Fentanyl Deaths Have Doubled in 10 States, but Speeded Forensic Data-Sharing May Help

Fentanyl Deaths Have Doubled in 10 States, but Speeded Forensic Data-Sharing May Help

The epidemic of opioid overdose deaths across America has not responded to most efforts to slow it down, never mind stop it for good.

The major reason for this has been the failure of law enforcement and other government agencies at every level to find effective ways to combat and contain the spreading use of fentanyl, the deadly powerful opioid being mixed into heroin and other drugs of abuse.

Fentanyl has become the major cause of illicit opioid overdoses in the country, says the CDC. The number of deaths in which fentanyl has been detected has doubled in at least 10 states, the CDC said in a mid-July Morbidity and Mortality Weekly Report. Fentanyl has caused 21 percent of all opioid overdose deaths, and medical examiners say fentanyl has at least contributed to the cause of death in more than 95 percent of cases where it was detected. This clearly makes synthetic opioids the number one type of drug causing overdose-related deaths, says the CDC.

A big problem with battling fentanyl has been the fact that clandestine chemists are able to tweak the chemical structures and churn out new versions of fentanyl with some ease. New fentanyl analogs are hitting the streets faster than they can be analyzed by the DEA and added to the list of illegal substances.

And it's not just happening in America. Fentanyl and fentanyl analogs and other synthetics are being found in illicit drug samples across Europe and elsewhere in the world.

The synthetic numbers are scary

The CDC's latest Health Alert Network Update details the soaring supply of drugs into the country and the accompanying overdoses, and the huge synthetic drug component. It provides new recommendations for healthcare professionals, coroners and medical examiners, first responders, and public health departments.

From November 2016 to 2017, 55 percent of national opioid overdose deaths - that's more than 27,000 deaths - involved synthetic opioids, says the CDC. That number is higher than the total number of all opioid overdose deaths during 2013, when the number of people killed by synthetic opioids started to increase.

The DEA reports that the number of cases submitted to forensic labs for analysis that tested positive for fentanyl more than doubled from 14,440 in 2015 to 34,119 in 2016. That trend continued to soar even higher in 2017, with an additional 25,460 reports during the first 6 months.

New data-sharing may help

Currently, there's a lot of city-, county- and state-level forensic testing of drug samples, and some data sharing between agencies. But not enough to really make a difference, say forensic analysts involved in the drug wars.

Enhancing the speed with which analogs can be identified, and that data rapidly shared across all agencies concerned, is seen as a critical component in the war against ever-changing fentanyl analogs and other synthetic "designer drugs."

"If people start overdosing and dying from a new drug analog, authorities need to identify it as quickly as possible," said Aaron Urbas, a research chemist at the National Institute of Standards and Technology (NIST). "If you want to focus your resources effectively, you need to know what you're looking for."
To that end, Urbas has launched a website project in cooperation with the German Federal Criminal Police Office (the BKA) and the DEA. Called the "NPS Data Hub" (NPS stands for Novel Psychoactive Substances), the website allows forensic chemists to instantly share data on new drug analogs and their chemical signatures which are key to identifying them in the lab.

Other synthetics are included

In addition to data on synthetic opioids such as fentanyl, the Data Hub also covers synthetic cannabinoids, synthetic cathinones (bath salts), amphetamines and any other dangerous new drugs, says NIST. The website makes collaboration among scientists much faster and easier, and hence far more effective.

Chemists from one lab can analyze a new drug and upload a proposed chemical structure and supporting data. Instantly, chemists from participating labs around the world can review the data and share it with others.

In addition to collaboration, the Data Hub offers additional advantages over most existing drug databases, which usually include only mass spectrometry analysis. The NPS Data Hub permits sharing of data using all techniques, including Raman spectroscopy, Nuclear Magnetic Resonance (NMR), and others that may be helpful to differentiate closely related compounds.

Also, existing databases can require months to vet and update. The NPS Data Hub is meant to be less "authoritative" but updated more frequently.
"These people have very rare expertise," said NIST senior policy advisor Jayne Morrow. "The Data Hub brings these experts together and provides a forum where they can discuss what they're seeing in real time. There haven't been great ways to do that before, and it's really needed."

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