{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:42:44Z","timestamp":1777898564016,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:p>Opioid overdose deaths in the United States quadrupled from 1999 (n = 8050 deaths) to 2015 (n = 33\u2009091 deaths), and the number of deaths associated with synthetic opioids, such as fentanyl, increased from 3105 deaths in 2013 to nearly 20\u2009000 deaths in 2016. Given this rapid increase, timely surveillance for drugs in circulation is crucial. However, current surveillance systems used to track drug overdoses do not detect new drugs in circulation quickly. We studied the change in the presence of fentanyl in \u201cstamp bag\u201d drug evidence in Allegheny County, Pennsylvania, from 2010 through 2016. Stamp bags are small wax packets with individual stamps that contain mixtures of drugs, most commonly heroin, that law enforcement officers seize and retain as legal evidence. The proportion of stamp bags determined to contain fentanyl or a fentanyl analog was 2.1% in 2014 and rose sharply to 17.1% in 2016. Monitoring the chemical makeup of drug evidence items could help public health authorities identify drug use trends in their jurisdictions.<\/jats:p>","DOI":"10.1177\/0033354917753119","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T12:32:05Z","timestamp":1517488325000},"page":"142-146","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["The Rapid Escalation of Fentanyl in Illicit Drug Evidence in Allegheny County, Pennsylvania, 2010-2016"],"prefix":"10.1177","volume":"133","author":[{"given":"Kathleen E.","family":"Creppage","sequence":"first","affiliation":[{"name":"Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA"},{"name":"Allegheny County Medical Examiner Office, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Yohannan","sequence":"additional","affiliation":[{"name":"Allegheny County Medical Examiner Office, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Williams","sequence":"additional","affiliation":[{"name":"Allegheny County Medical Examiner Office, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanine M.","family":"Buchanich","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas J.","family":"Songer","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen R.","family":"Wisniewski","sequence":"additional","affiliation":[{"name":"Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Fabio","sequence":"additional","affiliation":[{"name":"Epidemiology Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,2,1]]},"reference":[{"issue":"34","key":"bibr1-0033354917753119","doi-asserted-by":"crossref","first-page":"867","DOI":"10.15585\/mmwr.mm6634a2","volume":"66","author":"O\u2019Donnell JK","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"bibr2-0033354917753119","unstructured":"US Drug Enforcement Administration. Fentanyl (trade names: Actiq, Fentora, Duragesic). 2016. https:\/\/www.deadiversion.usdoj.gov\/drug_chem_info\/fentanyl.pdf. 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DEA-DCT-DIR-031-16. 2016. https:\/\/www.dea.gov\/divisions\/hq\/2016\/hq062716_attach.pdf. Accessed January 1, 2018."},{"key":"bibr13-0033354917753119","unstructured":"Centers for Disease Control and Prevention. Fentanyl: the problem. Illegally-made fentanyl use is on the rise. 2016. https:\/\/www.cdc.gov\/drugoverdose\/opioids\/fentanyl.html . Accessed January 1, 2018."},{"key":"bibr14-0033354917753119","unstructured":"DEA issues nationwide alert on fentanyl as threat to health and public safety [news release]. Washington, DC: US Drug Enforcement Administration; March 18, 2015. https:\/\/www.dea.gov\/divisions\/hq\/2015\/hq031815.shtml . Accessed January 1, 2018."},{"key":"bibr15-0033354917753119","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6533a2"},{"key":"bibr16-0033354917753119","unstructured":"US Drug Enforcement Administration. Analysis of drug-related overdose deaths in Pennsylvania, 2015. DEA-PHL-DIR-009-16. 2016. https:\/\/www.dea.gov\/divisions\/phi\/2016\/phi071216_attach.pdf. Accessed January 1, 2018."},{"key":"bibr17-0033354917753119","unstructured":"OverdoseFreePA. View overdose death data: Allegheny County, PA. 2017. https:\/\/www.overdosefreepa.pitt.edu\/know-the-facts\/view-overdose-death-data . Accessed January 1, 2018."},{"key":"bibr18-0033354917753119","unstructured":"Allegheny County Medical Examiner. Evidence submittal forms: Allegheny County Office of the Medical Examiner\u2019s (ACOME) evidence submission manual. 2014. http:\/\/www.alleghenycounty.us\/medical-examiner\/evidence-submittal-forms.aspx . 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