Can Chromatography Help the Opioid Crisis?

The US is amidst an opioid epidemic. According to the US Department of Health and Human Services (HHS) website, data from 2016 and 2017 estimates that over 130 people die every day from opioid related drug overdoses, with over 11 million people misusing prescription opioids. There were over 17,000 deaths from overdosing on commonly prescribed opioids, over 15,000 deaths due to heroin overdoses and over 19,000 due to overdoses on synthetic opioids other than methadone.

The beginnings of the crisis can be traced to the 1990s when opioid usage started to increase. This happened after the medical community was reassured by pharmaceutical companies that the opioid drugs used for pain relief were not addictive and physicians began prescribing opioid pain relief at a greater rate. With so many deaths due to opioids, the HHS declared a public health emergency in 2017.

Vicodin and Fentanyl enter mainstream language

 Addiction to pain killers is nothing new. In the US Civil War, morphine was used for pain relief and anaesthetic and many soldiers became addicted to the drug after the war. Heroin was then developed as a morphine substitute as it was thought to be less addictive than morphine – with doctors prescribing heroin to patients addicted to morphine. The problems this caused led to the US banning the production and sale of heroin in 1924.

More recently, opioids like Vicodin and Fentanyl have been in the headlines (or in the case of Vicodin, a major storyline in the drama House). Opioid drugs connect to the opioid receptors in the body located in various places including the spinal cord and brain. Once the drugs attach to the sites, they set off a cascade of chemical reactions that can reduce the perception of pain, generate feeling of euphoria and make you feel calm and relaxed. Like other drugs that are addictive, you need to keep increasing the dose to get the desired effect – hence, the propensity for people to overdose on the drugs, especially if not under medical supervision.

Screening with chromatography

To find out the extent of the crisis means you must have a method of measuring how many people are potentially using a drug. Chromatography is considered the gold standard when it comes to analysing samples for opioids and the residues and metabolites they leave behind. The role of chromatography in screening for drugs residues is discussed in the article, Sensitive and Robust Screening of Hundreds of PPCP Compounds Using Online SPE-LC-MS/MS.

By better understanding the epidemic – through better screening by chromatography for example – health authorities can put in place better strategies to allow them to counteract the rise in overdoses and misuse. This includes better pain management strategies, new medications to treat opioid disorders and prevention and reversal interventions for overdoses.