Rising Fentanyl-related Overdose Deaths in British Columbia
Bibliographic record
Abstract
There has been a surge in the number of fentanyl-detected overdoses in 2014 among people who use drugs in British Columbia. Provisional data indicates a constant increase in the number of fentanyl-detected overdoses over the past 3 years. A green pill, ‘fake oxy’ tablets, which resemble Oxycontin 80mg (oxycodone) have been found to contain variable amounts of fentanyl and not oxycodone. The physiological effects, symptoms and signs of fentanyl overdose are largely indistinguishable from that of heroin. This can complicate the management of overdoses in emergency settings. Emergency room physicians may find that the standard protocol dose of 0.4 - 0.8 mg of naloxone for heroin overdoses insufficient to reverse fentanyl overdoses. In such cases, in addition to investigations to rule out other potential use of other substances, larger doses of naloxone are often necessary to reverse the overdose. Take home naloxone programs are one harm reduction approach which is available in many jurisdictions in US1 and was initiated in British Columbia in 2012 and it is currently available at 62 sites throughout the province of British Columbia. Il y a eu une vague d'overdoses liées à la présence de fentanyl en 2014 parmi les personnes qui consomment des drogues en Colombie-Britannique. Des données provisoires indiquent une augmentation constante du nombre d'overdoses liées au fentanyl au cours des trois dernières années. Des comprimés verts, “fake oxy”, ressemblant à des comprimés d'Oxycontin 80mg (oxycodone), ont été identifiés comme contenant des quantités variables de fentanyl et non d'oxycodone. Les effets physiologiques, signes et symptômes d'une overdose par fentanyl s'apparentent à ceux de l'héroïne. Ce tableau complexifie la gestion des overdoses en situations d'urgence. Les médecins en salles d'urgence pourraient faire face à des situations où la dose standard de naloxone (0,4 - 0,8 mg) pour overdose d'héroïne soit insuffisante pour renverser les effets d'une overdose de fentanyl. Devant pareilles situations, en plus de chercher à éliminer la présence d'autres substances, de plus grandes doses de naloxone sont souvent nécessaires pour renverser l'overdose. Les programmes de naloxone à emporter sont une approche de réduction des méfaits disponible dans plusieurs juridictions aux États-Unis1 et en Colombie-Britannique depuis 2012. Ils sont présentement disponibles dans 62 sites à travers la province.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".