WMed will begin a new phase of rapid turnaround in testing opioid-related deaths as part of an effort to stem the opioid crisis sweeping the nation.
The Swift Toxicology for Opioid Related Mortalities (STORM) project started September 1, 2017, and more than 2,800 postmortem specimens have been analyzed for opioids, said Prentiss Jones, PhD, an associate professor in the medical school’s Department of Biomedical Sciences who is leading the project.
The aim of STORM, Dr. Jones said, was to produce improved and rapid assessments of deaths impacted by opioid use, along with identifying the specific opioids present at the time of death.
The results are published weekly and more than 200 health officials and law enforcement officials in Michigan receive the summary reports, Dr. Jones said.
“The overall goal is to show how this rapid toxicology testing will benefit the state of Michigan,” Dr. Jones said. “We’re setting up a model and we believe if this model is followed, we’ll be able to get our hands around the opioid crisis sooner than later.”
Traditional toxicology tests take 14 to 28 days, but the STORM project gets results to healthcare professionals within 72 hours.
In August 2019 WMed received a $286,809 grant from the Michigan Department of Health and Human Services to continue phase two of the STORM project. Dr. Jones said the funding will be used to purchase instrumentation that will allow WMed to expand testing to include non-opioids such as methamphetamine, cocaine and several novel psychoactive substances.
WMed’s work on the STORM project was key in securing funding for a three-year, $540,000 grant from the Centers for Disease Control and Prevention called the Overdose Data to Action (OD2A) program. The program began in September 2019 and highlights the need for an interdisciplinary, comprehensive and cohesive public health approach, Dr. Jones said. WMed’s participation of the OD2A project starts Oct. 1 with $180,000 per year in funding.
Since WMed was awarded the STORM grant in 2017, Dr. Jones said, the rate of opioid deaths has started to decline but STORM results have shown an uptick in the presence of the drug Naloxone – often referred to as Narcan. At times, Dr. Jones said, the presence of Naloxone is present in a specimen but the sample doesn’t test positive for opioids.
“We have a lot of cases where there’s Naloxone and no opioids whatsoever,” Dr. Jones said. “Possibly there’s an opioid we don’t look for but my suspicion is it’s methamphetamine, it’s cocaine, or a novel psychoactive substance.”
Dr. Jones said the OD2A program will allow WMed to test for illicit drugs including methamphetamine and cocaine and legal drugs including Kratom and Xylazine, a medicine commonly used by veterinarians that is used as a cutting agent.
“Some of these substances that we’re finding have not been officially attached to fatalities,” Dr. Jones said. “If you’re able to associate a cause of death with these substances, then that allows regulators to push up the urgency in getting the regulations in place. Not all of these substances are regulated. They’re not on the schedule list.”
Dr. Jones said he thinks the OD2A testing will show specimens with methamphetamine, a stimulant, and fentanyl, an opioid. He said this is a new way of “speedballing,” which historically is when drug users use a mixture of cocaine, a stimulant, with heroin, an opioid. Given the numerous opioids available today, the danger associated with combining other drugs to achieve different effects is uncharted, Dr. Jones said.
“This is going to continue to be a big issue because people who would normally use an opioid are naively exposed to other drugs,” Dr. Jones said. “Maybe they’re a cocaine user expecting to buy a speedball, thinking they’re getting cocaine and heroin but in reality they’re getting methamphetamine and fentanyl. I think we’re going to see that.”
Dr. Jones said specimens test positive for fentanyl more than anything else, which follows national trends. He said he believes it will be at least another five years until the opioid crisis is stemmed.
“There will be a lot more of these substances being introduced,” Dr. Jones said. “That’s the fear. It doesn’t take very much to tweak them. That’s a concern. What the public should understand is yes, maybe we’re having less people die (from opioid overdoses) due to Naloxone intervention, but the opioid crisis is still out there.”