoperative pain: pharmacokinetics and pharmacodynarnic effects. Pain. 1989;37:193–202.
Miguel R, Kreitzer JM, Reinhart D, Sebel PS, Bowie J, Freedman G, et al. Postoperative pain control with a new transdermal fentanyl delivery system. A multicenter trial. Anesthesiology. 1995;83:470–7.
Product Information: Duragesic (fentanyl transdermal system) for transdermal administration. Janssen Pharmaceuticals 2016. https://www.janssenmd.com/pdf/duragesic/duragesic_pi.pdf. Accessed May 7 2017.
Sebel PS, Barrett CW, Kirk CJC, Heykants J. Transdermal absorption of fentanyl and sufentanil in man. Eur J Clin Pharmacol. 1987;32:529–31.
Rhodes J, Clay C, Phillips M. The surface area of the hand and the palm for estimating percentage of total body surface area: results of a meta-analysis. Br J Dermatol. 2013;169(1):76–84.
Roy SD, Flynn GL. Transdermal delivery of narcotic analgesics: pH, anatomical, and subject influences on cutaneous permeability of fentanyl and sufentanil. Pharm Res. 1990;7(8):842–7.
George AV, Lu JJ, Pisano MV, Metz J, Erickson TB. Carfentanil—an ultra potent opioid. Am J Emerg Med. 2010;28(4):530–2.
Boyer EW. Management of opioid analgesic overdose. N Engl J Med. 2012;367(2):146–55.
Gussow L. Who said the opioid crisis couldn’t get any worse? Emerg Med News. 2016;38(11):1–29.
Moresco A, Larsen RS, Sleeman JM, Wild MA, Gaynor JS. Use of naloxone to reverse carfentanil citrate-induced hypoxemia and cardiopulmonary depression in Rocky Mountain wapiti (Cervus elaphus nelsoni). J Zoo Wildl Med. 2001;32(1):81–9.
Acknowledgments
The authors would like to acknowledge the following for contributions to the statement: Jeffrey Brent, Robert N.E. French, Howard Greller, and Adam Rowden
Funding
None.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of Interest
None.
Rights and permissions
About this article
Cite this article
Moss, M.J., Warrick, B.J., Nelson, L.S. et al. ACMT and AACT Position Statement: Preventing Occupational Fentanyl and Fentanyl Analog Exposure to Emergency Responders. J. Med. Toxicol. 13, 347–351 (2017). https://doi.org/10.1007/s13181-017-0628-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13181-017-0628-2