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Report on the risk assessment of N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]furan-2-carboxamide (furanylfentanyl) in the framework of the Council Decision on new psychoactive substances

This publication presents the data and findings of the risk assessment on N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]furan-2-carboxamide (furanylfentanyl), carried out by the extended Scientific Committee of the EMCDDA on 23 May 2017. On the basis of the Risk Assessment Report — and on the initiative of the European Commission — on 15 November 2017, the Council decided that furanylfentanyl should be subject to control measures across the Member States. (EMCDDA, Lissabon, Dezember 2017)

http://www.emcdda.europa.eu/publications/risk-assessments/furanylfentanyl_en

Report on the risk assessment of N-(1‑phenethylpiperidin-4-yl)-N-phenylacrylamide (acryloylfentanyl) in the framework of the Council Decision on new psychoactive substances

This publication presents the data and findings of the risk assessment on N-(1‑phenethylpiperidin-4-yl)-N-phenylacrylamide (acryloylfentanyl), carried out by the extended Scientific Committee of the EMCDDA on 22 February 2017. On the basis of the Risk Assessment Report — and on the initiative of the European Commission — on 25 September 2017, the Council decided that acryloylfentanyl should be subject to control measures across the Member States. (EMCDDA, Lissabon, Dezember 2017)

http://www.emcdda.europa.eu/publications/risk-assessments/acryloylfentanyl_en

USA. Skyrocketing fentanyl seizures illustrate its growing contribution to opioid crisis 

U.S. border patrol agents snagged about two pounds of fentanyl in 2013. This year, they seized nearly 1,500 pounds of the deadly substance.

Fentanyl, a synthetic opioid that is many times more potent than heroin, has exploded onto the nation’s illicit drug scene over the past few years – so much so that many experts are identifying it as the most dangerous and widespread culprit in the opioid abuse crisis. (Washington Post, 06.12.2017)

https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/12/06/the-health-202-skyrocketing-fentanyl-seizures-illustrate-its-growing-contribution-to-opioid-crisis/5a26b45a30fb0469e883f9ff/

USA. Separating side effects could hold key for safer opioids

NIH-funded scientists may have revealed brain functions in pre-clinical research that widen the safety margin for opioid pain relief without overdose. (NIH-NIDA, 16.11.2017)

https://www.drugabuse.gov/news-events/news-releases/2017/11/separating-side-effects-could-hold-key-safer-opioids

Australien. Fentanyl crisis: Figures show 1,800pc rise in overdose deaths from potent painkiller

Deaths from the potent prescription drug fentanyl have rapidly increased in Australia, with a senior doctor calling the trend a "national emergency". (abc-news, Australien, 24.11.2017)

http://www.abc.net.au/news/2017-11-24/deaths-from-prescription-drug-fentanyl-up-by-1800pc/9184396

Methadon bei Schmerzen: Wirksame Rezeptur ohne Zulassung

Dtsch Arztebl 2017; 114(39): A-1754 / B-1490 / C-1460

Gießelmann, Kathrin

https://www.aerzteblatt.de/archiv/193607/Methadon-bei-Schmerzen-Wirksame-Rezeptur-ohne-Zulassung

Oxycodone Ingestion Patterns in Acute Fracture Pain With Digital Pills

Peter R. Chai; Stephanie Carreiro; Brendan J. Innes; Brittany Chapman; Kristin L. Schreiber; Robert R. Edwards; Adam W. Carrico; Edward W. Boyer

Anesthesia & Analgesia. 125(6):2105–2112, DEC 2017, DOI: 10.1213/ANE.0000000000002574, Publication Date: 2017/12/01

Abstract

https://insights.ovid.com/crossref?an=00000539-201712000-00040

Kanada. Chemists develop method to quickly screen, identify fentanyl and other drugs of abuse

Researchers at McMaster University have developed a new drug screening technique that could lead to the rapid and accurate identification of fentanyl, as well as a vast number of other drugs of abuse, which up until now have been difficult to detect by traditional urine tests.

The method, outlined in the current edition of the journal Analytical Chemistry, addresses a serious public health emergency related to opioid addiction and unintentional overdose deaths: the lack of a reliable and inexpensive test that allows for comprehensive surveillance of synthetic drugs flooding the illegal market. (McMaster University News, Hamilton/Kanada, 01.11.2017)

http://dailynews.mcmaster.ca/article/new-tools-to-tackle-the-opioid-crisis-chemists-develop-method-to-quickly-screen-accurately-identify-fentanyl-and-a-broad-range-of-other-drugs-of-abuse/

EMCDDA–Europol Joint Report on a new psychoactive substance: methyl 1-(2-phenylethyl)-4-[phenyl(propanoyl)amino]piperidine-4-carboxylate (carfentanil)

Summary

In May 2017, the EMCDDA and Europol examined the available information on the new psychoactive substance methyl 1-(2-phenylethyl)-4-[phenyl(propanoyl)amino]piperidine-4-carboxylate (carfentanil), through a joint assessment. The two organisations launched a data collection on this substance for the preparation of a Joint Report as stipulated by Article 5.1 of the Council Decision. The Joint Report was submitted to the Council, the Commission and the European Medicines Agency on 27 July 2017. (EMCDDA, Europol, Lissabon, November 2017)

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

Bias Factor and Therapeutic Window Correlate to Predict Safer Opioid Analgesics

Schmid, Cullen L. et al.

Cell , Volume 171 , Issue 5 , 1165 - 1175.e13

Abstract

http://www.cell.com/cell/fulltext/S0092-8674(17)31257-6

USA – Fentanyl. Fentanyl Accounted for the Majority of Opioid Identifications in DEA Drug Evidence Analyzed in the Third Quarter of 2017

Since 2016, the DEA’s Special Testing and Research Laboratory’s Emerging Trends Program has been publishing quarterly Emerging Threat Reports in order to monitor new psychoactive substance (NPS) trends in the United States and provide a snapshot of the psychoactive substance market in the United States. Data for these reports are obtained from a query of archived seizure and analysis information from drug evidence analyzed by the U.S. Drug Enforcement Administration’s (DEA) laboratory system. According to data from the most recentEmerging Threat Report, there were 344 identifications of opioids in drug evidence analyzed by the DEA’s laboratory system in the third quarter of 2017. Of these opioid identifications, nearly two-thirds (64%) were identified as fentanyl, either as the only controlled substance (44% of the 219 fentanyl identifications), in combination with heroin (45%), or in combination with other controlled substances (11%; data not shown). (National Drug Early Warning System (NDEWS), 20.11.2017)

https://ndews.umd.edu/sites/ndews.umd.edu/files/ndews-news-issue-5-november-2017.pdf

A Vision for Vaccines: Combating the Opioid Epidemic.

Hwang CS, Janda KD.

Biochemistry. 2017 Oct 24;56(42):5625-5627. doi: 10.1021/acs.biochem.7b00948. Epub 2017 Oct 10.

http://pubs.acs.org/doi/ipdf/10.1021/acs.biochem.7b00948

Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews.

Els C, Jackson TD, Kunyk D, Lappi VG, Sonnenberg B, Hagtvedt R, Sharma S, Kolahdooz F, Straube S.

Cochrane Database Syst Rev. 2017 Oct 30;10:CD012509. doi: 10.1002/14651858.CD012509.pub2. Review.

Abstract

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD012509.pub2/abstract

Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report.

Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Jiang Kwete X, Arreola-Ornelas H, Gómez-Dantés O, Rodriguez NM, Alleyne GAO, Connor SR, Hunter DJ, Lohman D, Radbruch L, Del Rocío Sáenz Madrigal M, Atun R, Foley KM, Frenk J, Jamison DT, Rajagopal MR; Lancet Commission on Palliative Care and Pain Relief Study Group.

Lancet. 2017 Oct 11. pii: S0140-6736(17)32513-8. doi: 10.1016/S0140-6736(17)32513-8.

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)32513-8.pdf

Extremitäten: Ibuprofen plus Paracetamol lindern Schmerzen wie Opiat

Albany – Patienten, die nach einer akuten Verletzung des Bewegungsapparates in der Notfallambulanz eintreffen, benötigen in der Regel keine Opiate. In einer rando­misierten Vergleichsstudie im US-amerikanischen Ärzteblatt (JAMA 2017; 318: 1661-1667) erzielte eine Kombination aus Ibuprofen und Paracetamol eine gleich gute analgetische Wirkung. (aerzteblatt.de, 08.11.2017)

https://www.aerzteblatt.de/nachrichten/83345/Extremitaeten-Ibuprofen-plus-Paracetamol-lindern-Schmerzen-wie-Opiat

Heroin Contaminated with Fentanyl Dramatically Enhances Brain Hypoxia and Induces Brain Hypothermia.

Solis E Jr, Cameron-Burr KT, Kiyatkin EA.

eNeuro. 2017 Oct 30;4(5). pii: ENEURO.0323-17.2017. doi: 10.1523/ENEURO.0323-17.2017.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661359/

Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 — 10 States, July–December 2016.

O’Donnell JK, Halpin J, Mattson CL, Goldberger BA, Gladden RM.

MMWR Morb Mortal Wkly Rep 2017;66:1197–1202. doi.org/10.15585/mmwr.mm6643e1

https://www.cdc.gov/mmwr/volumes/66/wr/mm6643e1.htm

JES: FENTANYLBROSCHÜRE IN AKTUALISIERTER FASSUNG WIEDER VERFÜGBAR

Der intravenöse Konsum von Fentanyl, das aus Pflastern gekocht wird, bleibt trotz einiger wichtger Maßnahmen zur Risikominderung eine hochriskante Konsumform.

Dennoch haben wir uns entschlossen in einer übersichtlichen Broschüre Maßnahmen zur Risikominderung vorzustellen und grundsätzliche Informationen zum Umrechnung von Morphin, Metahdon und Fentanyl zu publizieren.

Die nun vorliegende Version der Broschüre wurde überarbeitet und enthält eine weitere Safer Use Strategie. In wenigen Wochen wird die Broschüre über die Deutsche AIDS-Hilfe auch kostenlos bestellbar sein. (JES-Bundesverband, 2017)

http://www.jes-bundesverband.de/fileadmin/user_upload/PDF/Medien/JES_Fentanyl-Booklet-2017_web.pdf

NASHVILLE — For the first time, Tennessee Bureau of Investigation scientists have detected fentanyl, a potentially deadly narcotic, mixed in with samples of cocaine. (USA Today, 20.10.2017)

https://www.usatoday.com/story/news/nation-now/2017/10/20/why-cocaine-cut-fentanyl-changes-game/786295001/

Many health professionals have suspected it for a while, and now it’s official: a study published in October in Health Affairs, and written up by HealthDay, reports that heroin has once again become more popular than prescription opioid painkillers as the opioid of first use. (AT Forum, USA, 24.10.2017)

http://atforum.com/2017/10/heroin-once-again-more-popular-than-rx-opioids/

How the Reformulation of OxyContin Ignited the Heroin Epidemic

William N. Evans, Ethan Lieber, Patrick Power

Abstract

We attribute the recent quadrupling of heroin death rates to the August, 2010 reformulation of an oft-abused prescription opioid, Oxycontin. The new abuse-deterrent formulation led many consumers to substitute to an inexpensive alternative, heroin. Using structural break techniques and a difference-in-differences analysis, we find that opioid consumption stops rising in August, 2010, heroin deaths begin climbing the following month, and growth in heroin deaths was greater in areas more likely to substitute from opioids to heroin. The reformulation did not generate a reduction in combinedheroin and opioid mortality—each prevented opioid death was replaced with a heroin death. (01.06.2017, JEL: I12, I18, K42)

https://www3.nd.edu/~elieber/research/ELP.pdf

Maintainence Treatment of Opioid Dependence with Tramadol.

Sarkar S, Varshney M, Patil V, Lal R.

J Neurosci Rural Pract. 2017 Aug;8(Suppl 1):S98-S101. doi: 10.4103/jnrp.jnrp_422_16.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602271/

Oxford academics say sales of synthetic opioid drug are proliferating on illicit websites, with Britain a significant player. (The Guardian, 16.10.2017)

https://www.theguardian.com/society/2017/oct/16/uk-accounts-for-largest-share-of-darknet-fentanyl-sales-in-europe

In September 2017 CGL and Volteface convened a ‘round table’ to discuss responses to the growing threat posed by fentanyl and its analogues (often referred to as ‘fentalogues’ or ‘fentanyls’). Fentanyl and its analogues range from highly valued medicines to highly dangerous synthetic opioid drugs with little or no legitimate use in humans. The round table followed reports of at least 60 deaths linked to fentanyls in England and Wales in the previous eight months and CGL’s direct experience of managing outbreaks of fentanyl-related overdose deaths in two areas in England. (change, grow, live, UK, October 2017)

https://www.changegrowlive.org/sites/cri.org.uk/files/cgl_fentanyl_report_2017.pdf

EMCDDA. Acryloylfentanyl to be placed under control across the EU

(EMCDDA, Lissabon  29.09.2017, News Release No 8/2017)

http://www.emcdda.europa.eu/news/2017/8/acryloylfentanyl-under-control-accross-eu_en

Researchers at Florida International University's International Forensic Research Institute (IFRI) have zeroed in on a unique component of heroin that could pinpoint where it was grown, giving authorities a new tool to potentially disrupt the nation's opioid crisis.

(...) Researchers needed to find something unique in the heroin itself that could not be masked or eliminated in order to determine its point of origin – something the typical manufacturer wouldn't know to look for or care to mask. They zeroed in on the ratio of radiogenic strontium isotopes, which are naturally occurring in bedrock. Strontium isotopes can be found in different ratios among geographic regions depending upon the nature of geologic formation.

Using heroin samples of known geographic origin provided to them by the DEA, researchers were able to measure ratios of strontium isotopes in samples known to come from the four distinct regions. (phys.org, 28.09.2017)

https://phys.org/news/2017-09-discovery-authorities-track-heroin.html