Summary: Opioid addiction is a significant health threat. However, not all opioids are equally addictive. It means that making changes to the chemical structures of existing opioids may make them less addictive. Researchers think that they have found a way to do so. It appears that introducing the fluorine atom to various opioids may make them less addictive and yet ensure that they work well at the site of injury.

Opioid epidemics are showing no signs of receding. However, on the other side, we cannot negate that opioids are among the best painkillers. It means that giving up opioid use altogether may cause specific issues. Doctors may find it hard to manage moderate to severe pain without opioids. The Lives of those living with chronic pain may become miserable.

On the other hand, it has long been known that various opioids differ significantly, and some of them are not addictive at all. For example, codeine used to treat pain and dry cough has a low probability of causing addiction. Likewise, the anti-diarrheal drug loperamide does not cause addiction at all. Finally, even the synthetic opioid painkiller tramadol does not appear to cause addiction. Hence, why not try to create potent opioid painkillers that might lack any addictive effect?

There is a need to make some minor changes in the existing opioids so that they stop penetrating the blood-brain barrier and causing euphoria. This is possible, though challenging. However, considering the rise in opioid overdose and painkiller abuse, it is also a need of time. Moreover, opioids are almost irreplaceable in many clinical conditions.

Of course, chemists could have done it a long time back if it was that simple. Nonetheless, in recent years, there have been many technological advances. Thus, for example, computational chemistry has provided greater power to chemists.

Understanding Opioid Chemistry

Though there are many types of opioids, as one can see in the image above, they share some basic structures. However, though they have minor differences, they result in entirely different chemical and even biological properties.

Of course, one of the issues is that one cannot make significant structural changes to opioids, as it may result in reduced efficacy. However, suppose we want to reduce addictive effects of opioids. In that case, we need to find ways of making more significant changes to opioids and yet ensuring that their pain-killing effect is preserved.

This subject is not new. There are already some opioids that have a pretty different chemical structure when compared to morphine or other classical opioids. One such example is fentanyl.

Studies show that one of the ways in which opioids work is by becoming positively charged upon coming in contact with body fluids.

This positive charge helps opioids to bind on the target site. However, the problem with the existing opioids is that they become positively charged in all body fluids, in different organs, including the brain. So, it means that if we could find some way of preventing it or ensure that it only becomes charged at specific sites, this can help overcome addiction and many side effects of opioids.

Making Opioids Less Addictive

Researchers think it is necessary to change the opioid structure so that they become positively charged only in high-acidity environments. Studies show that injured tissues or inflammation sites have higher acidity than other body parts due to lactic acid accumulation. It means that any opioid requiring a greater acidic environment for activation will have a greater effect on the target site and will be less likely to cause euphoria.

Researchers have found this is possible, especially with the introduction of a fluorine (F) atom near the nitrogen, in the amine group of fentanyl. This will ensure that fentanyl remains less active in various body fluids but gains a higher activity level at the sites of inflammation and pain. What is exciting about this finding is that new studies show that introducing the fluorine molecule into morphine may also alter its characteristics. Thus, morphine will need a bit higher acidity to become active and start acting. This will help produce morphine that is more active in injured tissues, and thus less active in the brain and other sites, and hence less likely to cause addiction.

Now-a-days, the opioid treatment programs have started to utilize suboxone in their treatment, which is another potential medication. Researchers think they can explore an approach to alter the working of oxycodone and hydrocodone further. However, to date, this approach has only been tested in labs and appears to work. Thus, now there is a need to evaluate it in clinical trials.

Summary: Opioid overdose-related death is a significant problem in the US. Experts think identifying the population groups at a greater risk of opioid addiction may help counter this threat. Researchers at the University of Cincinnati analyzed the health data of Ohio state and found 12 population clusters where opioid addiction is more common. They found that white men aged 30-39 were more likely to abuse opioids, and black men aged 30-39 were at greater risk of death due to an overdose.

 

If we want to overcome opioid addiction, we need to identify the groups at risk and then work with them. For this, there are many tools, including the availability of big data. This is precisely what researchers at the University of Cincinnati did. They used data to understand who is at risk of opioid overdose in Ohio state. And they published the findings of their study in the journal Nature.

 

For the study, they analyzed the Ohio Health Department records between the years 2010 to 2017. They found that white men aged 30-39 were at high risk. Moreover, this population group was at considerable risk. The risk in men was several folds higher than in women. Similarly, they found that black men of the age were also at an elevated risk.

 

They also identified population clusters with a relatively higher risk of opioid addiction. They identified 12 hotspots in the state. These were mainly larger population groups or cities that were home to about 21% of the state’s population. These population clusters accounted for 40% of all opiate-related mortalities.

 

Researchers say that their findings are relevant in many ways. They can help guide policymakers. Not only that, but they also show the areas where agencies must focus on preventing opioid addiction. Using such data can help carry out focused efforts, like raising awareness of health hazards posed by opiate addiction, improving healthcare in those areas, and more.

 

As the researchers said that prevention is better than treatment. The primary purpose of the research is to find ways of reducing the risk of opioid addiction and overdose.

 

This data can also help scientists to understand what drives addiction in certain population groups. For example, earlier studies show that regular use of opiates reduces the production of intrinsic endorphins. Thus, a person starts feeling less excited about the daily activities and less satisfied from exercise, meeting friends, and other usual activities.
Since opiates desensitize the impact of natural endorphins, people addicted to these substances do not enjoy life as usual. Thus, they are more likely to seek pleasure in the substances. Finally, people become tolerant of opiates, and each time they need a higher dose to achieve similar results.

 

Researchers say that to counter this epidemic, health experts, educators, doctors, and public advocates, would need to come together and work.
They also noted other addiction patterns in the study, like those who had relatives addicted to opioids, were at a 10-time greater risk than others. However, researchers say there is still a need to better characterize those at a greater risk of opioid misuse.

 

Further, researchers noted that although it appears that legal opioid prescriptions contributed to this epidemic, there is more to the story. In recent years, law enforcement agencies have become stricter and even punished several doctors. However, these measures do not seem to help, as people turn to cheaper illicit drugs.

 

Suboxone is one of the drugs utilized to treat opioid addiction. However, the dose prescription must be kept under check.

 

Many of these illicit opiates, like heroin, are often laced with a cheaper and more potent synthetic drug called fentanyl. Fentanyl is a very potent drug. However, adding it to opiates significantly increases the risk of overdose. In addition, it appears that fentanyl is easier to synthesize or source.

 

This study has been limited to a single state. However, researchers think preparing such data for other states, or the whole nation would be even more helpful. Thus, in the near future, they want to conduct such a study for Kentucky and West Virginia.

 

Keeping all of the things in mind, it is better to opt for systematic, opioid addiction treatment programs.

Summary: Studies show that opioid addiction treatment is crucial in the wake of alarming data revealing a 30% increase in overdose-related deaths between 2019 to 2020 in the US. The data analysis highlights the disproportionate impact on Blacks and Indigenous Americans. Young black people were hit particularly hard by the rise in overdose deaths. Fentanyl and fentanyl-laced drugs are believed to be the leading cause of overdose deaths.

Certain population groups in the US have historically been at a disadvantage. However, new data shows that drug overdose deaths are rising at an alarming and disproportionate rate among Black and Indigenous people in the US.

Analysis of the report published by the Centers for Disease Control and Prevention shows that deaths due to drug overdose rose by 30% between 2019 to 2020, which is a massive increase.

However, as they say, the devil is in the details. On further analyzing the same report, one can see that drug overdose deaths affected Black and Indigenous people more severely. This new report shows a massive jump of 44% in overdose-related deaths among Black people.

Things are also quite bad for American Indians and Alaska Native people. In this population group, the number of drug overdose-related deaths rose by 39%.

Researchers say that deaths among Indigenous people and Blacks outpaced those among white people. Thus, overdose-related deaths among white people rose by about 22% during the same period, which is significantly lower.

Of course, one way to explain these differences is the pattern of substance abuse. Whites choose different kinds of drugs than Blacks or Indigenous Americans. 

However, experts say that there are many reasons for such differences. For example, one of the significant causes of high mortality among specific population groups is treatment biases.

Though a 30% increase in overdose deaths is already a historical landmark, there is more to it. It appears that the overdose issue affected younger Black people (15 to 24 years old) worse, with an almost 86% increase in overdose deaths. It means that in just one year, overdose deaths nearly doubled in this population group.

Not only that, overdose deaths were seven times higher in Black men older than 65 years old compared to white men, which is an unbelievably massive difference.

Like many other reports, the study found that this difference was highest in the counties with the greatest socioeconomic disparities. Thus, for example, if the income gap in any county was less among various ethnic groups, then differences in overdose deaths also was lower.

Researchers say that income inequality between various racial groups seems to have the most significant impact since this leads to poor housing, lack of health insurance, limited access to treatment, and more.

When digging deep into the overdose death reports, experts also found that most of those who die do not get timely treatment for substance abuse or overdose. Thus, for example, data shows quite a low percentage of treatment for substance use among Blacks, with only one in 12 receiving any kind of treatment. Statistics were almost similar for disadvantaged populations like Hispanics and Indigenous people.

In the study, researchers noted a few other trends that may have practical implications. First, they found that most overdose deaths occurred due to illicitly produced fentanyl. Even in those with cocaine or methamphetamine overdose, fentanyl contamination appears to be a significant issue.

Hence, researchers say that tackling the illicit fentanyl supply is important for reducing overdose deaths in the US.

Further, researchers recommend increasing access to substance abuse treatment and better access to medications like naloxone that can reverse opioid overdose. Additionally, better availability of fentanyl test strips would also help in understanding which drug contains fentanyl.

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Summary: Connecticut legalized recreational marijuana in June 2021; by October, there were 39 reports of overdose. However, doctors now believe that fentanyl-laced marijuana caused these cases of acute toxicity. Although doctors could demonstrate fentanyl-laced marijuana in just one case, they know that fentanyl-laced drugs are pretty common. Moreover, the history of patients shows that 30 out of 39 had a history of opioid abuse. Thus, intentionally, or unintentionally, they were exposed to fentanyl. However, for legal reasons, they were hesitant to report the truth. Nevertheless, it is something that all users of legal marijuana must be aware of.

Marijuana is finally legal in many US states. People have been demanding to legalize marijuana for a long. There are many reasons for such a demand. After all, humans have used marijuana for ages, and despite some ill effects, it does not cause severe addiction or toxicity. Moreover, its health harms are well known to science. In short, it is a relatively safer substance of abuse and is of natural origin. But not only that as it also has some health benefits like pain reduction, managing gastrointestinal issues, and more.

 

Connecticut became the latest state to legalize marijuana in July 2021 finally. But then came the reports of severe intoxication with it. Within the three months of legalization, 39 reports of marijuana overdose were reported. However, the cases were not typical of marijuana overdose, and they benefited greatly from the naloxone dosage. Naloxone is mainly used to manage opioid overdose. This led experts to believe that people have misinformed doctors. Either intentionally or non-intentionally, they smoked fentanyl-laced marijuana. Moreover, testing of some samples confirmed the theory.

 

Recreational use of marijuana may be legal in some states. However, not everyone is going to use it for health conditions or responsibly. Many people addicted to street drugs and opioids are also likely to use marijuana. However, for many of them, marijuana fails to provide the kind of high they are looking for, and thus they might use marijuana laced with other drugs. In other cases, it may occur without users knowing about it. Some of the opioids are much cheaper to produce than growing marijuana. Thus, adding them to marijuana may help users achieve more substantial effects quickly.

 

Fentanyl-laced marijuana poses a significant health threat

One such opioid commonly mixed with various substances of abuse is fentanyl. It is a synthetic opioid. It is produced cheaply at the industrial scale and is readily available. Thus, it is often mixed with more expensive drugs like heroin, methamphetamine, cocaine, and more. This helps to produce addictive drugs cheaply. Unfortunately, however, many people unknowingly may use such drugs or fentanyl-laced marijuana.

 

However, here it is vital to understand that some addicted to opioids may do it intentionally. But, if they overdose on fentanyl, they are not likely to report it to avoid legal issues. Thus, they are more likely to inform only about marijuana use.

 

This kind of mixing is dangerous in many ways, as users are unaware of what they took. This also creates a problem for doctors treating drug overdose. Even if the users know that they have overdosed on fentanyl, they still avoid telling the truth. But doctors know that marijuana may cause acute toxicity but rarely causes severe issues like breathing problems or loss of consciousness, unlike fentanyl or other opioids.

 

Although in the Connecticut cases, experts could find fentanyl-laced marijuana in just one of the samples. Still, they have a firm reason to believe that most, if not all, of the cases, were due to fentanyl overdose. This is apparent in the history of users, as 30 out of 39 were known to have opioid abuse history. Additionally, doctors can judge based on the symptoms. Further, naloxone, a drug used to treat opioid overdose, could help in most cases.

 

Although not everyone believes the case of fentanyl-laced marijuana, experts warn that it is more common than many people realize. Fentanyl-laced drugs are pretty common, so why could fentanyl-laced marijuana not be possible?

 

Doctors warn that marijuana users be careful and aware of this, as fentanyl-laced marijuana or drugs may cause much more severe health effects. It is the common cause of unintentional drug overdose and death.