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Multiple Fentanyl Overdoses - New Haven, Connecticut, June 23, 2016.

Tomassoni AJ, Hawk KF, Jubanyik K, Nogee DP, Durant T, Lynch KL, Patel R, Dinh D, Ulrich A, D'Onofrio G.

MMWR Morb Mortal Wkly Rep. 2017 Feb 3;66(4):107-111. doi: 10.15585/mm6604a4.

https://www.cdc.gov/mmwr/volumes/66/wr/mm6604a4.htm

USA. FURANYL-FENTANYL·ACRYL-FENTANYL·ACETYL-FENTANYL: A Briefing Guide for First Responders

U.S. Department of Justice - Drug Enforcement Administration, 2017

https://www.dea.gov/druginfo/Fentanyl_BriefingGuideforFirstResponders_June2017.pdf

Opioids for cancer pain - an overview of Cochrane reviews.

Wiffen PJ, Wee B, Derry S, Bell RF, Moore RA.

Cochrane Database Syst Rev. 2017 Jul 6;7:CD012592. doi: 10.1002/14651858.CD012592.pub2. Review.

Abstract

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD012592.pub2/abstract;jsessionid=437108CFF4D2E456DF2C326190AF17D4.f04t01

Fentanyl and carfentanyl – which are many times stronger than morphine – found in bodies of up to 46 people who died this year. (The Guardian, UK, 06.07.2017)

https://www.theguardian.com/society/2017/jul/06/dozens-of-uk-drug-deaths-linked-to-drug-that-killed-singer-prince

Opioids in the Frame of New Psychoactive Substances Network: A Complex Pharmacological and Toxicological Issue.

Ventura L, Carvalho F, Dinis-Oliveira RJ.

Curr Mol Pharmacol. 2017 Jul 4. doi: 10.2174/1874467210666170704110146.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/28676005

EMCDDA–Europol Joint Report on a new psychoactive substance: N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]-furan-2-carboxamide (furanylfentanyl)

EMCDDA, Europol, Lissabon, Juli 2017

http://www.emcdda.europa.eu/publications/joint-reports/furanylfentanyl

Contrary to recent news reporting, there are no fentanyl analogues resistant to Naloxone. News reports indicated a “new” fentanyl analogue, acrylfentanyl, was “extremely powerful” and implied it resisted Naloxone’s effects.

However, acrylfentanyl binds to the same receptors within the human body as fentanyl, meaning correctly administered Naloxone is effective against it. (US Department of Homeland Security, 11.07.2017)

https://drive.google.com/file/d/0B4VhZtoliXjMdG91Q0hnTm1tLVlnZEc2TDZBUDBzZWdvZkNR/view?mc_cid=789b1c66dc&mc_eid=%5BUNIQID&mc_cid=473cb50e0c&mc_eid=5d5993ab16

Influence of opioids on immune function in patients with cancer pain: from bench to bedside.

Boland JW, Graham Pockley A.

Br J Pharmacol. 2017 Jun 8. doi: 10.1111/bph.13903. [Epub ahead of print] Review.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/28593737

Avoiding globalisation of the prescription opioid epidemic

Humphreys, Keith

The Lancet , Volume 390 , Issue 10093 , 437 - 439

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31918-9/fulltext

In 2016, 37 percent of overdose deaths involved cocaine and fentanyl without heroin, up from 11 percent in 2015

Last year more than 1,300 New Yorkers died of a drug overdose, and nearly half (44 percent) of those deaths involved fentanyl. (New York City Health Department, 01.06.2017)

https://www.drugabuse.gov/emerging-trends/new-york-city-issues-health-advisory-about-overdoses-fentanyl-added-to-cocaine

The American College of Obstetricians and Gynecologists: Opioid Use and Opioid Use Disorder in Pregnancy

Committee Opinion No. 711 Summary

Obstetrics & Gynecology: August 2017 - Volume 130 - Issue 2 - p 488–489

doi: 10.1097/AOG.0000000000002229

http://journals.lww.com/greenjournal/Fulltext/2017/08000/Committee_Opinion_No__711_Summary___Opioid_Use_and.50.aspx

LA JOLLA, CA. A vaccine developed at The Scripps Research Institute (TSRI) to block the “high” of heroin has proven effective in non-human primates. This is the first vaccine against an opioid to pass this stage of preclinical testing. (The Scripps Research Institute (TSRI), press release, 06.06.2017)

https://www.scripps.edu/news/press/2017/20170606janda.html

Two novel compounds powerfully suppressed animals’ pain responses, while producing little or none of the respiratory depression and liability for misuse and abuse associated with morphine and other typical opioids.

One of the compounds was extensively tested in a monkey model, laying key groundwork for moving to human trials.

The other compound was identified using computational modeling based on x-ray crystallography of a receptor’s structure, and exemplifies that technique’s potential for identifying novel compounds that can meet highly specific therapeutic needs. (NIDA Notes, 23.02.2017)

https://www.drugabuse.gov/news-events/nida-notes/2017/02/promising-advances-in-search-safer-opioids

Opioid antagonists with minimal sedation for opioid withdrawal.

Gowing L, Ali R, White JM.

Cochrane Database Syst Rev. 2017 May 29;5:CD002021. doi: 10.1002/14651858.CD002021.pub4. Review.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/28553701

Nektar Therapeutics has announced positive topline results from an oral human abuse potential (HAP) study of NKTR-181, a first-in-class opioid analgesic for chronic pain that reportedly carries significantly less abuse potential than oxycodone. (Medscape, 18.07.2017)

http://www.medscape.com/viewarticle/883088

Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study.

Carroll JJ, Marshall BDL, Rich JD, Green TC.

Int J Drug Policy. 2017 Jun 1. pii: S0955-3959(17)30127-5. doi: 10.1016/j.drugpo.2017.05.023.

http://www.ijdp.org/article/S0955-3959(17)30127-5/fulltext

Fentanyl is a short-acting synthetic opiate that is now being used as an adulterant in substances such as heroin, cocaine, and MDMA. Due to its high potency, it has caused numerous deaths on unsuspecting victims. In response to the rising death toll caused by fentanyl-laced drugs, DanceSafe and the University of California San Francisco have conducted a study assessing five different immunoassay fentanyl test strips for their effectiveness at detecting fentanyl and its various analogs at concentrations typically found in street drugs.

Although none of the five strips detected all of the fentanyl-related analogs, and one Chinese-manufactured strip did not work at all, one brand manufactured by the Canadian company, BTNX, did detect most of them, including carfentanil, an extremely potent synthetic opioid hundreds of times stronger than fentanyl. The strips detected fentanyl and most of its analogs at minuscule concentrations, making them a potentially life-saving harm reduction tool.

DanceSafe is now offering these strips through its website to harm reduction service providers and drug consumers alike in the hopes of reducing fentanyl-related fatalities. (dancesafe.org, USA, 18.07.2017)

https://dancesafe.org/dancesafe-now-offering-fentanyl-testing-strips/

Opioid analgesics-related pharmacokinetic drug interactions: from the perspectives of evidence based on randomized controlled trials and clinical risk management.

Feng XQ, Zhu LL, Zhou Q.

J Pain Res. 2017 May 24;10:1225-1239. doi: 10.2147/JPR.S138698. eCollection 2017. Review.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449157/

ATLANTA –  The yellow pills had already killed four before landing in Brian Hargett’s lab last month. They were clearly counterfeit — the letters P-E-R-C-O-C-E-T were as crooked as the dealer who had peddled them throughout central Georgia — but now his chemists had to figure out exactly what they were. And fast. Lives were still at stake; health officials wanted to alert the public about the phony pills. First, though, they had to know what was in them. (Fox News Health, 05.07.2017)

http://www.foxnews.com/health/2017/07/05/as-new-and-lethal-opioids-flood-us-streets-crime-labs-race-to-identify-them.html

London/UK. EVIDENCE OF HARM FROM FENTANYL-CONTAMINATED HEROIN

This alert advises of the availability of, and harms from, heroin that has been mixed with fentanyl or carfentanyl, both unusually potent synthetic opioids.

There is significant evidence from a small number of post-mortem results of recent drug user deaths and from police seizures that some heroin may contain fentanyl or carfentanyl added by dealers.

These are highly potent synthetic opioids and very small amounts can cause severe or even fatal toxicity.(PHE – Public Health England, 27.04.2017)

http://blenheimcdp.org.uk/wp-content/uploads/2017/06/170427-PHE-Fentanyl-alert-PC-final-3.pdf

USA. ACRYLFENTANYL AND NALOXONE EFFECTIVENESS

Recently there have been news reports of a “new” fentanyl analogue, acrylfentanyl, calling the drug ”extremely powerful” and implying that it can render naloxone ineffective. Elements of these reports are incorrect and misleading. (EXECUTIVE OFFICE OF THE PRESIDENT, OFFICE OF NATIONAL DRUG CONTROL POLICY, Juli 2017)

https://ndews.umd.edu/sites/ndews.umd.edu/files/pubs/ondcp-press-release-nalxone-effectiveness-july2017.pdf

Anonymous online sales are surging, and people are dying. Despite dozens of arrests, new merchants — many based in Asia — quickly pop up.

As the nation’s opioid crisis worsens, the authorities are confronting a resurgent, unruly player in the illicit trade of the deadly drugs, one that threatens to be even more formidable than the cartels.

The internet. (New York Times, 10.06.2017)

https://www.nytimes.com/2017/06/10/business/dealbook/opioid-dark-web-drug-overdose.html

Efficacy of Tramadol Extended-Release for Opioid Withdrawal.

Kelly E. Dunn, D. Andrew Tompkins, George E. Bigelow, Eric C. Strain.

JAMA Psychiatry, 2017; DOI: 10.1001/jamapsychiatry.2017.1838

http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2642924

The US opioid epidemic may be getting even worse. Preliminary data suggests overdoses are soaring, while law enforcement officials have been warned about the dangers of fentanyl after it caused a police officer to collapse. (New Scientist, 09.06.2017)

https://www.newscientist.com/article/2134181-police-warned-of-drug-so-powerful-it-can-kill-in-one-breath/

Silver Spring/Maryland – Die US-Arzneimittelbehörde FDA hat den Hersteller Endo Pharmaceuticals unmissverständlich aufgefordert, das Präparat Opana ER vom Markt zu nehmen. Das Schmerzmittel mit dem Opioid Oxymorphon in einer verzögerten Formulierung erfreute sich zuletzt bei Drogenabhängigen großer Beliebtheit, die Tabletten gemörsert und in Flüssigkeit aufgelöst intravenös injizierten. (aerzteblatt.de, 13.06.2017)

https://www.aerzteblatt.de/nachrichten/76296/Oxymorphon-FDA-will-haeufig-missbrauchtes-Opioid-vom-Markt-schaffen

Brüssel – Nach mehreren Todesfällen will die EU-Kommission die in manchen Nasensprays enthaltene Chemikalie Furanylfentanyl künftig strenger kontrollieren. Dies hat die EU-Behörde vorgeschlagen. (aerzteblatt.de, 07.07.2017)

https://www.aerzteblatt.de/nachrichten/76787/EU-Kommission-plant-strengere-Kontrollen-bei-Nasensprays-mit-Furanylfentanyl

Drug binding poses relate structure with efficacy in the μ opioid receptor.

Sutcliffe KJ, Henderson G, Kelly E, Sessions RB.

J Mol Biol. 2017 May 11. pii: S0022-2836(17)30223-1. doi: 10.1016/j.jmb.2017.05.009.

http://www.sciencedirect.com/science/article/pii/S0022283617302231