Acetyl fentanyl overdose fatalities--Rhode Island, March-May 2013

MMWR Morb Mortal Wkly Rep. 2013 Aug 30;62(34):703-4.


In May 2013, the Rhode Island State Health Laboratories noticed an unusual pattern of toxicology results among 10 overdose deaths of suspected illicit drug users that had occurred during March 7-April 11, 2013. An enzyme-linked immunosorbent assay (ELISA) for fentanyl in blood was positive for fentanyl in all 10 cases, but confirmatory gas chromatography/mass spectrometry (GC/MS) did not detect fentanyl. The mass spectrum was instead consistent with acetyl fentanyl, a fentanyl analog. Acetyl fentanyl, a synthetic opioid, has not been documented in illicit drug use or overdose deaths, and is not available as a prescription drug anywhere. Animal studies suggest that acetyl fentanyl is up to five times more potent than heroin as an analgesic.

MeSH terms

  • Adult
  • Drug Overdose / mortality*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fentanyl / analogs & derivatives*
  • Fentanyl / blood
  • Fentanyl / poisoning*
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Illicit Drugs / blood
  • Illicit Drugs / poisoning*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Rhode Island / epidemiology
  • Substance Abuse Detection / methods*
  • Young Adult


  • Illicit Drugs
  • Fentanyl