UW Study Shows Fentanyl's Outsized Impact On All Washingtonians

SEATTLE — A new study from the University of Washington School of Medicine may help cast some light on fentanyl, and the outsize impact the opioid is having on overdose deaths in the Evergreen State.

"Overdose deaths that involve fentanyl are increasing dramatically in WA State," write researchers Caleb J. Banta-Green, PhD, MPH, MSW and Jason Williams, PhD. "This trend is particularly concerning among young adults (those under age 30) who appear to be using fentanyl at much higher rates than ever before according to anecdotal reports from health care providers and families."

To learn more about the potential impact of fentanyl on overdose death rates, their study analyzed overdose deaths involving heroin, commonly prescribed opioids, synthetic opioids, and fentanyl. Overdose victims were sorted into two categories, patients under 30 and patients 30 and older. Researchers found that fentanyl was much more deadly in younger patients than other opioids.

“For any disease or condition, mortality rates of people under 30 are typically much lower than for people 30 and older," said Banta-Green. "But with fentanyl, we are seeing very similar trends in terms of the rate of increase and the level of deaths. That’s not normal for any health condition, let alone overdose."

Mapping out the data shows fentanyl is almost exactly as deadly in younger and older patients, compared to other drugs, which have significantly lower mortality rates in patients under 30.

“The data are stunning,” Banta-Green said. “Historically, deaths involving heroin and prescription opiates were big deals, but the fentanyl trends are even worse. What is profoundly different is the years of life lost among people who overdose at age 20 or 25, in contrast with people who are 45 or 50.”

Researchers say fentanyl use and overdose deaths appeared largely concentrated in three distinct demographics:

• Young adults who are inexperienced with opioids.
• Young adults with rapid-onset addiction disorders.
• Older adults with long-term opioid-use disorders.

Another reason fentanyl deaths are spiking: fentanyl users take the drug much more often than other opioids. According to clinical specialists in addiction, heroin users typically take the drug four to six times a day. Fentanyl users, on the other hand, partake two to three times as much.

"[P]eople who use fentanyl do so up to 15 times a day, like someone who smokes cigarettes," Banta-Green said. "Of course this increases their overdose chance dramatically and is very disruptive to their daily lives.”

Learning more about fentanyl is a priority for researchers, as fentanyl-related overdoses have exploded over recent years, doubling from 2019 to 2020 to eight overdose deaths per 100,000 Washingtonians under 30. And unfortunately, it's likely to get worse: Washington's fentanyl-related death rate is currently about half the nationwide death rate, authors said, but they expect the local rate to catch up with the rest of the country within the next three years.

Researchers conclude their study by offering several recommendations to limit fentanyl overdose deaths, including:

• Reducing harms and overdose. Spreading awareness about how to spot an overdose, and how to respond using the overdose reversal drug, naloxone, could help save lives. They also recommend harm reduction programs, which can spread education, supplies, onsite healthcare or referrals to community services.
• Offering treatment of opioid use disorder. Help can be found through the WA State Recovery Helpline, which connects addicts with local clinics and programs to treat opioid use disorder.