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When it comes to the opioid overdose crisis, there is a disconnect between lawmakers and the people they aim to protect, especially if those people are selling heroin. There has been a push to pass harsh penalties against those who provide fentanyl-laced heroin that results in an overdose. Here’s the problem: it’s virtually impossible to find heroin in its pure form. What’s more, people who use heroin have very little control over whether or not their products have been adulterated. (DPA – Drug Policy Alliance, USA. 30.08.2017)

http://www.drugpolicy.org/blog/because-drug-war-there-virtually-no-heroin-without-fentanyl-many-places

Research presented at the American Association for Clinical Chemistry Annual Scientific Meeting & Clinical Lab Expo indicated accuracy of a genetic risk assessment for prescription or heroin opioid addiction.  (Healio – Psychiatric Annals, 02.08.2017)

https://www.healio.com/psychiatry/addiction/news/online/%7Bcbc42077-a977-4c78-8589-179d90a7f199%7D/genetic-test-indicates-risk-for-opioid-addiction

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

Schätzung der Anzahl der Opioid (Heroin, Methadon, Buprenorphin, Fentanyl) oder Opiat (Codein, Morphin) konsumierenden Erwachsenen in Deutschland

Projektleiter: Prof. Dr. Ludwig Kraus, Laufzeit: 01.04.2017 - 31.01.2018, Förderung: Bundesministerium für Gesundheit. Durchführung: IFT – Institut für Therapieforschung (München)

http://www.ift.de/forschung/projekte/projekte-detailansicht.html?tx_projectmanager_projectmanager%5Bproject%5D=74&tx_projectmanager_projectmanager%5Baction%5D=show&tx_projectmanager_projectmanager%5Bcontroller%5D=Project&cHash=dcb1a69166e0aef8df479ceba917d199

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

Chronic pain and opioid misuse: a review of reviews

Pauline Voon, Mohammad Karamouzian and Thomas Kerr

Substance Abuse Treatment, Prevention, and Policy 2017, 12:36, doi.org/10.1186/s13011-017-0120-7

https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-017-0120-7

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/

In two dozen of the nation’s largest cities, fentanyl is becoming a major part of the national opioid crisis. (Washington Post, 15.08.2017)

https://www.washingtonpost.com/graphics/2017/national/fentanyl-overdoses/

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

Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines.

Manchikanti L, Kaye AM, Knezevic NN, McAnally H, Slavin K, Trescot AM, Blank S, Pampati V, Abdi S, Grider JS, Kaye AD, Manchikanti KN, Cordner H, Gharibo CG, Harned ME, Albers SL, Atluri S, Aydin SM, Bakshi S, Barkin RL, Benyamin RM, Boswell MV, Buenaventura RM, Calodney AK, Cedeno DL, Datta S, Deer TR, Fellows B, Galan V, Grami V, Hansen H, Helm Ii S, Justiz R, Koyyalagunta D, Malla Y, Navani A, Nouri KH, Pasupuleti R, Sehgal N, Silverman SM, Simopoulos TT, Singh V, Solanki DR, Staats PS, Vallejo R, Wargo BW, Watanabe A, Hirsch JA.

Pain Physician. 2017 Feb;20(2S):S3-S92.

http://www.painphysicianjournal.com/current/pdf?article=NDIwMg%3D%3D&journal=103

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

Last year saw the highest number of drug-related deaths since records began in 1993, according to data from the Office for National Statistics (ONS). More than half of these deaths involved an opiate, such as heroin. Those aged 40 to 49 years old made up the largest group dying as a result of drug poisoning. Compared with the general population, this group are dying decades before they should. (The Independent, UK, 15.08.2017)

http://www.independent.co.uk/life-style/health-and-families/drug-related-deaths-are-at-their-highest-level-in-25-years-here-s-why-a7875331.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

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

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

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

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

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

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

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

Fentanyl drug profile

EMCDDA, Portugal, 2017

http://www.emcdda.europa.eu/publications/drug-profiles/fentanyl

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

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

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

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