Changes in Fentanyl Distribution in California (preprint)

ABSTRACT

Abstract Background: Fentanyl is a synthetic opioid that is commonly given as a medication to alleviate pain. This drug can be administered through multiple routes hence making it easy to exploit at high rates. Due to the flexibility in which it can be taken it increases the ease of both access and use. The purpose of this study was to analyze trends in the distribution of fentanyl and its formulations across Medicaid enrollees in California and among the 3 - digit registrant zip codes in California over the period of pre-pandemic (2018 - 2019) to the early stages of the COVID -19 pandemic (2020). Methods: Using the Automated Reports and Consolidated Ordering System (ARCOS) the distribution of fentanyl across California was compiled from 2018 to 2020. Utilizing ARCOS the number of individuals within the source population who lived in one of California's many zip codes was observed. To analyze the fentanyl distribution trend we used Google Sheets GraphPad Prism (Version 9.3.0 [463]) and Microsoft 365 Excel. These were helpful to organize the Medicaid ARCOS data, and as well as to create graphs. The Medicaid database was used to compile the number of fentanyl formulations prescribed from 2018 to 2020 across California. Results: The analyses from both databases provided insight into the difference in fentanyl distribution in California from the years 2018 to 2020. After looking further into the many 3 - digit registrant zip codes as well as Medicaid enrollees it was found that there was a decrease in the distribution of fentanyl and its formulations. Additionally it was found that the distribution of fentanyl as a medication by business activities also decreased from 2018 to 2020. Conclusion: The results indicate that there was more fentanyl being distributed and prescribed before the pandemic (2018 - 2019). On the other hand, when we considered the effects of the pandemic during 2020 there was quite a drastic decrease in the amount of fentanyl being prescribed and distributed to those living in California and those enrolled in Medicaid.