The CDC’s (Centers for Disease Control) response to the opioid overdose crisis is a current example of how federal intervention can help meet a public health challenge. The case in point is the CDS’s response for pleas from labs for reference standards to aid in qualitative and quantitative analysis of fentanyl and related analytes using LCMS/MS. This was described in a webinar featuring Dr. Mellissa Carter and Dr. Elizabeth (Beth) Hamlin of the CDC and Dr. Michael David of the American Chemical Society, broadcast on September 12, 2019.
The problem with opioids is growing. Annual deaths increased by six-fold from 1999 to 2017 to over 40,000 Americans /year. The US Drug Enforcement Administration reports that 75% of these are related to overdoses of fentanyl. Worse, the number of illicit fentanyl analogs is growing as chemists develop new analogs. Dr. Carter reports that they identified 20 new fentanyls in the first half of 2018. In the first half of 2019, the new hits increased by about 20 more.
Since the spectrum of fentanyl targets is increasing so rapidly the CDC has introduced a Fentanyl Screening Kit (Called the FAS Kit) which includes 200 ug of each of 150 fentanyl analogs. It is offered for free to laboratories with appropriate DEA license through several vendors including CaymanChem.com/forensics/fastlit/.
The compound library is growing rapidly with new materials added quarterly. This library is designed for qualitative analysis by LCMS/MS. In the Q&A, Dr. Carter advised that the kit has been used successfully with GCMS/MS. The authors avoided endorsing the particular instruments they used, but they referred to them as “Research Grade.”
For quantitative analysis, Dr. Carter introduced the Opioid Certified Reference Material Kit available without charge from Celliant. The kit contains 1 mg each of 22 opioids and their corresponding stable isotope (13C and 15N) isotopes, which enable quantitative analysis. This kit is also growing rapidly.
The CDC also contracted the development of a kit for Traceable Opioid Materials (TOM). The 2019 TOM kit provides a minimum of 87.5% coverage of the Opioids on the DEA’s hit lit and 100% coverage of the National Forensic Laboratory Information System (NFLIS) list. Again, the compounds in the TOM kits are being updated frequently.
If your lab has a DEA License and complies with local regulations the kits are free. Already the kits are popular with 344 FAS kits, 223 CRM kits and 1024 TOM kits have been shipped by September 11, 2019. California was the leader with 125. A polling question asked for attendees to indicate if they were aware of these kits. 58 %, including me, were not.
The CDC wants to receive credit for the work, with a request that users of the kits acknowledge the origin of the kits in publications, web postings, lectures, posters, etc. The kit titles and abbreviations are service marks of the U.S. Department of Health and Human Services. So, I hope that I’ve fulfilled my obligation.
This very favorable status report is a stark contrast to my observations of the status of cannabis science. The lack of federal participation in cannabis assay technology including standards is clearly impeding public health. So stay tuned.
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