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OUD

CE / CME

Module 6: Opioid Use Disorder

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurses: 1.00 Nursing contact hour

ABIM MOC: maximum of 1.00 Medical Knowledge MOC point

Optometrists: 1.00 COPE CE credit 

ABP MOC: maximum of 1.00 MOC point

ABS MOC: maximum of 1.00 Continuous Certification credit

ABOHNS MOC: maximum of 1.00 Part II Self-Assessment Credit

ABPath MOC: maximum of 1.00 Lifelong Learning point

Dental Professionals: 1.00 ADA CERP credit

Physicians: maximum of 1.00 AMA PRA Category 1 Credit™

Released: May 31, 2023

Expiration: May 30, 2026

Timothy Atkinson
Timothy Atkinson, PharmD, BCPS, CPE
CME/CE Information

Activity

Progress
1 2 3
Course Completed

Overdose Death Rates Involving Opioids, by Type, United States, 1999-2020

These data from the Centers for Disease Control and Prevention show the overdose death rates from opioids for the period 1999‑2020 that correspond to the different waves of the opioid overdose crisis.1 It is now known, however, that the crisis was driven by illicit fentanyl far earlier than we thought. That being said, many people had their first exposure to opioids through prescription opioids. 

Expansion of Illicitly Manufactured Fentanyl and Fentanyl Analogs

The emerging concern about fentanyl includes not only illicitly manufactured fentanyl but all fentanyl analogs.2 In an attempt to crack down on the illicit manufacturing and trafficking of fentanyl, legislation was introduced recently to simplify the problem for the US Drug Enforcement Administration. This new legislation makes illegal any fentanyl analog that may be produced and will not require these analogs to be named and added. This is important because illicitly manufactured fentanyl and its analogs are now appearing in counterfeit pills as well as in heroin and cocaine. Therefore, fentanyl is found not only in opioids, but in other substances, affecting people who may not have an opioid tolerance. In such circumstances, the fentanyl exposure can be lethal.

In a 10‑state study, more than 57% of people who died by overdose tested positive for fentanyl and fentanyl analogs; many of them also tested positive for cocaine, methamphetamine, and heroin.2 Therefore, what we previously considered an opioid crisis has really turned into a polysubstance use crisis.

A complicating factor is that detection of fentanyl analogs requires specialized toxicology testing. In other words, routine urine drug testing does not detect fentanyl analogs.

Overdose Deaths per 100,000 Residents

This map of the United States depicts the overdose death rate from narcotics per 100,000 residents.3 Although some small states such as West Virginia have a lower number of overall deaths, they have a much higher per capita rate of overdose death compared with other states. Similarly, other states in the South such as Tennessee and Alabama also have high rates of deaths per capita.

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