Source: Journal of Emergency Medicine
ToxIC Project Data Source: Fentalog Study
Publication Date: May 2025
Authors: Kim Aldy, DO; Alex Krotulski, PhD ; Jeffrey Brent, MD, PhD; Sharan Campleman, PhD; Rachel Culbreth, PhD, MPH; Barry Logan, PhD; Paul Wax, MD; Alexandra Amaducci, DO; Bryan Judge, MD; Michael Levine, MD; Evan Schwarz, MD; Diane P. Calello, MD; Christopher W. Meaden, MD; Joshua Shulman, MD; Adrienne Hughes, MD; Robert Hendrickson, MD; Joseph Carpenter, MD; Jennie Buchanan; Alex F. Manini, MD, MS - on behalf of the Toxicology Investigators Consortium (ToxIC) Fentalog Study Group
Keywords/Topics: Fentanyl analogs, fentalogs, para-fluorofentanyl (PFF), opioids, overdose, toxico-surveillance

Journal of Emergency Medicine: Emergency Department Patients with Para-Fluorofentanyl Overdose

This study from the ToxIC Fentalog Project examined 833 emergency department patients across 10 U.S. hospitals between 2020 and 2023 with confirmed fentanyl overdoses, focusing on the presence of para-fluorofentanyl (PFF), a rising fentanyl analog.

Nearly 20% (139 patients) tested positive for PFF. The average age was 41, and the majority were male. Most PFF cases were concentrated in New York and Pennsylvania. While clinical presentations were similar between PFF-positive and -negative patients, PFF-positive individuals were significantly less likely to receive higher doses of naloxone (over 2 mg), particularly among men. They were also less likely to receive out-of-hospital naloxone.

These findings point to important differences in overdose response and treatment linked to fentanyl analogs, with sex-specific effects that merit further investigation. Clinicians and public health officials should remain vigilant about changes in the illicit opioid supply and adjust harm reduction strategies accordingly. Read more...