The Rise of Overdose Deaths Involving Fentanyl and the Value of Early Warning
Bibliographic record
Abstract
Information collected, collated, and disseminated by the Canadian Community Epidemiology Network on Drug Use (CCENDU) on the emergence of fentanyl or fentanyl analogues for sale in the illicit marketplace is presented as an example of how CCENDU has functioned as a Canadian early warning system to detect and disseminate reliable, timely information on alcohol and other drug related harms. In July 2013, the network issued its first alert on the sale of fentanyl or fentanyl analogues in the illicit drug marketplace. In February 2014, the network issued a second alert on the appearance of fentanyl powder that had been pressed into tablets in order to resemble oxycodone tablets. A year later (February 2015), the network issued a third alert indicating that partners were reporting increased incidences of fatal and nonfatal overdoses suspected or confirmed to involve illicit fentanyl. In August 2015, more than two years following the first alert, the network issued a bulletin on the marked increase in the number of deaths involving fentanyl in Canada between 2009 and 2014. This paper discusses the value and importance of a Canadian early warning monitoring and surveillance system to detect and disseminate reliable timely information on alcohol and other drug related harms. L'information recueillie, synthétisée et diffusée par le Réseau communautaire canadien d’épidémiologie des toxicomanies (RCCET) concernant l'apparition du fentanyl ou d'analogues du fentanyl sur le marché illicite est présenté comme un exemple du fonctionnement du RCCET en tant que système d'alerte rapide canadien permettant de relever et de diffuser en temps opportun de l'information fiable sur les méfaits de l'alcool et d'autres drogues. En juillet 2013, le réseau a émis sa première alerte concernant la vente de fentanyl ou d'analogues du fentanyl sur le marché des drogues illicites. En février 2014, le réseau a émis une deuxième alerte, sur l'apparition de fentanyl en poudre transformé en comprimés de façon à ressembler à des comprimés d'oxycodone. Un an plus tard, en février 2015, le réseau a émis une troisième alerte s'appuyant sur la hausse du nombre de cas soupçonnés ou confirmés de surdoses mortelles ou non mortelles impliquant du fentanyl illicite signalées par des partenaires. La présente étude porte sur la valeur et l'importance d'un système canadien de surveillance et d'alerte rapide permettant de relever et de diffuser en temps opportun de l'information fiable sur les méfaits liés à l'alcool et aux autres drogues.
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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 | 0.003 | 0.020 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".