CDC supplement year 2

CDC 补充第 2 年

• 批准号: 10828080
• 负责人: Alex Francis Manini
• 金额: $ 50万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-15 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10828080
• 关键词: Accident and Emergency department; Address; Admission activity; Adverse effects; Adverse event; Affect; American; Biological Markers; Caring; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Chronology; Clinical; Clinical Data; Clinical Management; Collaborations; Commerce; Critical Care; Data; Diagnosis; Disease Outbreaks; Disparity; Dose; Drug abuse; Emergency Care; Emergency Department evaluation; Emergency Department patient; Emergency department visit; Enrollment; Epidemic; Epidemiology; Evaluation; Forensic Medicine; Health; Heroin; Hospitals; Incidence; Ingestion; Knowledge; Length of Stay; Liquid Chromatography; Mechanical ventilation; Medical; Molecular; Morphine; Naloxone; National Institute of Drug Abuse; Opioid; Outcome; Overdose; Patient Self-Report; Patients; Pattern; Periodicals; Pharmaceutical Preparations; Poison; Population; Prevalence; Principal Investigator; Property; Prospective, cohort study; Public Health; Qualifying; Reporting; Research; Research Activity; Research Personnel; Resource Allocation; Resources; Risk Factors; Sampling; Severities; Standardization; System; Testing; Time; Time trend; Toxicology; Treatment Protocols; Visit; abuse liability; addiction; analytic epidemiology; clinical effect; clinical predictors; clinical risk; cohort; cost; design; drug of abuse; fentanyl analog; fentanyl overdose; heroin overdose; illicit opioid; improved; insight; multidisciplinary; novel; opioid epidemic; opioid overdose; opioid use; organ injury; overdose death; patient registry; prescription opioid; prospective; regional difference; screening; sedative; sex; stem; substance use; synthetic opioid; tandem mass spectrometry; time of flight mass spectrometry; trend; trend analysis

ABSTRACT AND PROJECT SUMMARY The purpose of this R01 proposal is to deepen our knowledge of the primary cause of drug overdose deaths in the U.S. today: novel psychoactive synthetic opioids, the majority of which are fentanyl analogues. Using a nationwide registry of patients who present to emergency departments, novel fentanyl analogue overdose will be studied in terms of its epidemiology, analytical confirmation, clinical risk factors, and treatment needs, by a uniquely qualified multidisciplinary team with an extensive track record of collaboration in the field. The scope of the U.S. opioid epidemic is broadening, with drug overdose deaths nearly tripling from 1999- 2015. For the first time ever, in 2015 U.S. drug overdose deaths surpassed 50,000 (52,404), of which 33,091 (63.1%) involved an opioid. Overdose deaths continued to increase in 2016 to 63,600. Opioid overdoses cost Americans $504 billion in 2015 (2.8% of gross domestic product), up from six times the prior estimates in 2013. There was a 27% increase in nationwide Emergency Department visits for opioid overdoses last year alone. Strategies to mitigate this trend by decreasing the availability and abuse potential of prescription opioids have been followed by an increase in illicit opioid use. While initially the predominance of illicit opioid overdoses were a result of heroin exposure, the changing face of global drug commerce introduced synthetic opioid fentanyl analogues into the drug supply, where they are now estimated to have surpassed heroin as the primary cause of drug overdose deaths. Using nearly 70 hospital centers nationwide with bedside evaluation of patients, over 10,000 overdose patients have been enrolled in the Principal Investigator’s prior study giving this proposal momentum and feasibility. Our specific aims are four-fold: (1) To derive and validate clinical predictors of adverse health consequences of fentanyl analogue overdose; (2) To confirm fentanyl analogue exposure via state-of-the-art toxicology testing; (3) To investigate treatment utilization, duration, and disparities for fentanyl analogue overdose; and (4) To assess epidemiology of analytically-confirmed fentanyl analogue overdose. To achieve these Specific Aims, we will prospectively enroll a national sampling of patients. We will implement the rapid dissemination of alerts and information to the public and public health entities on adverse effects of fentanyl analogues. At the completion of the proposed research, the field of drug abuse will be significantly advanced to the benefit of thousands of victims of the U.S. opioid epidemic.

摘要及项目总结

项目成果

Naloxone Use in Novel Potent Opioid and Fentanyl Overdoses in Emergency Department Patients.

在急诊科患者中，纳洛酮在新型有效阿片类药物和芬太尼过量中使用。

• DOI: 10.1001/jamanetworkopen.2023.31264
• 发表时间: 2023-08-01
• 期刊: JAMA NETWORK OPEN
• 影响因子: 13.8
• 作者: Amaducci, Alexandra;Aldy, Kim;Campleman, Sharan L.;Li, Shao;Meyn, Alison;Abston, Stephanie;Culbreth, Rachel E.;Krotulski, Alex;Logan, Barry;Wax, Paul;Brent, Jeffrey;Manini, Alex F.
• 通讯作者: Manini, Alex F.

Identification of a novel opioid, N-piperidinyl etonitazene (etonitazepipne), in patients with suspected opioid overdose.

• DOI: 10.1080/15563650.2022.2084406
• 发表时间: 2022-09
• 期刊: CLINICAL TOXICOLOGY
• 影响因子: 3.3
• 作者: Calello, Diane P.;Aldy, Kim;Jefri, Mohamed;Nguyen, Tuyet-Anh T.;Krotulski, Alex;Logan, Barry;Brent, Jeffrey;Wax, Paul;Walton, Sara;Manini, Alex F.
• 通讯作者: Manini, Alex F.

Opioid Use Disorder and COVID-19: Biological Plausibility for Worsened Outcomes.

• DOI: 10.1080/10826084.2020.1791184
• 发表时间: 2020
• 期刊: Substance use & misuse
• 影响因子: 2
• 作者: Schimmel J;Manini AF
• 通讯作者: Manini AF

Notes from the Field: Illicit Benzodiazepines Detected in Patients Evaluated in Emergency Departments for Suspected Opioid Overdose - Four States, October 6, 2020-March 9, 2021.

• DOI: 10.15585/mmwr.mm7034a4
• 发表时间: 2021-08-27
• 期刊: MMWR. Morbidity and mortality weekly report
• 作者: Aldy K;Mustaquim D;Campleman S;Meyn A;Abston S;Krotulski A;Logan B;Gladden MR;Hughes A;Amaducci A;Shulman J;Schwarz E;Wax P;Brent J;Manini A;Toxicology Investigators Consortium Fentalog Study Group
• 通讯作者: Toxicology Investigators Consortium Fentalog Study Group