Cychlorphine-related deaths prompt questions about overdose prevention
Meanwhile, a new CDC report revived debate about whether kratom is dangerous.
Meanwhile, a new CDC report revived debate about whether kratom is dangerous.
In recent months, persistent online conversation about cychlorphine, a potent synthetic opioid, has prompted questions about whether there is a way to determine if it’s mixed with other illicit drugs and whether naloxone is effective against it. Plus, a new CDC report on kratom resurfaced debate about the supplement’s risks, and a CDC health advisory on medetomidine, a non-opioid sedative, in the illicit fentanyl supply prompted more naloxone questions.
In light of these conversations, communicators may recirculate information about these substances and highlight when to use naloxone.
What’s trending nationally in conversations about substance use
On March 13, the White House’s Office of National Drug Control Policy warned that cychlorphine had been identified in the illicit drug supply. In late March, health officials in more states—including Oklahoma and Indiana—warned about the opioid, linking it to multiple overdose deaths. Commenters expressed fear that cychlorphine could lead to an uptick in overdose deaths. They also asked if there is a way to determine if other illicit drugs contain cychlorphine and if naloxone can reverse a cychlorphine overdose, echoing questions in previous online conversations.
On March 26, the CDC released a report showing that kratom-related reports to poison centers increased dramatically over the past decade. Plus, articles reported that several states are considering and enacting new kratom restrictions. Many social media users discussing kratom framed the supplement as a useful tool for managing chronic pain and opioid withdrawal symptoms, suggesting that it isn’t as dangerous as alcohol, cigarettes, or pharmaceutical medications. Others warned that kratom can cause serious health problems and be addictive, with some sharing personal stories about kratom addiction and withdrawal.
On April 2, the CDC released a health advisory warning of increasing reports of medetomidine in the illicit fentanyl supply. Many social media users responding to the advisory alleged that restrictions on prescription opioids have pushed people with chronic pain to use dangerous illicit drugs. Others asked what medetomidine is, how it differs from other illicit substances, and whether naloxone is effective against it.
Recommendations for public health professionals
The Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about substance use.
Online conversations about cychlorphine are ongoing. In response, communicators may explain that current commercially available drug test strips do not detect cychlorphine. Messaging may stress that naloxone is effective at reversing an overdose from any opioid, including potent opioids like cychlorphine and fentanyl, but multiple doses may be needed. Messaging may remind community members about overdose response steps: Call 911 before administering naloxone, give additional doses every two to three minutes if the person does not respond to the initial dose, and stay with the person until medical help arrives. Communicators may want to direct people to local harm reduction programs that offer free naloxone, outline where to buy it nearby, and share information about any local naloxone trainings.
Given an uptick in conversations about kratom, communicators may emphasize that the Drug Enforcement Agency lists kratom as a “drug and chemical of concern” because consuming it can potentially lead to substance use disorder. Messaging may stress that kratom is not an FDA-approved medication or supplement and that it can cause serious side effects like liver damage, dizziness, trouble breathing, seizures, and delusions. People seeking support for chronic pain or opioid withdrawal symptoms should talk to a health care provider about the safest options for them.
Online discussion about medetomidine provides an opportunity to reiterate that the potent sedative may be unknowingly mixed with other drugs, contributing to overdose deaths. Messaging may explain how test strips for medetomidine and xylazine, another sedative, can help people determine if their drugs contain these substances and may be available for free through harm reduction programs and can also be purchased online. However, drug test strips are not legal everywhere, so communicators should ensure that messaging aligns with your state’s drug checking equipment laws. Communicators may explain the importance of administering naloxone any time an overdose is suspected, even if someone doesn’t know what substances are involved, because non-opioids like medetomidine are often mixed with opioids. Messaging may stress that it’s safe to administer naloxone even if a person isn’t overdosing or isn’t overdosing on opioids. Outlining your state’s Good Samaritan laws, which protect people responding to an overdose, is also recommended.
Insights reported by Public Good News, with communication guidance from the experts behind Infodemiology.com.