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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

Adapting methadone inductions to the fentanyl era

Buresh, Megan et al.

Journal of Substance Abuse Treatment, Volume 141, 108832 

Abstract

https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(22)00114-3/fulltext

"It wasn't here, and now it is. It's everywhere": fentanyl's rising presence in Oregon's drug supply. 

Shin SS, LaForge K, Stack E, Pope J, Leichtling G, Larsen JE, Leahy JM, Seaman A, Hoover D, Chisholm L, Blazes C, Baker R, Byers M, Branson K, Korthuis PT. 

Harm Reduct J. 2022 Jul 11;19(1):76. doi: 10.1186/s12954-022-00659-9. PMID: 35818072; PMCID: PMC9275036.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275036/

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. 

Socias ME, Wood E, Le Foll B, Lim R, Choi JC, Mok WY, Bruneau J, Rehm J, Wild TC, Bozinoff N, Hassan A, Jutras-Aswad D; OPTIMA Research Group within the Canadian Research Initiative in Substance Misuse. 

Addiction. 2022 Jun 17. doi: 10.1111/add.15954. Epub ahead of print. PMID: 35712892.

Abstract

https://pubmed.ncbi.nlm.nih.gov/35712892/

Dose- and Sex-Dependent Bidirectional Relationship between Intravenous Fentanyl Self-Administration and Gut Microbiota. 

Ren M, Lotfipour S. 

Microorganisms. 2022 May 30;10(6):1127. doi: 10.3390/microorganisms10061127. PMID: 35744645; PMCID: PMC9229572.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9229572/

Fentanyl preference among people who use opioids in New York City. 

Urmanche AA, Beharie N, Harocopos A. 

Drug Alcohol Depend. 2022 Jun 6;237:109519. doi: 10.1016/j.drugalcdep.2022.109519. Epub ahead of print. PMID: 35714532.

Abstract

https://pubmed.ncbi.nlm.nih.gov/35714532/

USA. Bromazolam Prevalence Surging Across the United States Driven In Part by Increasing Detections Alongside Fentanyl

Purpose: The objective of this announcement is to notify public health and safety, law enforcement, first responders, clinicians, medical examiners and coroners, forensic and clinical laboratory personnel, and all other related communities about new information surrounding the emergent benzodiazepine bromazolam. (cfsre – nps discovery, USA, Juni 2022)

https://www.npsdiscovery.org/wp-content/uploads/2022/06/Public-Alert_Bromazolam_NPS-Discovery_061522.pdf?mc_cid=5d1e4ead17&mc_eid=0872426f82

Unique Pharmacology, Brain Dysfunction, and Therapeutic Advancements for Fentanyl Misuse and Abuse. 

Han Y, Cao L, Yuan K, Shi J, Yan W, Lu L. 

Neurosci Bull. 2022 May 15:1–18. doi: 10.1007/s12264-022-00872-3. Epub ahead of print. PMID: 35570233; PMCID: PMC9107910.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107910/

"They say it's fentanyl, but they honestly look like Perc 30s": Initiation and use of counterfeit fentanyl pills. 

Daniulaityte R, Sweeney K, Ki S, Doebbeling BN, Mendoza N. 

Harm Reduct J. 2022 May 25;19(1):52. doi: 10.1186/s12954-022-00634-4. PMID: 35614447; PMCID: PMC9131678.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131678/

A comprehensive evaluation of the potential binding poses of fentanyl and its analogs at the µ-opioid receptor. 

Xie B, Goldberg A, Shi L. 

Comput Struct Biotechnol J. 2022 May 14;20:2309-2321. doi: 10.1016/j.csbj.2022.05.013. PMID: 35615021; PMCID: PMC9123087.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9123087/

Rapid changes in illegally manufactured fentanyl products and prices in the United States

Kilmer, B., Pardo, B., Pujol, T. A., and Caulkins, J. P. (2022) 

Addiction. doi.org/10.1111/add.15942

https://onlinelibrary.wiley.com/doi/abs/10.1111/add.15942

What is fentanyl?

Pharmaceutical fentanyl is a synthetic opioid, approved for treating severe pain, typically advanced cancer pain.1 It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.

However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl.2 It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects. (CDC - Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, USA, 16.02.2021)

https://www.cdc.gov/opioids/basics/fentanyl.html

How a powdered fentanyl program has improved a client’s quality of life

Andreas Laupacis

CMAJ May 16, 2022 194 (19) E681; doi.org/10.1503/cmaj.220649 

https://www.cmaj.ca/content/194/19/E681

USA. PODCAST: Director of NIDA Dr. Nora Volkow

Like many families, Dr. Nora Volkow’s had kept it a secret that her grandfather had a substance use disorder and eventually committed suicide. Today, as the director of the National Institute on Drug Abuse at the National Institutes of Health, she speaks out regularly about how important it is to share these stories to help other families impacted by addiction. 

Dr. Volkow sits down with Heart of the Matter host Elizabeth Vargas to discuss the growing complexities of fentanyl-laced drugs; the state of mental health in our nation; what the pandemic can teach us about allocating resources to communities in need; and her deeply personal story. 

Complete episode transcript: https://drugfree.org/article/heart-of-the-matter-guest-nora-volkow/

(drugfree.org, USA, 17.05.2022, Audio, 41:32)

https://drugfree.org/elizabeth-vargas-podcast/#Listen%20now

USA/China. US asks China to do more to stop rising drug deaths from fentanyl

Beijing must "do more" to stop the export of chemicals to make fentanyl, the US drug law enforcement agency has said.

The plea from the Drug Enforcement Agency (DEA) comes as US deaths from drug overdoses exceeded 100,000 for the first time in a single calendar year.

Two-thirds were linked to fentanyl, a synthetic opioid some 50 times more powerful than heroin.

Officials say most US fentanyl is made in Mexico from Chinese-made chemicals. (BBC, UK, 11.05.2022)

https://www.bbc.com/news/world-us-canada-61413783

Case report: acute care management of severe opioid withdrawal with IV fentanyl. 

Azar P, Westenberg JN, Ignaszewski MJ, Wong JSH, Isac G, Mathew N, Krausz RM. 

Addict Sci Clin Pract. 2022 Apr 5;17(1):22. doi: 10.1186/s13722-022-00305-6. PMID: 35382882; PMCID: PMC8980769.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980769/

Naloxone’s dose-dependent displacement of [11C]carfentanil and duration of receptor occupancy in the rat brain. 

Kang, Y., O’Conor, K.A., Kelleher, A.C. et al.

Sci Rep 12, 6429 (2022). doi.org/10.1038/s41598-022-09601-2

https://www.nature.com/articles/s41598-022-09601-2