U-47700

Illicit U-47700

Illicit U-47700

 

 

 

My patients are sometimes my best teachers, so when one of them mentioned a new opioid drug, I searched for information online. This new drug is called Pink, or Pinky, but its chemical name is U 47700.

This drug was first developed in the 1970’s by a scientist at Upjohn, a pharmaceutical company. This drug has never been studied in humans, but produces a strong opioid-type effect due to its action at the mu opioid receptor. It’s quite powerful, with estimated potency at seven or eight times that of morphine.

Last year, forty to eighty overdose deaths in the U.S. were attributed to this drug, depending on which source you read. As a man-made research drug, it was legal to obtain until late last year, when the DEA placed U-47700 on Schedule 1 status. This means it is no longer legal to buy online, and that it has a high potential for causing addiction and harm.

Rolling Stone did an article on this drug last fall, saying it was one of the drugs that contributed to Prince’s death, found in his blood at autopsy along with fentanyl. When Rolling Stone published their article, it was still an unscheduled drug. According to that report, there had been around 80 deaths attributable to U 47700, which is usually combined with fentanyl or other drugs. [1]

In some areas, fake Norco tablets were peddled by drug dealers. These pills actually contained U-47700, or a combination of U-47700 and fentanyl. At least a dozen people died from these fake pills, because they believed they were buying hydrocodone, but actually ingested the much more powerful opioids U-47700 and/or fentanyl.

When I listened to an online lecture from last year’s American Society of Addiction Medicine’s fall conference, one of the speakers, Robert DuPont M.D., said the drugs of the future will be synthetics. We’ve already seen this in the rise of synthetic marijuana products, and now it appears we are seeing synthetic, novel opioids hit the streets.

These drugs are cheaper to make by the big drug labs in China and Mexico than traditional heroin, as I said in a former blog post.

It’s impossible to tell how big a problem U-47700 is at this time. Routine toxicology may not detect this substance, unless the lab is told to test for it specifically. It’s quite possible this drug could be a component of much of what is sold as heroin. We already know heroin is frequently mixed with fentanyl because it’s cheaper to manufacture. If U- 47700 is cheap to make, it’s also likely to become a common component.

Synthetic drugs present legal problems. A chemist who is experimenting may come up with a new psychoactive product, and it can hit the market before any law can be passed against its use.

These novel drugs aren’t illegal until after they appear on the streets and cause harm. Then governmental agencies like the DEA rush to change laws to cover these drugs.

There’s another big danger to synthetics. Sometimes the chemists making drugs aren’t that careful. Not all chemists are Walter White, the character on “Breaking Bad.” Walter was an educated chemist who wanted to make the purest product possible, in order to please his customers and maintain his reputation. I dare say most chemists aren’t as educated as Walter, and aren’t as meticulous with details.

There’s always the risk that these people will inadvertently make a similar drug with completely different properties and side effects.

MPTP is a great example of a drug manufacturing error.

MPTP, chemically known as 1-Methyl-4-phenyl-1,2,3,6-tetrahydrophyridine, can be accidently manufactured instead of MPPP, a closely related drug with opioid-like effects. In the 1980’s a handful of people injected what they thought was MPPP, and developed severe Parkinson’s disease. This happened because the chemist accidently made MPTP, which destroys cells in the brain that control movement of the body. MPTP caused Parkinson’s disease in these drug users. This error, though tragic for the people affected, led to useful information to better understands Parkinson’s disease and its treatments.

And some of what I read online seemed overblown. For example, one section of the Rolling Stone article said the drug could cause rectal bleeding. Upon closer reading of the article, the rectal bleeding was reported by people who had used the drug rectally. So yeah, that might cause problems down there.

In another online article, the police chief of Park City, Utah, is quoted as saying, “This stuff is so powerful that if you touch it, you could go into cardiac arrest.” [2]

I am skeptical about that statement. Unless there’s something in it allowing it to pass through the barrier of the skin, that’s doubtful.

Making speculative statements without proof can lead to hysteria, and can undermine the credibility of people who are trying to inform drug users of some very real dangers.

For me, the message is “buyer beware” with heroin. It may or may not be heroin. It could be fentanyl, it could be U-47700, and it could be a whole lot of other things.

This means it’s even more important for drug users to try “tester shots,” meaning use a fraction of drug to assess its potency. It’s important not to use alone, and to stagger injection times, so that there’s always someone able to call for help if needed. Drug users of opioids should have up-to-date naloxone kits on hand in case the worst happens and someone overdoses.

And above all, consider getting into opioid use disorder treatment: https://findtreatment.samhsa.gov/

  1. http://www.rollingstone.com/culture/news/u-47700-everything-you-need-to-know-about-deadly-new-drug-w443344
  2. http://www.inquisitr.com/3600359/new-drug-pink-causing-deaths-nationwide-opioid-u-47700-easily-purchased-online-despite-federal-ban/
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5 responses to this post.

  1. Posted by Helen Williams on February 6, 2017 at 5:35 pm

    Doc I have tried finding a way to contact you by email ,but this is the best route I have found. Have you seen the new legislation they are trying to pass in Virginia. My son is an addict, he has been in medication assisted treatment for opiate dependency for a little while. He was jumped by mean people years ago, left him with a fractured jaw, other bones in his face. He had 63 stitches in his mouth and another 40 in his lip. They kept him hopped up on pain killers and when he tried to come off them he couldnt so he sought help. He was giving subutex that day and the next couple days. A few days went by and he was written Suboxone we paid 400 dollars that day, and only got a portion of it back of back when he had a allergic reaction to naloxone, got hives and bumps in mouth, and his tongue swelled up. He had to have an epipen shot, and the doctor here referred him to out of state doctor to get buprenorphine without naloxone because the doctor there couldnt prescribe it because it was against the clinics rules. He is doing great, but now Virginia is trying to pass a law to only give buprenorphine mono to women that are pregnant and are being treated for substance abuse. He is scared to death that it will all be ripped out for under him and he cant have methadone because it restricts his breathing to much due to his asthma. It would be great if you could help get the news out that its wrong if a patient cannot have suboxone then he or shecan’t have nothing at all in Virginia. It is called HB2163, Thank you for your time.

    Reply

    • I have heard of it and I hope it doesn’t pass. It’s a bad law in my opinion.
      Write to your state representatives & let them know how you feel and how you vote!!

      Reply

      • Posted by Helen Williams on February 7, 2017 at 5:30 am

        Thank you for your reply, I have sent messages to representatives, Gov. McAuliffe, and Ms. Kana Enomoto one of the heads of SAMHSA. It is a bad law, I keep up with your blog for the most part when I can. These people are willing to rip peoples alives apart for no reason. I have urged them to at least include people that have a documented allergy. My son has never failed a urine screen, a count, nothing he has really got his life going in the right direction. I know the medication isn’t for everyone, and it has a potential for abuse but people in general will abuse any system. It just really sucks that the people that are relying on it may have it taken from them because of people that abuse the system. Again thank you for your time, and have a nice day.

      • Excellent! We all need to be contacting legislators.

  2. Posted by Mikael Langner on February 6, 2017 at 7:19 pm

    Synthetic opioids seem to be the future of drug misuse for the simple reason that they are the cheapest way for dealers to supply their clients with drugs of misuse. It is somewhat surprising, therefore, that Prince, a guy without a shortage of money, would find himself in trouble with these things. One wonders whether his supplier was sold the wrong stuff. One can imagine Prince telling his dealer: Don’t go for the first thing you find, go find the best money can buy.

    I went to medical review officer course over the weekend, and learned that the synthetics are the most difficult to test for because the testing technology is only able to detect molecular patterns it has been taught to identify.

    Reply

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