Toxicosurveillance of novel opioids: just screening tests may not be enough.
Toxicosurveillance of novel opioids: just screening tests may not be enough.
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DOI：
10.1080/00952990.2021.1917588
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发表时间：
2021-05-04
期刊：
影响因子：
--
通讯作者：
Palamar JJ
中科院分区：
文献类型：
--
作者：
Salomone A;Palamar JJ
在过去十年中，美国和世界大部分地区的毒品形势发生了巨大变化。这在很大程度上是由于各种新型精神活性物质（NPS）的出现，例如新型合成阿片类药物（NSO）。nso包括芬太尼以及越来越多的新的芬太尼衍生物；这些衍生品是为非法市场秘密合成的（1,2）。芬太尼和它的许多类似物被认为是特别危险的，因为它们的效力高，它们被用作海洛因和其他药物的切割剂或掺假剂，它们被用作海洛因的替代品。在美国，nso的非法使用是导致致命性用药过量危机不断增加的原因(3)。及时检测个体接触芬太尼类似物是一项具有挑战性的目标，因为它们在体液中的浓度通常极低，并且与母体药物的微小结构变化相关的化学变异性(4)。进一步的困难包括新的类似物的快速开发，它们被新合成的化合物快速替代，以及不完整或缺乏药理学和结构信息。因此，对几种非甾体物质（如卡芬太尼）暴露情况的描述主要局限于少数病例报告（5-7）和对生物标本进行芬太尼及其一些类似物消费后暴露测试的初步研究（8-11）。当然，需要更多的监测研究来评估芬太尼、其类似物和其他非甾体抗炎药物的扩散。
In the last decade, the drug landscape in the United States (US) and throughout much of the world has dramatically changed. This is due, in large part, to the emergence of a variety of new psychoactive substances (NPS), such as novel synthetic opioids (NSO). NSOs include fentanyl as well as a growing number of new fentanyl derivatives; these derivatives are clandestinely synthesized for the illegal market (1, 2). Fentanyl and many of its analogues are considered particularly risky due to their high potency, their use as cutting or adulterant agents for heroin and other drugs, and their use simply as substitutes for heroin. The illicit use of NSOs has been responsible for the ever-increasing crisis of lethal overdose cases in the US (3). The timely detection of individual exposure to fentanyl analogues represents a challenging objective because of their typically minuscule concentration in bodily fluids and the chemical variability associated with minor structural changes of the parent drug (4). Further difficulties include the rapid development of new analogues, their rapid replacement with newly synthetized compounds, and incomplete or lacking pharmacological and structural information. Hence, description of exposures to several NSOs, such as carfentanil, is largely limited to a few case reports (5–7) and preliminary studies testing biospecimens for exposure to fentanyl and some of its analogues post-consumption (8–11). Certainly, more surveillance studies are needed to assess the diffusion of fentanyl, its analogues, and other NSOs.
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影响因子：
3.8
作者：
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通讯作者：
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