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Avoiding globalisation of the prescription opioid epidemic

Humphreys, Keith

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


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


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)


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)


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)


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)



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)


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


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)



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


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)


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


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.



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)


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)


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.



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.


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.



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)


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)


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)


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)


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.


Opiate Analgesics as Negative Modulators of Adult Hippocampal Neurogenesis: Potential Implications in Clinical Practice.

Bortolotto V, Grilli M.

Front Pharmacol. 2017 May 9;8:254. doi: 10.3389/fphar.2017.00254. eCollection 2017. Review.


Endogenous opioids regulate social threat learning in humans

Jan Haaker, Jonathan Yi, Predrag Petrovic & Andreas Olsson

Nature Communications 8, Article number: 15495 (2017), doi:10.1038/ncomms15495


Deaths from fentanyl and other synthetic opioids (not including methadone), rose a staggering 72 percent in just one year, from 2014 to 2015. Government agencies and officials of all types are rightly concerned by what some are describing as the third wave of our ongoing opioid epidemic.

As a concerned parent, whose top priority is keeping your child safe — and alive — the following are the most important things to understand about fentanyl. (Partnership for Drug-Free Kids, 20.04.2017)


Opioid Agonist Treatment for Patients with Dependence on Prescription Opioids: Clinical Evidence Synopsis

Nielsen, S., Larance, B. & Lintzeris, N. (2017)

JAMA 317(9):967-968. doi: 10.1001/jama.2017.0001