Cychlorphine headlines raise concern online about overdose deaths

Plus, social media users dismissed using medication to treat substance use disorder.

Online conversation about cychlorphine, a potent synthetic opioid, continued this month, prompting more questions about whether naloxone is effective against it. Meanwhile, a study finding that GLP-1 medication may prevent substance use disorder sparked debate, with some commenters suggesting that taking any medication for SUD is “trading” one addiction for another.

In response, communicators may recirculate information about when to use naloxone and outline the benefits of medication for SUD.

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What’s trending nationally in conversations about substance use

In late February, health officials in Kentucky, Tennessee, and Ohio issued warnings that cychlorphine was identified in local drug supplies and linked to overdose deaths. This month, the drug was identified in Illinois, and articles reported on cychlorphine-related deaths in other states. On March 13, the White House’s Office of National Drug Control Policy warned about cychlorphine in an X post, which received approximately 108,500 views as of March 17. Commenters expressed concern that cychlorphine could cause overdose deaths to rise, and some asked if there is a way to determine if other illicit drugs contain it. (Current commercially available drug test strips do not detect cychlorphine.) In response to other posts, commenters asked whether naloxone can reverse a cychlorphine overdose, echoing questions in online conversations last month.

On March 4, BMJ published a study finding that people who take GLP-1 against medications for diabetes or weight loss may be less likely to develop substance use disorder or overdose. Several articles discussed the study, garnering mixed reactions online. Some commenters said that GLP-1 medication helped them or their loved ones stop consuming alcohol or nicotine. Others were skeptical that GLP-1 medication could prevent SUD and alleged that taking medication to prevent or manage SUD is “trading” one addiction for another.

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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 and naloxone are ongoing. Communicators responding to questions about naloxone may explain that the medication is effective at reversing an overdose from any opioid, including potent opioids like fentanyl and cychlorphine. However, messaging may remind individuals to give additional doses of naloxone every two to three minutes if the person does not respond to the initial dose. Messaging may reiterate that it’s safe to administer naloxone any time an overdose is suspected, even if you’re not sure if the person is overdosing on opioids, and that bystanders should always call 911 and stay with the person until medical help arrives. Directing people to local harm reduction programs that offer free naloxone and outlining where people can buy it nearby is recommended. Communicators may also want to share information about any local naloxone trainings.

Given stigmatizing comments about the use of medication to treat SUD, communicators may explain that SUD is a chronic medical condition that may require medication management, just like diabetes or heart disease. Communicators may explain that a combination of medication and therapy has been shown to help people with SUD reestablish normal brain function, reduce substance cravings, and reduce or prevent drug use. Messaging may stress that while GLP-1 medications are not approved to treat SUD, approved medications are available. Outlining the types of medications that treat SUD and how they work is recommended. Communicators may also recirculate information about local drug treatment centers, recovery groups, therapist directories, SAMHSA’s National Helpline (1-800-662-HELP), and local harm reduction programs, which offer tools that help people who use drugs live healthier lives and connect them to treatment when they are ready.