A- A A+

Webinar. Treatment Considerations in the Age of Fentanyl 

Fentanyl and other high-potency synthetic opioids are increasingly present in the U.S. drug supply. Healthcare systems, treatment providers, and justice systems are grappling with the physiological consequences of chronic fentanyl use and how its use may impact treatment.

Presenters will discuss practical clinical practice-based guidance on treating opioid use disorder in the age of fentanyl, the use of medications for opioid use disorder (MOUD) in the treatment of individuals using fentanyl, and other considerations and challenges. The free webinar from the Justice Community Opioid Innovation Network (JCOIN) at the National Institute on Drug Abuse (NIDA), in partnership with the American Academy of Addiction Psychiatry (AAAP), the Providers Clinical Support System (PCSS) and the Addiction Policy Forum.

https://us06web.zoom.us/webinar/register/WN_g8r16sesQhSk0AOxmawmLA

Fentanyl Facts and Overdose Risk: A DEA Educational Foundation Course 

Welcome to our course on Fentanyl Facts and Increased Overdose Risk. This course was developed by the Addiction Policy Forum in partnership with the Drug Enforcement Administration (DEA) Educational Foundation and JCOIN to share facts about fentanyl in the U.S., increasing overdose risk, and resources for communities. The course takes approximately 20 minutes to complete. (JCOIN Coordination and Translation Center, Februar 2023)

https://www.jcoinctc.org/courses/fentanyl-facts-and-overdose-risk-a-dea-educational-foundation-course/

USA. Fentanyl Facts and Overdose Risk: An Addiction Policy Forum Course 

This course (20 Minuten, Anm. Forum Substitutionspraxis) was developed by the Addiction Policy Forum and JCOIN to share facts about fentanyl in the U.S., increasing overdose risk, resources for communities, and myths and misconceptions. The course takes approximately 20 minutes to complete. (Addiction Policy Forum and JCOIN, USA, Februar 2023)

https://www.jcoinctc.org/courses/fentanyl-facts-and-overdose-risk-an-apf-course/

Illicit Non-Pharmaceutical Fentanyl and Its Analogs: A Short Review of Literature. 

Velagapudi V, Sethi R. 

Kans J Med. 2023 Jan 18;16:25-27. doi: 10.17161/kjm.vol16.18555. PMID: 36703950; PMCID: PMC9872502.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9872502/

Just Say KNOW: Fentanyl, Fakery & the New Drug Talk. 

Ed, Ternan M. 

Mo Med. 2022 Nov-Dec;119(6):487-488. PMID: 36588636; PMCID: PMC9762230.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9762230/

Wooden chest syndrome: A curious case of fentanyl induced rigidity in adults. 

Baruah U, Gaur H, Saigal D, Pandey D. 

Indian J Anaesth. 2022 Dec;66(12):881-882. doi: 10.4103/ija.ija_171_22. Epub 2022 Dec 20. PMID: 36654889; PMCID: PMC9842087.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842087/

Atypical Fentanyl Transdermal Patch Consumption and Fatalities: Case Report and Literature Review. 

Manetti F, David MC, Gariglio S, Consalvo F, Padovano M, Scopetti M, Grande A, Santurro A. 

Toxics. 2022 Dec 31;11(1):46. doi: 10.3390/toxics11010046. PMID: 36668772; PMCID: PMC9863810.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9863810/

Creating a safer fentanyl. How researchers are making the deadly drug less addictive

A group of scientists say they've created a safer version of fentanyl that could potentially diminish the drug's addictive side effects, which have resulted in annual deaths of tens of thousands of people across the United States. (MedicalXpress, USA, 23.01.2023)

https://medicalxpress.com/news/2023-01-safer-fentanyl-deadly-drug-addictive.html

USA. Tranq Dope: Animal Sedative Mixed With Fentanyl Brings Fresh Horror to U.S. Drug Zones

A veterinary tranquilizer called xylazine is infiltrating street drugs, deepening addiction, baffling law enforcement and causing wounds so severe that some result in amputation. (New York Times, USA, 07.01.2023)

https://www.nytimes.com/2023/01/07/health/fentanyl-xylazine-drug.html

USA. Verheerender neuer Drogenmix in den USA Dealer mischen Pferdeberuhigungsmittel in Opioide 

In den Vereinigten Staaten werden Drogen immer häufiger mit Xylazin versetzt, einem Narkotikum für Tiere. Die Folgen sind fürchterlich. (Spiegel online, 08.01.2023)

https://www.spiegel.de/wissenschaft/medizin/usa-dealer-mischen-pferdeberuhigungsmittel-in-opioide-junkies-faulen-finger-ab-a-eb37a784-c1d4-43af-9637-e18afd24dfb3

Case report on postmortem fentanyl measurement after overdose with more than 67 fentanyl patches. 

Peeters LEJ, Vleut IT, Tan GE, Croes EA, Bethlehem C. 

Forensic Toxicol. 2022 Jan;40(1):199-203. doi: 10.1007/s11419-021-00598-3. Epub 2021 Oct 6. PMID: 36454494; PMCID: PMC9715521.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715521/

Fentanyl Overdose. 

Walter K. 

JAMA. 2022 Dec 2. doi: 10.1001/jama.2022.22462. Epub ahead of print. PMID: 36459152.

https://jamanetwork.com/journals/jama/fullarticle/2799344

Characteristics and context of fentanyl test strip use among syringe service clients in southern Wisconsin. 

Tilhou AS, Birstler J, Baltes A, Salisbury-Afshar E, Malicki J, Chen G, Brown R. 

Harm Reduct J. 2022 Dec 15;19(1):142. doi: 10.1186/s12954-022-00720-7. PMID: 36522777; PMCID: PMC9753354.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9753354/

Abuse, dependence and withdrawal associated with fentanyl and the role of its (designated) route of administration: an analysis of spontaneous reports from Europe. 

Jobski K, Bantel C, Hoffmann F. 

Eur J Clin Pharmacol. 2022 Dec 16. doi: 10.1007/s00228-022-03431-x. Epub ahead of print. PMID: 36525039.

https://link.springer.com/article/10.1007/s00228-022-03431-x

USA. Opioid-Krise in den USA - Fentanyl überschwemmt San Francisco (Video)

Am Golden Gate zeigt sich ein unschönes Bild: Der Konsum harter Drogen auf offener Strasse nimmt stark zu. 

(…) Fentanyl ist überall in Amerika angekommen. Am Golden Gate hat die Droge in den letzten zweieinhalb Jahren nahezu 1400 Tote gefordert. Das sind etwa zwei Drittel aller Drogentoten in diesem Zeitraum in San Francisco. 

Der Ruf wird immer lauter, dass das Weisse Haus Fentanyl als Massenvernichtungswaffe einstuft. So könne besser gegen die mexikanischen Kartelle, die Drogendealer und die chinesischen Importeure vorgegangen werden. (SRF – Schweizerischer Rundfunk, Schweiz, Rendez-vous, 28.11.2022, Video, 05:13)

https://www.srf.ch/news/international/opioid-krise-in-den-usa-fentanyl-ueberschwemmt-san-francisco

Higher potency of fentanyl affects addiction treatment, screening

As fentanyl-related overdose deaths continue to increase, clinicians should take note of important differences that set the drug apart from the other drugs of misuse – and the troubling reality that fentanyl now contaminates most of them.

“It would be fair to tell patients, if you’re buying any illicit drugs – pills, powder, liquid, whatever it is, you’ve got to assume it’s either contaminated with or replaced by fentanyl,” said Edwin Salsitz, MD, an associate clinical professor at the Icahn School of Medicine at Mount Sinai, New York, during a presentation on the subject at the 21st Annual Psychopharmacology Update presented by Current Psychiatry and the American Academy of Clinical Psychiatrists. (MDedge, USA, 01.12.2022)

https://www.mdedge.com/psychiatry/article/259877/addiction-medicine/higher-potency-fentanyl-affects-addiction-treatment

USA. DEA Laboratory Testing Reveals that 6 out of 10 Fentanyl-Laced Fake Prescription Pills Now Contain a Potentially Lethal Dose of Fentanyl

WASHINGTON – The U.S. Drug Enforcement Administration is alerting the public of a sharp nationwide increase in the lethality of fentanyl-laced fake prescription pills.  

The DEA Laboratory has found that, of the fentanyl-laced fake prescription pills analyzed in 2022, six out of ten now contain a potentially lethal dose of fentanyl. This is an increase from DEA’s previous announcement in 2021 that four out of ten fentanyl-laced fake prescription pills were found to contain a potentially lethal dose. (DEA – Drug Enforcement Administration, USA, 21.11.2022)

https://www.dea.gov/alert/dea-laboratory-testing-reveals-6-out-10-fentanyl-laced-fake-prescription-pills-now-contain

An Immunconjugate Vaccine Alters Distribution and Reduces the Antinociceptive, Behavioral and Physiological Effects of Fentanyl in Male and Female Rats. 

Haile CN, Baker MD, Sanchez SA, Lopez Arteaga CA, Duddupudi AL, Cuny GD, Norton EB, Kosten TR, Kosten TA. 

Pharmaceutics. 2022; 14(11):2290. doi.org/10.3390/pharmaceutics14112290

https://www.mdpi.com/1999-4923/14/11/2290

Fentanyl isn’t just causing overdoses. It’s making it harder to start addiction treatment

Doctors are reporting a troubling trend when it comes to fentanyl.

The powerful drug, they say, isn’t just causing overdoses — it’s also making it more difficult to begin addiction treatment. In particular, fentanyl appears more likely to cause severe withdrawal symptoms for patients put on buprenorphine, a key medication used to treat opioid use disorder. (STAT, USA, 16.11.2022)

https://www.statnews.com/2022/11/16/fentanyl-isnt-just-causing-overdoses-its-making-it-harder-to-start-addiction-treatment/

Combating illicit fentanyl: Will increased Chinese regulation generate a public health crisis in India? 

Wang C, Lassi N. 

Front Public Health. 2022 Oct 14;10:969395. doi: 10.3389/fpubh.2022.969395. PMID: 36311594; PMCID: PMC9614337.

https://pubmed.ncbi.nlm.nih.gov/36311594/

"There's No Heroin Around Anymore. It's All Fentanyl." Adaptation of an Opioid Overdose Prevention Counseling Approach to Address Fentanyl Overdose: Formative Study. 

McMahan VM, Arenander J, Matheson T, Lambert AM, Brennan S, Green TC, Walley AY, Coffin PO. 

JMIR Form Res. 2022 Sep 7;6(9):e37483. doi: 10.2196/37483. PMID: 36069781; PMCID: PMC9494212.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9494212/

Fentanyl-Themenseite von Drug Science (UK)

https://www.drugscience.org.uk/drug-information/fentanyl

A Peculiar Case of Fentanyl-Induced Cardiomyopathy. 

Badar F, Ashraf A, Bhuiyan MR, Bimal T, Iftikhar A. 

Cureus. 2022 Aug 5;14(8):e27708. doi: 10.7759/cureus.27708. PMID: 36081981; PMCID: PMC9440989.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440989/

First Known Opiate Biomarker Shows Fentanyl's Effect on the Brain

Fentanyl depresses breathing about 4 minutes before symptoms of distress are evident at a dose that is 1700 times lower than that needed for sedation, new research shows.

This new information comes after researchers identified a unique EEG signature produced by fentanyl, the first known biomarker of an opiate's effect on the brain. (Medscape, USA, 23.09.2022)

https://www.medscape.com/viewarticle/981324

“Rainbow Fentanyl” Is Probably a Good Thing, at This Point

Kanada. When Toronto’s Moss Park Overdose Prevention Site opened as an unsanctioned service in August 2017, drug-checking data contributed by staff and participants caught the final few months that the city’s heroin supply was still mostly heroin. By Christmas, it had shifted completely to fentanyl. Initially this looked clear or white or beige; either powder or small crystals. But almost immediately it started showing up in color. Drug sellers, faced with a sudden crisis, were innovating to protect their customers and themselves. (Filter, USA, 23.09.2022)

https://filtermag.org/rainbow-fentanyl-dea-pills/

An EEG Biomarker of Fentanyl Drug Effects, 

Gustavo A Balanza, Kishore M Bharadwaj, Andrew C Mullen, Amanda M Beck, Erin C Work, Francis J McGovern, Timothy T Houle, Eric T Pierce, Patrick L Purdon, 

PNAS Nexus, 2022;, pgac158, doi.org/10.1093/pnasnexus/pgac158

https://academic.oup.com/pnasnexus/advance-article/doi/10.1093/pnasnexus/pgac158/6678861

Australien. Fentanyl seizure: experts warn potent drug could rapidly emerge as a problem in Australia

Experts say news of record haul of more than 11kg of the opioid drug, found in February, should have been announced sooner. (Guardian, UK, 22.08.2022)

https://www.theguardian.com/australia-news/2022/aug/22/fentanyl-seizure-experts-warn-potent-drug-could-rapidly-emerge-as-a-problem-in-australia

Fentanyl Purity, Potency, & Synthesis: Real-Time Testing of Opioid Drug Products in the United States 

Krotulski, AJ, Shinefeld, J, DeBord, J, Logan, BK (2022), 

Center for Forensic Science Research and Education, United States of America.

https://www.npsdiscovery.org/fentanyl-purity-potency-synthesis-real-time-testing-of-opioid-drug-products-in-the-united-states%EF%BF%BC/

Interaction With the Lipid Membrane Influences Fentanyl Pharmacology. 

Sutcliffe KJ, Corey RA, Alhosan N, Cavallo D, Groom S, Santiago M, Bailey C, Charlton SJ, Sessions RB, Henderson G, Kelly E. 

Adv Drug Alcohol Res. 2022 Mar 21;2:adar.2022.10280. doi: 10.3389/adar.2022.10280. PMID: 35909438; PMCID: PMC7613138.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613138/

When someone overdoses on fentanyl and makes it to the hospital Emergency Department, a high dose of buprenorphine is a lifesaver.

Dr. Gail D’Onofrio, an expert in emergency medicine and addiction, knows that to be true. “In emergency medicine, I was the first person to prescribe in the Emergency Department in the country,” she said. “In the Yale health system, I had the expectation that every faculty member who served here in New Haven had to be waivered.” (New Haven Register, USA, 11.06.2022)

https://www.nhregister.com/news/article/High-dose-drug-treats-fentanyl-overdose-if-you-17234073.php?t=47c3762bb3

  1. Adapting methadone inductions to the fentanyl era
  2. "It wasn't here, and now it is. It's everywhere": fentanyl's rising presence in Oregon's drug supply. 
  3. Impact of fentanyl use on initiation and discontinuation of methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: secondary analysis of a Canadian treatment trial. 
  4. Dose- and Sex-Dependent Bidirectional Relationship between Intravenous Fentanyl Self-Administration and Gut Microbiota. 
  5. Fentanyl preference among people who use opioids in New York City.