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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

How mu-Opioid Receptor Recognizes Fentanyl. 

Vo Q, Mahinthichaichan P, Shen J, Ellis C. 

Res Sq [Preprint]. 2020 Sep 9:rs.3.rs-67888. doi: 10.21203/rs.3.rs-67888/v1. PMID: 32935088; PMCID: PMC7491576.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491576/

A qualitative study of repeat naloxone administrations during opioid overdose intervention by people who use opioids in New York City.

Stephen Parkin, Joanne Neale, Caral Brown, Jermaine D. Jones, Laura Brandt, Felipe Castillo, Aimee N.C. Campbell, JohnStrang, Sandra D.Comer

International Journal of Drug Policy, Volume 87, January 2021, 102968, doi.org/10.1016/j.drugpo.2020.102968

https://www.sciencedirect.com/science/article/pii/S0955395920303066?dgcid=author

Perceptions about fentanyl-adulterated heroin and overdose risk reduction behaviors among persons seeking treatment for heroin use. 

Stein MD, Kenney SR, Anderson BJ, Bailey GL. 

J Subst Abuse Treat. 2019;104:144-147. doi:10.1016/j.jsat.2019.07.006

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702957/

Fentanyl: Receptor pharmacology, abuse potential, and implications for treatment. 

Comer SD, Cahill CM. 

Neurosci Biobehav Rev. 2019;106:49-57. doi:10.1016/j.neubiorev.2018.12.005

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233332/

How μ -Opioid Receptor Recognizes Fentanyl. Preprint. 

Vo QN, Mahinthichaichan P, Shen J, Ellis CR. 

bioRxiv. 2020;2020.08.16.253013. Published 2020 Aug 20. doi:10.1101/2020.08.16.253013

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444290/

Training to reduce emergency responders’ perceived overdose risk from contact with fentanyl: early evidence of success. 

Winograd, R.P., Phillips, S., Wood, C.A. et al.

Harm Reduct J 17, 58 (2020). doi.org/10.1186/s12954-020-00402-2

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00402-2

Training to reduce emergency responders’ perceived overdose risk from contact with fentanyl: early evidence of success. 

Winograd, R.P., Phillips, S., Wood, C.A. et al.

Harm Reduct J 17, 58 (2020). doi.org/10.1186/s12954-020-00402-2

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00402-2

Determination of 37 fentanyl analogues and novel synthetic opioids in hair by UHPLC-MS/MS and its application to authentic cases. 

Qin N, Shen M, Xiang P, et al. 

Sci Rep. 2020;10(1):11569. Published 2020 Jul 14. doi:10.1038/s41598-020-68348-w

Determination of 37 fentanyl analogues and novel synthetic opioids in hair by UHPLC-MS/MS and its application to authentic cases. 

Europa. How can EU countries be prepared and equipped for a continued rise in Synthetic Opioids prevalence, use and incidents?

Synthetic Opioids – PREParedness: On this website, you find the project related information. Reports, resources, briefing papers and fact sheets will be added during the course of the project. (TRIMBOS INSTITUUT, Niederlande, Juli 2020. This project is funded by the European Union’s Justice Programme – Drugs Policy Initiatives)

so-prep-project.eu/

One year of methadone maintenance treatment in a fentanyl endemic area: Safety, repeated exposure, retention, and remission. 

Stone AC, Carroll JJ, Rich JD, Green TC. 

J Subst Abuse Treat. 2020;115:108031. doi:10.1016/j.jsat.2020.108031

Abstract

https://pubmed.ncbi.nlm.nih.gov/32600619/

Take-home Test Strips Allow Drug Users to Detect Fentanyl

Illicit drug users seem to overwhelmingly appreciate being able to use take-home test strips to detect the extremely common presence of dangerous fentanyl in opioids and other drugs, a new study finds. More than 95% said they'd use the inexpensive strips again.

"These tests accurately detect fentanyl in the drug supply, and they can be a valuable addition to other drug prevention strategies," said study lead author addiction medicine specialist Sukhpreet Klaire, MD, of the British Columbia Center on Substance Use in Vancouver, in an interview. (Medscape, USA, 03.07.2020)

https://www.medscape.com/viewarticle/933389

Harm reduction measures employed by people using opioids with suspected fentanyl exposure in Boston, Baltimore, and Providence. 

Rouhani S, Park JN, Morales KB, Green TC, Sherman SG. 

Harm Reduct J. 2019;16(1):39. Published 2019 Jun 24. doi:10.1186/s12954-019-0311-9

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591810/

Fentanyl but not Morphine Interacts with Non-Opioid Recombinant Human Neurotransmitter Receptors and Transporters 

Torralva R, Eshleman AJ, Swanson TL, et al. 

[published online ahead of print, 2020 Jun 8]. J Pharmacol Exp Ther. 2020;jpet.120.265561. doi:10.1124/jpet.120.265561

http://jpet.aspetjournals.org/content/early/2020/06/08/jpet.120.265561.long

An Efficient and Smooth Methadone-to-Buprenorphine Transition Protocol Utilizing a Transdermal Fentanyl Bridge and a Pharmacokinetic Inducer: The Stanciu Method. 

Stanciu CN, Gibson S, Teja N, Healey CJ. 

Cureus. 2020;12(5):e8310. Published 2020 May 27.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320635/

Illicit fentanyls in the opioid street market: desired or imposed?. 

Mars SG, Rosenblum D, Ciccarone D. 

Addiction. 2019;114(5):774-780. doi:10.1111/add.14474

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6548693/

Higher naloxone dosing in a quantitative systems pharmacology model that predicts naloxone-fentanyl competition at the opioid mu receptor level. 

Moss RB, Pryor MM, Baillie R, Kudrycki K, Friedrich C, Reed M, et al. (2020) 

PLoS ONE 15(6): e0234683. https://doi.org/10.1371/journal.pone.0234683

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234683

Regional variation in states' naloxone accessibility laws in association with opioid overdose death rates-Observational study (STROBE compliant). 

You HS, Ha J, Kang CY, et al. 

Medicine (Baltimore). 2020;99(22):e20033. doi:10.1097/MD.0000000000020033

https://journals.lww.com/md-journal/FullText/2020/05290/Regional_variation_in_states__naloxone.18.aspx

Generational trends in US opioid-overdose deaths 

Deaths from opioid overdose in the USA have followed three distinct waves that have all affected baby boomers, generation X and millennials. Wayne Hall, Louisa Degenhardt and Matthew Hickman. (Nature Medicine, Published online 04. May 2020, doi.org/10.1038/s41591-020-0875-7

https://www.nature.com/articles/s41591-020-0875-7.epdf