HEAL Initiative: Rapidly Assessing the Public Health Impact of Emerging Opioid Threats (UG1 - Clinical Trial Not Allowed)

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The need to rapidly develop methods to assess the prevalence / health impact of emerging illicit drugs has never been greater. Illicit chemists are marketing potent drugs of abuse taken from deep wells of scientific and patent literature, which we can expect to continue to yield new drugs for many years. Over the last few years, fentanyl/fentalogs (fentanyl-related opioids) have flooded the illicit opioid market, which has complicated patient stabilization / harm reduction, and caused mortality rates to skyrocket. Even understanding the drugs being used is difficult due to unstandardized analytical methods, and urine test strip kit variabilities. When test strips do detect fentalogs they simply indicate fentanyl and clinicians base treatment on this homogenous grouping. However, it is unclear that the addictive or mortality risk of fentalogs are generalizable. Initially fentanyl was reported to be long-lasting and poorly antagonizable, but such reports diminished when carfentanil, an ultrapotent and long-lasting fentalog, diminished in drug supplies. Now, ultrapotent "nitazene" opioids are on the market and a lack of validated analytical protocols and standards, has meant these drugs are over-looked in most jurisdictions. Nitazene urine test strips do not yet exist and so clinicians are ill-equipped to recognize nitazenes and respond appropriately. Users certainly do not know whether nitazenes (or fentalogs) are illicit purchased drugs. This FOA promotes development and distribution of tools to detect nitazenes in the necessary range of settings needed to enable appropriately calculated responses. Additionally, this RFA builds-in funds to allow awardees to rapidly bring their discoveries and expertise to bear on the future generations of threats that are surely coming

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