The current opioid crisis is under the magnifying glass in regard to public health in the United States. President Donald Trump recently declared it to be a public health emergency, which claims about 140 American lives each day, due to opioid overdose, according to the Centers for Disease Control and Prevention. The significance of this problem is due to the marked increase in prescription opioids dispensed. From 1999 to 2010, the amount of prescription opioids sold in the United States quadrupled. Since 1999, the number of deaths due to prescription opioids such as oxycodone, hydrocodone, and methadone has also more than quadrupled.
The advent of designer opioids has also captured the public’s attention. One of these designer opioids, U-47700, is known to cause serious harm and even death in those that overdose on this drug. Originally developed in the 1970s, U-47700 never received Food & Drug Administration (FDA) approval; however, manufacturers with access to the expired patent are producing U-47700 and deeming it a “research chemical” for purchase on the internet.
The Drug Enforcement Administration (DEA) scheduled U-47700 last year because the DEA reported, at the time, 46 deaths that occurred in six states including New Hampshire, New York, North Carolina, Ohio, Texas, and Wisconsin due to U-47700 overdose. U-47700 is deemed a schedule I agent meaning that it is a drug with no currently accepted medical use and a high potential for abuse.
U-47700 is about 7.5 times the potency of morphine that can reduce pain a person may be experiencing. However, some of the side effects reported by individuals that overdosed on U-47700 include shallow breathing where an individual could stop breathing, pinpoint eyes, increased heart rate, and bluish discoloration of the skin. U-47700 requires specialized instrumentation to detect its presence in blood or urine.
With the continuing problem of prescription opioids and the advent of designer opioids, such as U-47700, the question begs: how do we solve the opioid crisis? Experts believe the opioid crisis will need better coordination of care, community involvement to come up with solutions, and more consistent use of improved pain-control options. In regard to coordination of care, patients and providers may not know resources in the community to get individual help in treating addiction.
Furthermore, patients treated for addiction unfortunately can get “lost in the system” if there is no follow-up after treatment with their provider. Community involvement requires tracking patients receiving opioid prescriptions in order to understand if patients are using opioids correctly or are abusing the system. Patients that might be abusing the system should then have avenues to get help for issues relating to prescription opioids. Finally, education is extremely important on how opioids are used. Pain management programs and safe prescribing of opioids are needed for providers that prescribe opioids regularly. Educating the community about opioids, overdose prevention, and reversing opioid overdoses with agents such as naloxone can help fight this crisis.
If you or a loved one needs help fighting opioid addiction, please visit the American Society of Addiction Medicine’s website at https://www.asam.org/resources/patientresources.
SOURCES
https://www.cdc.gov/drugoverdose/epidemic/index.html
https://www.dea.gov/druginfo/ds.shtml
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481299/
https://www.cureus.com/articles/7941-u-47700-an-emerging-threat
Saeed Alzghari, M.S., M.B.A. (HOM), Pharm.D., BCPS
Dr. Saeed Alzghari is the director of clinical pharmacy at Gulfstream Diagnostics. Saeed has authored over a dozen publications and his work has been cited by the National Comprehensive Cancer Network. Saeed is passionate about patient care especially in the fields of oncology, toxicology, and pharmacogenetics. Saeed lives in Dallas, Texas, with his fiancée Marie. You can learn more about Saeed at www.saeedalzghari.com.
ABOUT GULFSTREAM DIAGNOSTICS
Founded in 2014 by Frank G. Howard Jr. and Keu Zafar, Gulfstream Diagnostics’ mission is to help medical professionals provide the best possible care and ultimately help their patients get back to the lives they want to lead. Gulfstream Diagnostics provides reliable and expedient clinical, toxicology, and pharmacogenetic test results around the United States. Based in Dallas, Texas, Gulfstream Diagnostics features a state-of-the-art laboratory with up-to-date instrumentation allowing for the most comprehensive and accurate testing possible. Gulfstream Diagnostics: Results that Shape Lives! For more information, please visit www.gulfdiagnostics.com.