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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

Treatment of overdose in the synthetic opioid era. 

Skolnick P. 

Pharmacol Ther. 2022 May;233:108019. doi: 10.1016/j.pharmthera.2021.108019. Epub 2021 Oct 9. PMID: 34637841.

https://www.sciencedirect.com/science/article/pii/S0163725821002217

Kanada. ‘I Want Them to Break Up with Their Drug Dealer’

A new Vancouver program provides prescribed fentanyl with few barriers. (The Tyee, Kanada, 11.04.2022)

https://thetyee.ca/News/2022/04/11/I-Want-Them-To-Break-Up-Drug-Dealer/

USA. ‘We’re done with dead kids’: U.S. bars are handing out free fentanyl tests

(…) Strips to test drugs for the presence of the deadly synthetic opioid are becoming more commonplace in bars, restaurants and venues as the country grapples with the opioid epidemic and soaring death toll. (Medscape, USA, 21.04.2022)

https://www.reuters.com/business/healthcare-pharmaceuticals/were-done-with-dead-kids-us-bars-hand-out-free-fentanyl-tests-2022-04-20/

USA. Law enforcement seizures of pills containing fentanyl increased dramatically between 2018-2021 

NIH-supported research highlights growing, dangerous trend, particularly for people new to drug use. (NIH – National Institute on Drug Abuse, 31.03.2022)

https://nida.nih.gov/news-events/news-releases/2022/03/law-enforcement-seizures-of-pills-containing-fentanyl-increased-dramatically-between-2018-2021

Modelling buprenorphine reduction of fentanyl-induced respiratory depression. 

Olofsen E, Algera MH, Moss L, Dobbins RL, Groeneveld GJ, van Velzen M, Niesters M, Dahan A, Laffont CM. 

JCI Insight. 2022 Mar 22:e156973. doi: 10.1172/jci.insight.156973. Epub ahead of print. PMID: 35316224.

https://insight.jci.org/articles/view/156973

In vitro and in vivo pharmaco-dynamic study of the novel fentanyl derivatives: Acrylfentanyl, Ocfentanyl and Furanylfentanyl. 

Bilel S, Azevedo Neto J, Arfè R, Tirri M, Gaudio RM, Fantinati A, Bernardi T, Boccuto F, Marchetti B, Corli G, Serpelloni G, De-Giorgio F, Malfacini D, Trapella C, Calo' G, Marti M. 

Neuropharmacology. 2022 May 15;209:109020. doi: 10.1016/j.neuropharm.2022.109020. Epub 2022 Mar 2. PMID: 35247453.

https://www.sciencedirect.com/science/article/pii/S002839082200079X?via%3Dihub

Pharmacological profiling of anti-fentanyl monoclonal antibodies in combination with naloxone in pre- and post-exposure models of fentanyl toxicity. 

Baehr CA, Wu MM, Pandit SG, Arias-Umana J, AuCoin D, Pravetoni M. 

J Pharmacol Exp Ther. 2022 Feb 13:JPET-AR-2021-001048. doi: 10.1124/jpet.121.001048. Epub ahead of print. PMID: 35153198.

https://jpet.aspetjournals.org/content/early/2022/02/13/jpet.121.001048.long

USA. As fentanyl overdoses rise, so does use of 'party drug' test strips

(HealthDay)—Potent and poisonous, the synthetic opioid known as fentanyl has infiltrated nearly every corner of the U.S. illegal street drug market, experts warn. 

In the process, it's killing addicts and recreational "party drug" users alike. (MedicalXpress, USA, 18.02.2022)

https://medicalxpress.com/news/2022-02-fentanyl-overdoses-party-drug.html

Complicating the Opioid Epidemic: The Many Faces of Fentanyl 

Expanded library of known variants, new research efforts aid the fight against fentanyl. (PNNL - Pacific Northwest National Laboratory, USA, 10.02.2022)

https://www.pnnl.gov/news-media/complicating-opioid-epidemic-many-faces-fentanyl

Effect of sustained high buprenorphine plasma concentrations on fentanyl-induced respiratory depression: A placebo-controlled crossover study in healthy volunteers and opioid-tolerant patients. 

Moss LM, Algera MH, Dobbins R, Gray F, Strafford S, Heath A, et al. (2022) 

PLoS ONE 17(1): e0256752. doi.org/10.1371/journal.pone.0256752

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256752

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/