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The co-presence of opioids in Cannabinoidrelated mortality during the COVID-19 pandemic in Florida

Armiel Suriaga
Florida Atlantic University

Background: As more Americans died from opioid overdoses (more than half a million opioid deaths in the US since 1999 and 75 673 during the COVID-19 pandemic’s initial year), medicationassisted treatment (MAT) to curb opioid overdoses was one of the top priorities. The MAT treatment includes methadone, buprenorphine, and cannabinoids. Some studies implicate the role of cannabinoids in opioid use disorder or its analgesic properties to reduce opioid use. However, research on the co-use of opioids in cannabinoid-related mortality (CRM) is limited.

Purpose: This study reports the copresence of opioids in cannabinoids as a cause of death during the COVID-19 pandemic in Florida. (A drug is considered the cause of death when it plays a causal role in the death of a person through autopsy and toxicology results).

Methods: We used retrospective analysis of people who died from cannabinoids as a cause of death with the co-presence of opioids in their system. We used descriptive statistics in describing the co-presence of opioids in CRM using the Florida Department of Law Enforcement data in 2020.

Results: 42 decedents died from cannabinoids as a cause of death in Florida in 2020. Age range from 17-74 years, mean age of 39.52 (SD=14.829). Most decedents were male (83.3%), non-Hispanic whites (n=33 or 78.6%).

All 42 decedents died in accidents, 16 of 42 from vehicular motor accidents and, 21 of 42 from polysubstance use while under the influence of cannabis, 17 of 42 active tetrahydrocannabinol or THC (no dosage reported). Twelve cases involved morphine, 11 cases with fentanyl, 6 cases with heroin, 3 cases with codeine, 2 cases with oxycodone and buprenorphine, and a case with hydrocodone. Heroin involvement accounts for 6 cases.

Implications: Cannabinoid-related mortality is indeed a serious problem. The co-presence of opioids such as morphine and fentanyl is notable, warrants further study. Until a safety level of the analgesic effect of cannabinoids is proven safe, the public is warned about the potential adverse effects of using the drugs concurrently.

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