Morrow Jayne B, Ropero-Miller Jeri D, Catlin Megan L, Winokur Agnes D, Cadwallader Amy B, Staymates Jessica L, Williams Shannan R, McGrath Jonathan G, Logan Barry K, McCormick Michael M, Nolte Kurt B, Gilson Thomas P, Menendez M J, Goldberger Bruce A
Material Measurement Laboratory, National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, MD, USA.
RTI International, Research Triangle Park, NC, USA.
J Anal Toxicol. 2019 Jan 1;43(1):1-9. doi: 10.1093/jat/bky049.
In many jurisdictions, public safety and public health entities are working together to enhance the timeliness and accuracy of the analytical characterization and toxicology testing of novel synthetic opioids. The improved sharing and early detection of these analytical data are intended to inform surveillance, interdiction efforts, patient intervention and treatment, all of which are critical to curbing the opioid epidemic. Forensic practitioners working to identify novel synthetic opioids struggle to provide timely results when encountering new or unknown substances, such as the fentanyl analogs. These compounds, which mimic heroin in pharmacologic effect but can be far more potent, are inconsistently present in chemical identification libraries, and are currently largely unavailable as reference materials for analytical comparison. Additionally, federal, state and local governments as well as nongovernmental organizations require potency, toxicity and potential-for-abuse data to evaluate the potential health risks of emerging drug threats. Subsequent scheduling efforts and criminal prosecutions also require these thorough drug characterization studies. Pilot programs have demonstrated that early communication of real-time drug toxicity and analytical data significantly impacts the successful response to emerging opioids. High-quality, real-time, national-level data on chemical composition, toxicological test data, drug toxicity and overdoses, and analysis of seized materials by law enforcement are needed to track drug trends. However, the USA still lacks a national system to coordinate and communicate toxicology, medical and medical examiner and coroner data with the broader medical and law enforcement communities. Opportunities to address these gaps as well as recent advancements collected through interagency efforts and technical workshops in the toxicology and analytical chemistry communities are presented here. Opportunities for partnership, increased communication and expanding best practices to move toward an integrated, holistic analytical response are also explored.
在许多司法管辖区，公共安全和公共卫生实体正在共同努力，以提高对新型合成阿片类药物进行分析表征和毒理学测试的及时性和准确性。改进这些分析数据的共享和早期检测旨在为监测、拦截行动、患者干预和治疗提供信息，所有这些对于遏制阿片类药物流行至关重要。致力于识别新型合成阿片类药物的法医从业人员在遇到新的或未知物质（如芬太尼类似物）时，难以提供及时的结果。这些化合物在药理作用上模仿海洛因，但效力可能更强，在化学识别库中的存在情况不一致，目前作为分析比较的参考材料基本无法获取。此外，联邦、州和地方政府以及非政府组织需要效力、毒性和滥用潜力数据来评估新出现的药物威胁的潜在健康风险。随后的管制安排和刑事起诉也需要这些全面的药物表征研究。试点项目表明，实时药物毒性和分析数据的早期沟通对成功应对新出现的阿片类药物有重大影响。需要高质量、实时的国家级数据，包括化学成分、毒理学测试数据、药物毒性和过量用药情况，以及执法部门对查获材料的分析，以跟踪药物趋势。然而，美国仍然缺乏一个全国性系统，用于与更广泛的医疗和执法社区协调和沟通毒理学、医学、法医和验尸官的数据。本文介绍了弥补这些差距的机会，以及通过跨部门努力和毒理学与分析化学领域的技术研讨会收集到的最新进展。还探讨了建立伙伴关系、加强沟通以及推广最佳做法以实现综合、全面分析应对的机会。
