Description of the video:
What started as a prescription drug crisis in the U.S. has morphed into a synthetic drug epidemic that encompasses every class of illicit drug. But few labs can detect the ever-growing number of synthetic drugs, leaving emergency room providers waiting weeks for results if they come at all.
To address this issue, we have developed new technology that would simplify synthetic drug testing, allowing for more rapid, and less expensive, detection of synthetic drugs currently going undetected.
Through the Responding to the Addictions Crisis Grand Challenge, we hope to implement this new technology in emergency departments, and eventually create a database that links clinical and location data with chemical information.
Our goal is to better identify chemical structures causing overdoses to help health officials better understand which drugs are causing problems in which communities; allow researchers and physicians to develop better treatment options and allow lawmakers better craft legislation.
Synthetic opioids — drugs manufactured from chemicals rather than derived from plants — are the most dangerous form of opioid, accounting for more fatal overdoses than any other type of drug.
These drugs are so deadly because they are many times stronger than heroin, can be purchased easily through illegal online sales, and are very difficult to detect in blood.
Because so many different varieties of these drugs are being produced and current drug testing systems are designed to look only for a few specific drugs, doctors may be unable to determine the cause of a patient’s symptoms when they arrive unconscious at the hospital due to an overdose.
Nicholas Manicke, associate professor in the department of chemistry and chemical biology, forensic and investigative sciences program at IUPUI, is addressing this problem through a new drug testing system that can quickly scan for hundreds of synthetic drugs.
Through the IU's Responding to the Addictions Crisis Grand Challenge initiative, Manicke and his team will not only provide a testing tool for health care settings, they will also develop a database showing where different types of synthetic drugs are in used in Indiana in order to support outreach, education and prevention efforts.
"What started as a prescription drug problem in this country has morphed into a synthetic drug epidemic encompassing nearly every class of illicit drug," Manicke said. "Few labs around the country can detect the ever-growing number of synthetic drugs. Healthcare providers wait weeks to get back results, so few clinicians test for synthetic drugs. As result, we know surprisingly little about the drugs that are causing nonfatal overdoses."
Synthetic drugs have become extremely common because they are inexpensive to produce from readily available chemicals, whereas drugs like cocaine, heroin and cannabis (marijuana) come from plants that require time, space and resources to grow.
In addition to synthetic opioids, most of which are similar to the prescription drug fentanyl, there are many synthetic cannabinoids (often known as "spice" or "K2"). Unlike the cannabis plant, these drugs can be fatal, making them especially dangerous for those who expect the mild effects of marijuana.
Other common synthetic drugs include synthetic cathinones (bath salts) and hallucinogens (nbombs). Because synthetic drugs tend to be extremely strong — a fatal dose of fentanyl is just two milligrams, the equivalent of one-tenth of a grain of rice — the difference between an intoxicating dosage and a fatal dosage is microscopic, leading to frequent overdose.
"Common drug tests generally fail to detect these drugs because they use a 'targeted' approach that looks only for a few specific drugs," Manicke said. "Our technology uses a 'non-targeted' approach to scan for many different types of chemical compounds. This simplifies synthetic drug testing, allowing for more rapid, and less expensive, detection of synthetic drugs currently going undetected."
Manicke's method relies on mass spectrometry, a technique for separating out and measuring all the different chemical components of a particular substance such as blood, soil or water. This technology is not commonly used in health care because it is typically time-consuming, expensive and available only in research laboratories.
Manicke's innovation overcomes these problems by providing a small device that collects a tiny amount of plasma (the liquid portion of blood) and prepares it for both transportation and analysis. This device can then pair with a desktop mass spectrometry machine to detect drugs in the patient’s blood.
In the first phase of the project titled "Chemical surveillance system for the synthetic drug crisis," plasma samples are being collected from an Indianapolis hospital emergency department and analyzed in Manicke's laboratory. One goal of the project is to improve the collection device so that it can use simple blood samples rather than requiring the step of separating out the plasma.
In the near future, testing for synthetic drugs could be as simple as a finger-prick blood test. Once the testing processes and tools have been improved, the researchers will expand to other hospitals throughout Indiana and use that data to build an interactive database showing which synthetic drugs are being used in different areas as well as symptoms and risks of those drugs.
Through this project, Manicke hopes to build toward using this technology in healthcare settings without the need for a separate research facility.
"Our goal is to better identify chemical structures causing overdoses to help health officials better understand which drugs are causing problems in which communities, allow researchers and physicians to develop better treatment options and allow lawmakers and better craft legislation," he said.
