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Fight against opioid epidemic continued in 2016

Public health experts work to expand access to overdose treatment; DEA proposes then reconsiders ban on opioid alternative

by Michael Torrice
December 14, 2016 | A version of this story appeared in Volume 94, Issue 49

Opioid epidemic
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Deaths from overdoses of heroin and opioid pain medications continue to grow in the U.S.
Source: CDC
Chart of overdose deaths from opioids.
Deaths from overdoses of heroin and opioid pain medications continue to grow in the U.S.
Source: CDC

The statistics on the U.S.’s opioid epidemic are stark: Since 1999, overdose deaths from heroin and opioid prescription drugs have more than quadrupled, according to the Centers for Disease Control & Prevention. Public health officials and advocates continued to battle this opioid epidemic in 2016.

Part of the fight has been over expanding access to naloxone, a drug that counteracts opioid overdoses, for first responders and people who live with opioid users. Naloxone acts as an antagonist for opioid receptors, knocking heroin and other opioid molecules out of the receptors’ binding sites.

In recent years, drug companies have developed easy-to-use naloxone delivery systems. For example, earlier this year Adapt Pharma started selling a naloxone nasal spray.

Meanwhile, scientists have been searching for opioid alternatives. Some researchers hope to find molecules that relieve pain without activating signaling pathways in the body associated with addiction.

Those who are worried about opioid addiction but looking to relieve chronic pain have turned to kratom, a drug derived from the leaves of the Mitragyna speciosa plant. Researchers this year determined that alkaloids in the leaves bind and activate opioid receptors in the brain (J. Am. Chem. Soc. 2016, DOI: 10.1021/jacs.6b00360).

At the end of August, the Drug Enforcement Agency announced it planned to temporarily list two alkaloids in kratom as Schedule I substances, effectively banning the drug and plant. After outcry from users, scientists, and even some members of Congress, the agency reversed its plans and solicited comments from the public through Dec. 1 to help make a final decision.


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