Tag Archives: Opioid Addiction

University of California Davis study: A breath test for opioids

6 Oct

The National Institute on Drug Abuse provides information on opioids:

Brief Description
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.
• Summary
• All opioids are chemically related and interact with opioid receptors on nerve cells in the body and brain. Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused (taken in a different way or in a larger quantity than prescribed, or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead to dependence and, when misused, opioid pain relievers can lead to addiction, overdose incidents, and deaths.
• An opioid overdose can be reversed with the drug naloxone when given right away. Improvements have been seen in some regions of the country in the form of decreasing availability of prescription opioid pain relievers and decreasing misuse among the Nation’s teens. However, since 2007, overdose deaths related to heroin have been increasing. Fortunately, effective medications exist to treat opioid use disorders including methadone, buprenorphine, and naltrexone.
• A NIDA study found that once treatment is initiated, both a buprenorphine/naloxone combination and an extended release naltrexone formulation are similarly effective in treating opioid addiction. However, naltrexone requires full detoxification, so initiating treatment among active users was more difficult. These medications help many people recover from opioid addiction.
• NIDA’s Role in the NIH HEAL Initiative℠ https://www.drugabuse.gov/drugs-abuse/opioids/nidas-role-in-nih-heal-initiative
• Prescription Opioids https://www.drugabuse.gov/publications/drugfacts/prescription-opioids
• Heroin https://www.drugabuse.gov/drugs-abuse/heroin
• Fentanyl https://www.drugabuse.gov/drugs-abuse/fentanyl
• Opioid Research Findings Funded by NIDA
https://www.drugabuse.gov/drugs-abuse/opioids

Opioids are powerful drugs and can be abused.

Resources:
What Is an Opioid? – Teens – Drug Information
https://teens.drugabuse.gov/blog/post/what-opioid

What are opioids and why are they dangerous? – Mayo Clinic
https://www.mayoclinic.org/…/expert-answers/what-are-opioids/faq-20381270

The American Society of Anesthesiologists has a concise description of opioid abuse at their site:

Opioid Abuse
Opioids are highly addictive, and opioid abuse has become a national crisis in the United States. Statistics highlight the severity of the epidemic, with the National Institute on Drug Abuse reporting that more than 2 million Americans abuse opioids and that more than 90 Americans die by opioid overdose every day, on average.
Why do people become addicted to opioids?
Opioids can make your brain and body believe the drug is necessary for survival. As you learn to tolerate the dose you’ve been prescribed, you may find that you need even more medication to relieve the pain or achieve well-being, which can lead to dependency. Addiction takes hold of our brains in several ways — and is far more complex and less forgiving than many people realize.
How can you avoid addiction to opioids?
If you or a loved one is considering taking opioids to manage pain, it is vital to talk to a physician anesthesiologist or other pain medicine specialist about using them safely and exploring alternative options if needed. Learn how to work with your physician anesthesiologist or another physician to use opioids more wisely and safely and explore what pain management alternatives might work for you.
What are the signs of an addiction?
People addicted to drugs may change their behavior. Possible signs include:
• Mixing with different groups of people or changing friends
• Spending time alone and avoiding time with family and friends
• Losing interest in activities
• Not bathing, changing clothes or brushing their teeth
• Being very tired and sad
• Eating more or less than usual
• Being overly energetic, talking fast and saying things that don’t make sense
• Being nervous or cranky
• Quickly changing moods
• Sleeping at odd hours
• Missing important appointments
• Getting into trouble with the law
• Attending work or school on an erratic schedule
• Experiencing financial hardship
https://www.asahq.org/whensecondscount/pain-management/opioid-treatment/opioid-abuse/

The University of California Davis has developed a breath test for opioids.

Science Daily reported in A breath test for opioids:

A test to detect opioid drugs in exhaled breath has been developed by engineers and physicians at the University of California, Davis. A breath test could be useful in caring for chronic pain patients as well as for checking for illegal drug use.
“There are a few ways we think this could impact society,” said Professor Cristina Davis, chair of the Department of Mechanical and Aerospace Engineering at UC Davis, who led the research along with Professor Michael Schivo from the UC Davis Medical Center. The work is described in a paper published in the Journal of Breath Research Oct. 3.
Doctors and nurses treating chronic pain may need to monitor patients to make sure they are taking their drugs correctly, that their prescribed drugs are being metabolized properly and that they are not taking additional medications. Blood tests are the gold standard: a reliable, noninvasive test would be a useful alternative.
Collecting droplets from breath
For the test developed by postdoctoral researcher Eva Borras, Davis and colleagues, subjects breathe normally into a specialized collection device. Droplets in breath condense and are stored in a freezer until testing. Davis’ lab uses mass spectrometry to identify compounds in the samples.
The researchers tested the technique in a small group of patients receiving infusions of pain medications including morphine and hydromorphone, or oral doses of oxycodone, at the UC Davis Medical Center. They were therefore able to compare opioid metabolites in breath with both blood samples and the doses given to patients.
“We can see both the original drug and metabolites in exhaled breath,” Davis said.
Fully validating the breath test will require more data from larger groups of patients, she said. Davis’ laboratory is working toward real-time, bedside testing…. https://www.sciencedaily.com/releases/2019/10/191004105645.htm

Citation:

A breath test for opioids
Date: October 4, 2019
Source: University of California – Davis
Summary:
A test to detect opioid drugs in exhaled breath has been developed by engineers and physicians. A breath test could be useful in caring for chronic pain patients as well as for checking for illegal drug use.

Journal Reference:
Eva Borras, Andy Cheng, Ted Wun, Kristen L Reese, Matthias Frank, Michael Schivo, Cristina E Davis. Detecting opioid metabolites in exhaled breath condensate (EBC). Journal of Breath Research, 2019; 13 (4): 046014 DOI: 10.1088/1752-7163/ab35fd

Here is the press release from University of California Davis:

A Breath Test for Opioids
By Andy Fell on October 3, 2019 in Human & Animal Health
UC Davis researchers have developed a method for detecting opioid drugs and drug metabolites in breath. The test could be useful for management of patients with chronic pain, as well as for detecting illegal opioid use. (Credit: Charles Wollertz/Getty Images)
A test to detect opioid drugs in exhaled breath has been developed by engineers and physicians at the University of California, Davis. A breath test could be useful in caring for chronic pain patients as well as for checking for illegal drug use.
“There are a few ways we think this could impact society,” said Professor Cristina Davis, chair of the Department of Mechanical and Aerospace Engineering at UC Davis, who led the research along with Professor Michael Schivo from the UC Davis Medical Center. The work is described in a paper published in the Journal of Breath Research Oct. 3.
Doctors and nurses treating chronic pain may need to monitor patients to make sure they are taking their drugs correctly, that their prescribed drugs are being metabolized properly and that they are not taking additional medications. Blood tests are the gold standard: a reliable, noninvasive test would be a useful alternative.
Collecting droplets from breath
For the test developed by postdoctoral researcher Eva Borras, Davis and colleagues, subjects breathe normally into a specialized collection device. Droplets in breath condense and are stored in a freezer until testing. Davis’ lab uses mass spectrometry to identify compounds in the samples.
The researchers tested the technique in a small group of patients receiving infusions of pain medications including morphine and hydromorphone, or oral doses of oxycodone, at the UC Davis Medical Center. They were therefore able to compare opioid metabolites in breath with both blood samples and the doses given to patients.
“We can see both the original drug and metabolites in exhaled breath,” Davis said.
Fully validating the breath test will require more data from larger groups of patients, she said. Davis’ laboratory is working toward real-time, bedside testing.
Other authors on the paper include graduate student Andy Cheng, UC Davis forensic science program; Ted Wun, Department of Internal Medicine; Kristen Reese and Matthias Frank, Lawrence Livermore National Laboratory; and Michael Schivo, UC Davis School of Medicine and VA Northern California Health System.
Davis’ laboratory is working on a variety of applications for detecting small amounts of chemicals, especially in air and exhaled breath. Other projects include diagnosing influenza in people and citrus greening disease in fruit trees.
The work was supported by grants from the UC Davis Medical Center’s Collaborative for Diagnostic Innovation, the U.S. Department of Energy and the NIH.
Media contact(s)
Cristina Davis, Mechanical and Aerospace Engineering, 530-754-9004, cedavis@ucdavis.edu
Andy Fell, News and Media Relations, 530-752-4533, ahfell@ucdavis.edu
Media Resources
Read the paper (Journal of Breath Research) https://iopscience.iop.org/article/10.1088/1752-7163/ab35fd

The National Institute on Drug Abuse defines the opioid crisis:

Revised January 2019
Every day, more than 130 people in the United States die after overdosing on opioids.1 The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.2
How did this happen?
In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive.3,4 Opioid overdose rates began to increase. In 2017, more than 47,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid.1 That same year, an estimated 1.7 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 652,000 suffered from a heroin use disorder (not mutually exclusive).5
What do we know about the opioid crisis?
• Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.6
• Between 8 and 12 percent develop an opioid use disorder.6
• An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.7–9
• About 80 percent of people who use heroin first misused prescription opioids.7
• Opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states.10
• The Midwestern region saw opioid overdoses increase 70 percent from July 2016 through September 2017.10
• Opioid overdoses in large cities increase by 54 percent in 16 states.10

This issue has become a public health crisis with devastating consequences including increases in opioid misuse and related overdoses, as well as the rising incidence of neonatal abstinence syndrome due to opioid use and misuse during pregnancy. The increase in injection drug use has also contributed to the spread of infectious diseases including HIV and hepatitis C. As seen throughout the history of medicine, science can be an important part of the solution in resolving such a public health crisis.
https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

 

“The mentality, thought system and relationships that got you into addiction will keep you there unless you disentangle yourself from them.”

Oche Otorkpa,
The Night Before I killed Addiction

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