Abstract
A class of opioid agonists not structurally related to fentanyl, derived from research publications of pharmaceutical companies or patents within the United States and abroad are contributing to the current opioid epidemic. Novel synthetic opioids (NSOs) created to circumvent drug control laws such as U-47700, U-49900, AH-7921, or MT-45 have no recognized therapeutic use, are clandestinely manufactured and sold on conventional or dark web. We herein provide a review of the pharmacological properties available on most of these substances trying to provide a better knowledge on these compounds, particularly with respect to toxicity and dangerous adverse effects in users. Indeed, these NSOs share not only a great potency of action and receptor affinity with respect to natural or synthetic opiates (e.g., morphine, heroin, and methadone) but also a non-negligible toxicity leading to intoxications and fatalities, posing a serious harm to public health and society.
Highlights
INTRODUCTIONNon-fentanyl derived novel synthetic opioids (NSOs) have initially emerged worldwide as nonillegal drugs diffused to replace heroin and circumvent prohibition laws, resulting in numerous abuse reports and overdose cases, especially across United States and Europe (Carroll et al, 2012; Armenian et al, 2017b; Baumann et al, 2017; Fabregat-Safont et al, 2017)
Non-fentanyl derived novel synthetic opioids (NSOs) have initially emerged worldwide as nonillegal drugs diffused to replace heroin and circumvent prohibition laws, resulting in numerous abuse reports and overdose cases, especially across United States and Europe (Carroll et al, 2012; Armenian et al, 2017b; Baumann et al, 2017; Fabregat-Safont et al, 2017).These NSOs are a broad family of analgesics and anesthetics, mainly synthesized in the 1970s, acting at the mu (μ) opioid receptor, and at the delta (δ) and kappa (κ) ones
Novel synthetic opioids were originally synthesized by pharmaceutical companies in their research for analgesic drugs without addictive properties
Summary
Non-fentanyl derived novel synthetic opioids (NSOs) have initially emerged worldwide as nonillegal drugs diffused to replace heroin and circumvent prohibition laws, resulting in numerous abuse reports and overdose cases, especially across United States and Europe (Carroll et al, 2012; Armenian et al, 2017b; Baumann et al, 2017; Fabregat-Safont et al, 2017). Since the popularity of these substances is rapidly increasing and evolving over time, there is a great need to update all possible information, with respect to their subjective and side effects and to tackle unsolved issues, including limited analytical methods to disclose and monitor different compounds (Katselou et al, 2015; Lucyk and Nelson, 2017) To fill this gap, we here sought to report the latest information available on non-fentanyl derived NSOs U-47700, U-50488, U51754, U-49900, U-48800, AH-7921, and MT-45 with particular regard to their pharmacotoxicology and adverse effects on users (see Figure 1)
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