Two potent drugs exacerbate US overdose crisis

Emerging reports show that two little-known drugs are making a deadly new contribution to America’s drug overdose crisis.

Parafluorofentanil and methonitazine are more common in medical examiners examining overdose deaths, according to a government report released Thursday. They are often taken or mixed with illegal fentanyl, the drug largely responsible for more than 100,000 overdose deaths in the US over the past year.

According to Dr. Darinka Mileusnik-Polchan, one of the report’s authors, one or the other of the two drugs is increasingly responsible for some overdose deaths.

They are often injected or snorted and are more effective than fentanyl, she says.

“These (victims) just crumple and fall. Often they don’t even inject a full syringe” before overdosing,” said Mileusnik-Polchan, head of the medical examiner’s office in Knoxville, Tennessee.

The overdose drug naloxone can still work, she says, but it may take more than other drugs.

The report, released by the Centers for Disease Control and Prevention to U.S. healthcare and public health professionals, is one of the first of its kind to raise alarms about drugs. It was written by DEA officials; toxicology laboratory at the University of California at San Francisco; and the Knox County Regional Forensic Center.

The authors write that there were 770 unintentional drug overdose deaths in the Knoxville area from November 2020 to August 2021. Of these, 562 tested positive for fentanyl, and nearly 190 of them also tested positive for methamphetamine. But according to the report, 48 of them were associated with parafluorofentanil and 26 with methonitazene.

According to Mileusnik-Polchan, since the summer, the number of deaths associated with these drugs has increased.

Parafluorofentanil is a synthetic opioid such as fentanyl. It was invented in the 1960s and sold illegally in the past, sometimes under the name “Chinese White”.

In 2020, investigators began to see a spike in overdoses with the drug. He was recently found in packages of heroin and counterfeit pills.

Methonitazine belongs to a class of pain relievers developed in the 1950s but never approved for treatment. The drug began to appear more frequently in overdose autopsy reports last year.

It is unclear how widespread the drugs are. Money-strapped medical examiner’s and coroner’s offices can’t pay a toxicologist’s job, which looks for every conceivable drug, Mileusnik-Polchan said. Her office documented two drugs because he was part of a DEA program that uses a UCSF lab for analysis.

Overdose deaths in the US have been on the rise for more than two decades, but they have accelerated over the past two years – up to June 2021, according to the latest data available from the CDC, they have increased by more than 20% in the last year alone.

Experts say the growing prevalence of the deadly fentanyl and the COVID-19 pandemic, which has left many drug users socially isolated and unable to access treatment or other support, are the main reasons, experts say.

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