In response to a rising number of deaths, the U.S. Drug Enforcement Administration (DEA) has labelled U-47700, also known by its street name ‘Pink’, as a Schedule I product under the Controlled Substances Act.1 As of November 2016, at least 46 deaths around the U.S. have been associated with the use of Pink. This includes two 13 year-old boys, who tragically overdosed on Pink obtained from teens who had ordered it online.2
Pink was previously developed in the 1970s as a potential
analgesic alternative to morphine. Today, amidst a global opioid abuse crisis,
it has concerningly re-surfaced as a new
synthetic opioid. With principal manufacturing occurring overseas, Pink’s
composition, purity and exact effects are unknown, and it is often encountered
with other illicit substances, such as heroin and fentanyl. Furthermore, it can
appear in a number of different forms (e.g. powders, tablets), or may be
marketed as other prescription products by producers. Evidently, any quantity
of Pink could be fatal.
Reports
indicate that Pink’s potency is up to 8-fold
that of another highly abused opioid, heroin.2 As a class, opioids
bind to the mu-opioid receptors in the brain, which mediate biochemical responses
associated with pleasure and reward. In the event of an opiate overdose, the
body’s central nervous system is unable to regulate basic bodily functions.
This can lead to slowed breathing, a decline in body temperature and a loss of
consciousness. Overdosed persons may also become cyanotic, myoclonic and
develop seizures. 
Naloxone, an
opioid antagonist, can be used to reverse the effects of various opiates. As of
June 24, 2016, naloxone was designated as a Schedule II product, enabling individuals to obtain this
potentially life-saving drug from their local pharmacy without a prescription.3
Despite its proven ability to prevent opioid-related deaths, the efficacy of
naloxone for Pink overdoses remains unclear.
In light of the above, where do pharmacists fit in? As one of
the most accessible, front-line health practitioners, pharmacists have the
ability to recognize the signs of
opioid addiction, monitor safe
opioid use and refer patients for
help. Now, with the advent of naloxone availability in community pharmacies,
pharmacists also have a valued role in the safe distribution of and training
for naloxone. For more information, please visit the following sites: CAMH, the Drug
and Alcohol Helpline and The Works.
Vivian
References
1.
United States of America Drug Enforcement
Administration. DEA
Schedules Deadly Synthetic Drug U-47700. November 2016. Available: https://www.dea.gov/divisions/hq/2016/hq111016.shtml
(accessed December 12, 2016).
2.
CBS News. Police: 2 Utah 13 year-old boys died from
dangerous, new synthetic drug ‘pink’. October 2016. Available: http://www.cbsnews.com/news/police-2-utah-13-year-old-boys-died-from-dangerous-new-synthetic-drug-pink/
(accessed December 12, 2016).
3. Ministry
of Health and Long Term Care. Ontario naloxone program for pharmacies. August
2016. Available: http://www.health.gov.on.ca/en/pro/programs/drugs/opdp_eo/notices/fq_exec_office_20160817.pdf
(accessed December 12, 2016).
