Journal article coauthored by S&T’s Chemical Security Analysis Center highlights medical countermeasures to intentional opioid harm.
The Department of Homeland Security’s (DHS) Homeland Security Investigations recently announced in its Strategy for Combating Illicit Opioids that the agency has seized more than 54,000 pounds of fentanyl and interdicted over 2.2 million pounds of synthetic drug precursor chemicals over the last five years. Still, overdose deaths continue to rise, and the ways opioids reach users constantly evolve.
The Science and Technology Directorate (S&T) is working with partners at every government level on opioid detection and is curtailing the illicit flow of fentanyl into the country, both cornerstones of the Biden Administration’s Unity Agenda Strategy for defeating the overdose epidemic. S&T’s Chemical Security Analysis Center (CSAC), the preeminent national laboratory dedicated to identifying and assessing chemical threats, has been researching opioids since its establishment in 2006 and currently has a number of efforts focusing on combating the threat that synthetic opioids pose.
“Select synthetic opioids are on the S&T compounds of interest list,” said Jessica Cox, CSAC program manager for chemical threat characterization. “CSAC is continually searching for new and emerging potential chemical threats to the United States. S&T, through various programs, is performing and funding laboratory studies, as well as collecting literature data on the chemical, physical and toxicological properties of synthetic opioids. Then the S&T Probabilistic Analysis for National Threats Hazards and Risks (PANTHR) program uses these data to calculate the risk to the nation from an opioids attack in numerous scenarios.”
“CSAC is a critical research partner in understanding how harmful chemicals, including fentanyl, can be used against us and in finding novel detection methods for opioids and other emerging compounds in border protection and law enforcement scenarios,” said Dr. Rosanna Anderson, director of Program Operations and Execution in S&T’s Office of Mission and Capability Support and a leading U.S. opioids expert.
Synthetic opioids like fentanyl are highly potent, fast acting, and the health consequences, like stopping breathing, can manifest within minutes. CSAC collaborated with U.S. and foreign government agencies and academia to study appropriate medical countermeasures, particularly should opioids be used intentionally to cause harm. Their findings were released in the journal article Public health and medical preparedness for mass casualties from the deliberate release of synthetic opioids, published in May in Frontiers in Public Health. CSAC contributed toxicity data, historical background, and provided overall feedback to enhance risk assessment and management tools.
“CSAC’s expertise is to pull data together, analyze it and understand what it means—how the synthetic opioids behave, what their hazards and threats are, what countermeasures and personal protective equipment we have or do not have—for first responders to respond to an incident,” said Cox. “And then we channel that back to the Homeland Security Enterprise (HSE), which turns it into policy directives, standard operating procedures or to develop new or more effective countermeasures.”
Beyond the published article, CSAC is leveraging the data and the lab’s expertise in additional actionable ways:
Providing expertise to HSE. Year-round, 24/7, CSAC answers technical requests and questions for synthetic opioids and pharmaceutical-based agents and provides in-depth knowledge from subject matter experts. For example, law enforcement agencies could enquire during an operation about specific opioid or chemical toxicity, available relevant detection technologies, and more. CSAC generates numerous publications documenting the research on various compounds and their detection technologies.
Detection. To help first responders, CSAC conducted a comprehensive survey of government-tested handheld field detection technology to see if they are applicable for various synthetic opioids. Then S&T’s National Urban Security Technology Laboratory, in partnership with the Department of Energy’s Pacific Northwest National Laboratory (PNNL), worked with manufacturers to expand these devices’ libraries. S&T and PNNL tested the devices in the field, per ASTM standards, in detecting substances in pure form, mixtures or dilutions, and trace amounts.
Master Question List. CSAC and S&T’s Opioid Program published and continue to update a publicly-available Master Question List (MQL) for Synthetic Opioids to aggregate what we know about them and what we still need to determine about medical countermeasures, decontamination, and persistence in the environment. The MQL serves as a resource for first responders and researchers to inform planning and preparedness and influence operational decisions. CSAC plans to work with law enforcement to operationalize some of the latest data.
Risk assessment. CSAC collects chemical, physical and toxicological data for fentanyl compounds and other opioids annually. The data are given to PANTHR for use in the risk assessments, which will help inform federal, state, and local governments’, and the HSE’s emergency planning, preparedness, policies, directives and guidance. Many tailored assessments and technical requests rely on the data each year as well.
Nitazenes research. CSAC is collecting information on the synthesis, precursors toxicity, and physical properties of nitazene opioids. Nitazenes, discovered and patented in the 1950’s for pharmaceutical use, are now becoming prevalent illicit drugs in the United States. They will be added to PANTHR’s list of chemical hazards and national risk calculations, opioid detection technologies’ capabilities, the compounds of interest list, and will be in the 2025 National Strategic Chemical, Biological, Radiological, and Nuclear Risk Assessment.
Studying synthetic opioid toxicity. Knowing about synthetic opioids’ toxicity via inhalation, skin and ingestion routes is critical for understanding the danger synthetic opioids pose and for supporting the realistic calculation of the potential consequences from an event. As direct human studies with fentanyl and its numerous analogues are scarce, CSAC has estimated toxicity values from decedent case studies.
Studying opioid ingestion. S&T funded the U.S. Army Medical Research Institute of Chemical Defense (MRICD) to conduct multiple animal studies on the acceptance of food tainted by synthetic opioids like fentanyl. These results were used to inform the sensory values (taste, sight, smell, and touch) in PANTHR Risk Assessments and increased opioid hazard awareness and knowledge.
Studying dermal penetration characterization. S&T funds the MRICD to conduct a dermal penetration characterization study for carfentanil to fully understand the effects from a skin exposure.
As the United State remains in the throes of an opioid crisis, S&T’s continued research is critical to understanding the problems that opioids could pose.
“Having a thorough understanding is critical to saving lives if an incident involving synthetic opioids occurs. There is no time to learn during an incident,” said Cox. “Quick recognition, decisions and providing effective treatment are only possible if we do the research before we need it.”
Information is still needed to fully understand and protect against the growing synthetic opioid threat. CSAC is continuing to monitor emerging opioid threats, gather new experimental data, and identify improved detection technologies. This knowledge will assist in preparedness, prevention, mitigation and recovery from an opioid event.