Over the past few years,there has been an emerging number of new psychoactive drugs.These drugs are frequently mentioned as“legal highs”,“herbal highs”,“bath salts”and“research chemicals”.They are mostly sold ...Over the past few years,there has been an emerging number of new psychoactive drugs.These drugs are frequently mentioned as“legal highs”,“herbal highs”,“bath salts”and“research chemicals”.They are mostly sold and advertised on online forums and on the dark web.The emerging new psychoactive substances are designed to mimic the effects of psychoactive groups,which are often abused drugs.Novel synthetic opioids are a new trend in this context and represent an alarming threat to public health.Given the wide number of fatalities related to these compounds reported within the last few years,it is an important task to accurately identify these compounds in biologic matrices in order to administer an effective treatment and reverse the respiratory depression caused by opioid related substances.Clinicians dealing with fentanyl intoxication cases should consider that it could,in fact,be a fentanyl analogue.For this reason,it is a helpful recommendation to include synthetic opioids in the routine toxicological screening procedures,including analysis in alternative matrices,if available,to investigate poly-drug use and possible tolerance to opioids.To address this public health problem,better international collaboration,effective legislation,effective investigation,control of suspicious“research chemicals”online forums and continuous community alertness are required.This article aims to review diverse reported fatalities associated with new synthetic opioids describing them in terms of pharmacology,metabolism,posology,available forms,as well as their toxic effects,highlighting the sample procedures and analytical techniques available for their detection and quantification in biological matrices.展开更多
Fentanyl,a powerful opioid analgesic introduced over 50 years ago,has a major role in modern anesthesia and chronic pain relief but has also gained a major role in illicit use.After a spike in fentanyl abuse between 2...Fentanyl,a powerful opioid analgesic introduced over 50 years ago,has a major role in modern anesthesia and chronic pain relief but has also gained a major role in illicit use.After a spike in fentanyl abuse between 2005 and 2007,fentanyl deaths decreased until 2010,with the introduction of“abuse‑deterrent”OxyContin.Our data indicate a recent rise in fentanyl‑related deaths beginning in 2013,which follows national trends.With the re‑emergence of the synthetic narcotic analgesic of high potency as a popular drug of abuse and the alarmingly increasing mortality associated with its abuse,there are profound implications for public health,health care providers,law enforcement,and the society in general.展开更多
基金funded by FEDER funds through the POCI-COMPETE 2020-Operational Programme Competitiveness and Internationalization in Axis IStrengthening Research,Technological Development and Innovation[grant number:Project POCI-01-0145-FEDER-007491]National Funds by FCT-Fundac¸ão para a Ciência e a Tecnologia[grant number:Project UID/Multi/00709/2013]S.Soares and J.Gonc¸alves acknowledge Program Santander-Totta Universidades in the form of a fellowship grant number[Bolsa BID/UBISantander Universidades/2018].Â.Luís acknowledges the contract in the scientific area of Microbiology(Scientific Employment)financed by FCT.
文摘Over the past few years,there has been an emerging number of new psychoactive drugs.These drugs are frequently mentioned as“legal highs”,“herbal highs”,“bath salts”and“research chemicals”.They are mostly sold and advertised on online forums and on the dark web.The emerging new psychoactive substances are designed to mimic the effects of psychoactive groups,which are often abused drugs.Novel synthetic opioids are a new trend in this context and represent an alarming threat to public health.Given the wide number of fatalities related to these compounds reported within the last few years,it is an important task to accurately identify these compounds in biologic matrices in order to administer an effective treatment and reverse the respiratory depression caused by opioid related substances.Clinicians dealing with fentanyl intoxication cases should consider that it could,in fact,be a fentanyl analogue.For this reason,it is a helpful recommendation to include synthetic opioids in the routine toxicological screening procedures,including analysis in alternative matrices,if available,to investigate poly-drug use and possible tolerance to opioids.To address this public health problem,better international collaboration,effective legislation,effective investigation,control of suspicious“research chemicals”online forums and continuous community alertness are required.This article aims to review diverse reported fatalities associated with new synthetic opioids describing them in terms of pharmacology,metabolism,posology,available forms,as well as their toxic effects,highlighting the sample procedures and analytical techniques available for their detection and quantification in biological matrices.
文摘Fentanyl,a powerful opioid analgesic introduced over 50 years ago,has a major role in modern anesthesia and chronic pain relief but has also gained a major role in illicit use.After a spike in fentanyl abuse between 2005 and 2007,fentanyl deaths decreased until 2010,with the introduction of“abuse‑deterrent”OxyContin.Our data indicate a recent rise in fentanyl‑related deaths beginning in 2013,which follows national trends.With the re‑emergence of the synthetic narcotic analgesic of high potency as a popular drug of abuse and the alarmingly increasing mortality associated with its abuse,there are profound implications for public health,health care providers,law enforcement,and the society in general.
