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Consuming illicit opioids during a drug overdose epidemic: Illicit fentanyls, drug discernment, and the radical transformation of the illicit opioid market. 

Duhart Clarke SE, Kral AH, Zibbell JE. 

Int J Drug Policy. 2021 Oct 15;99:103467. doi: 10.1016/j.drugpo.2021.103467. Epub ahead of print. PMID: 34662847.

https://www.sciencedirect.com/science/article/pii/S0955395921003728

Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls — United States, 2019–2020. 

O’Donnell J, Tanz LJ, Gladden RM, Davis NL, Bitting J. 

MMWR Morb Mortal Wkly Rep 2021;70:1740-1746. doi.org/10.15585/mmwr.mm7050e3

https://www.cdc.gov/mmwr/volumes/70/wr/mm7050e3.htm

Can touch this: training to correct police officer beliefs about overdose from incidental contact with fentanyl. 

Del Pozo B, Sightes E, Kang S, Goulka J, Ray B, Beletsky LA. 

Health Justice. 2021 Nov 24;9(1):34. doi: 10.1186/s40352-021-00163-5. PMID: 34817717; PMCID: PMC8612110.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8612110/

Illicitly Manufactured Fentanyl Entering the United States. 

Pergolizzi J, Magnusson P, LeQuang JAK, Breve F. 

Cureus. 2021 Aug 27;13(8):e17496. doi: 10.7759/cureus.17496. PMID: 34603876; PMCID: PMC8476199.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476199/

Fentanyl-Induced Respiratory Depression: A Narrative Review on the Possible Single-Nucleotide Polymorphism. 

Udayakumar P, Udayakumar S. 

Anesth Essays Res. 2021 Jan-Mar;15(1):4-7. doi: 10.4103/aer.aer_94_21. Epub 2021 Aug 30. PMID: 34667340; PMCID: PMC8462425.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462425/

EMCDDA. Spotlight on… Fentanils and other new opioids 

What are new opioids?

New opioids are synthetic narcotic analgesics that have recently appeared on the drugs market, many of which are highly potent substances that can pose a life-threatening risk of poisoning. Fentanils are a particularly potent group of synthetic opioids. In some cases, these substances are used in human and veterinary medicine, in anaesthesia and for pain management. However, fentanils are also synthesised illicitly and may be sold as ‘synthetic heroin’, or mixed with heroin or other illicit drugs, and even counterfeit or fake medicines. (EMCDDA, Lissabon, 20.10.2021)

https://www.emcdda.europa.eu/spotlights/fentanils-and-other-new-opioids_en

Addressing fentanyl use disorder with fentanyl-assisted treatment

Krausz, R Michael et al.

The Lancet Psychiatry, Volume 0, Issue 0 

Abstract

Addressing fentanyl use disorder with fentanyl-assisted treatment

Results from a mobile drug checking pilot program using three technologies in Chicago, IL, USA. 

Karch L, Tobias S, Schmidt C, Doe-Simkins M, Carter N, Salisbury-Afshar E, Carlberg-Racich S. 

Drug Alcohol Depend. 2021 Aug 28;228:108976. doi: 10.1016/j.drugalcdep.2021.108976. Epub ahead of print. PMID: 34536717.

Abstract

https://pubmed.ncbi.nlm.nih.gov/34536717/

Fentanyl causes naloxone-resistant vocal cord closure: A platform for testing opioid overdose treatments. 

Miner NB, Schutzer WE, Zarnegarnia Y, Janowsky A, Torralva R. 

Drug Alcohol Depend. 2021 Oct 1;227:108974. doi: 10.1016/j.drugalcdep.2021.108974. Epub 2021 Aug 28. PMID: 34492557.

Abstract

https://pubmed.ncbi.nlm.nih.gov/34492557/

Transition from injecting opioids to smoking fentanyl in San Francisco, California. 

Kral AH, Lambdin BH, Browne EN, Wenger LD, Bluthenthal RN, Zibbell JE, Davidson PJ. 

Drug Alcohol Depend. 2021 Oct 1;227:109003. doi: 10.1016/j.drugalcdep.2021.109003. Epub 2021 Aug 27. PMID: 34482046.

Abstract

https://pubmed.ncbi.nlm.nih.gov/34482046/

Fentanyl versus Methadone in Management of Withdrawal Syndrome in Opioid Addicted Patients; a Pilot Clinical Trial. 

Najafi B, Shadnia S, Hassanian-Moghaddam H, Heydarian A, Mahdavinejad A, Zamani N. 

Arch Acad Emerg Med. 2021 Sep 13;9(1):e62. doi: 10.22037/aaem.v9i1.1384. PMID: 34580660; PMCID: PMC8464014.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464014/

USA. One Pill Can Kill - PUBLIC SAFETY ALERT

Sharp Increase in Fake Prescription Pills Containing Fentanyl and Meth - Illegal, Dangerous, Potentially Deadly.

(Department of Justice – DEA Drug Enforcement Administration, USA, September 2021)

https://www.dea.gov/onepill

Anti-Fentanyl Vaccines as Medical Solutions to Overdose Deaths

Thomas R. Kosten, MD

Manufactured fentanyl is a major cause of overdoses for opioids and nonopiods. Can a vaccine immunize against overdose? (Psychiatric Times, USA, 10.08.2021)

https://www.psychiatrictimes.com/view/anti-fentanyl-vaccines-as-medical-solutions-to-overdose-deaths

Imagining a fentanyl future: Some consequences of synthetic opioids replacing heroin. 

Reuter P, Pardo B, Taylor J. 

Int J Drug Policy. 2021 Jan 7:103086. doi: 10.1016/j.drugpo.2020.103086. Epub ahead of print. PMID: 33423915.

Abstract

https://pubmed.ncbi.nlm.nih.gov/33423915/

Fentanyl-related overdose during incarceration: a comprehensive review. 

Kaplowitz E, Truong AQ, Macmadu A, Peterson M, Brinkley-Rubinstein L, Potter N, Green TC, Clarke JG, Rich JD. 

Health Justice. 2021 May 19;9(1):13. doi: 10.1186/s40352-021-00138-6. PMID: 34013442; PMCID: PMC8133055.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133055/

The epidemic of fentanyl misuse and overdoses: challenges and strategies. 

Volkow ND. 

World Psychiatry. 2021 Jun;20(2):195-196. doi: 10.1002/wps.20846. PMID: 34002497; PMCID: PMC8129846.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8129846/

Steep increases in fentanyl-related mortality west of the Mississippi River: Recent evidence from county and state surveillance. 

Shover CL, Falasinnu TO, Dwyer CL, Santos NB, Cunningham NJ, Freedman RB, Vest NA, Humphreys K. 

Drug Alcohol Depend. 2020 Nov 1;216:108314. doi: 10.1016/j.drugalcdep.2020.108314. Epub 2020 Sep 28. PMID: 33038637; PMCID: PMC7521591.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521591/

Kanada. Students' innovative idea could help prevent fentanyl overdoses

A group of University of Alberta science students won $100,000 to help turn a brainstorming session about what could have helped family members avoid a fentanyl overdose into a street-ready solution that will ultimately be a lifeline for those who struggle with addiction. (University of Alberta, Kanada, 19.04.2021)

https://educationnewscanada.com/article/education/level/university/1/893300/students-innovative-idea-could-help-prevent-fentanyl-overdoses.html

USA. Federal Grantees May Now Use Funds to Purchase Fentanyl Test Strips

New Guidance Aims to Reduce Drug Overdose Deaths

The Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) announced today that federal funding may now be used to purchase rapid fentanyl test strips (FTS) in an effort to help curb the dramatic spike in drug overdose deaths largely driven by the use of strong synthetic opioids, including illicitly manufactured fentanyl. (Substance Abuse and Mental Health Services Administration (SAMHSA), USA, 07.04.2021)

https://www.samhsa.gov/newsroom/press-announcements/202104070200

High concentrations of illicit stimulants and cutting agents cause false positives on fentanyl test strips. 

Lockwood, TL.E., Vervoordt, A. & Lieberman, M. 

Harm Reduct J 18, 30 (2021). doi.org/10.1186/s12954-021-00478-4

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-021-00478-4

Australien. Drug Warning: Fentanyl and acetylfentanyl

Fentanyl and acetylfentanyl have been found in heroin in central Sydney during January 2021.These drugs were also found in regional NSW and Sydney during November and December 2020. (New South Wales, Government, NSW Health, Australien, 28.01.2021)

https://www.health.nsw.gov.au/aod/public-drug-alerts/Documents/public-drug-warning-heroin-fentanyl-sydney-update.pdf

Increasing presence of xylazine in heroin and/or fentanyl deaths, Philadelphia, Pennsylvania, 2010–2019

Johnson J, Pizzicato L, Johnson C, et al

Injury Prevention Published Online First: 03 February 2021. doi: 10.1136/injuryprev-2020-043968 

https://injuryprevention.bmj.com/content/early/2020/12/02/injuryprev-2020-043968

Causes, Nature and Toxicology of Fentanyl-Associated Deaths: A Systematic Review of Deaths Reported in Peer-Reviewed Literature. 

Cheema E, McGuinness K, Hadi MA, Paudyal V, Elnaem MH, Alhifany AA, Elrggal ME, Al Hamid A. 

J Pain Res. 2020 Dec 7;13:3281-3294. doi: 10.2147/JPR.S280462. PMID: 33324089; PMCID: PMC7732170.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732170/

A randomized clinical trial of a theory-based fentanyl overdose education and fentanyl test strip distribution intervention to reduce rates of opioid overdose: study protocol for a randomized controlled trial. 

Jacka BP, Goldman JE, Yedinak JL, Bernstein E, Hadland SE, Buxton JA, Sherman SG, Biello KB, Marshall BDL. 

Trials. 2020 Nov 26;21(1):976. doi: 10.1186/s13063-020-04898-8. PMID: 33243291; PMCID: PMC7690169.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690169/

Addressing fentanyl‐related harms: maximizing the efficiency of innovative interventions. 

May, T., Buhociu, M., and Holloway, K. (2020)

Addiction, doi.org/10.1111/add.15323

https://onlinelibrary.wiley.com/doi/full/10.1111/add.15323

Australien. Fentanyl found in street drugs

Strong opioids have been identified as likely adulterants in some drugs following recent cases of serious harm, with those at risk encouraged to access naloxone. (

Australian Journal of Pharmacy, 27.11.2020)

https://ajp.com.au/news/fentanyl-found-in-street-drugs/

How the complex pharmacology of the fentanyls contributes to their lethality. 

Gill H, Kelly E, Henderson G. 

Addiction. 2019 Sep;114(9):1524-1525. doi: 10.1111/add.14614. Epub 2019 Apr 17. PMID: 30883941; PMCID: PMC6767370.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767370/

USA. Street Fentanyl Surges In Western U.S., Leading To Thousands Of Deaths

(…) “Chinese chemical companies quickly adapted by selling their product to "middle man" drug cartels in Mexico. “They're sending precursor chemicals directly to cartels in Mexico to produce the fentanyl along with the fentanyl in pills," Donahue said.
Once they got into the fentanyl trade, Mexican cartels used their existing drug routes and street markets in Western cities to push the new product. Their motives are simple: Fentanyl is deadly, but it's also cheap and easy to make and ship. It's also highly addictive, making it far more profitable than heroin or cocaine.” (NPR – National Public Radio, USA, 17.11.2020)

https://www.npr.org/2020/11/17/934154859/street-fentanyl-surges-in-western-u-s-leading-to-thousands-of-deaths?

Fentanyl panic goes viral: The spread of misinformation about overdose risk from casual contact with fentanyl in mainstream and social media. 

Beletsky L, Seymour S, Kang S, Siegel Z, Sinha MS, Marino R, Dave A, Freifeld C. 

Int J Drug Policy. 2020 Sep 16;86:102951. doi: 10.1016/j.drugpo.2020.102951. Epub ahead of print. PMID: 32949901; PMCID: PMC7492952.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492952/

Stop ignoring China's other killer export: fentanyl 

As coronavirus infections continue to rise, the pandemic has remained a key focus of the 2020 presidential campaign. At the same time, another health threat has taken hundreds of thousands of American lives and has hardly been mentioned: the opioid crisis, which is being driven by China's other killer export, fentanyl. (The Hill, USA, 31.10.2020)

https://thehill.com/opinion/healthcare/523752-stop-ignoring-chinas-other-killer-export-fentanyl