The Icahn School of Medicine at Mount Sinai announced today the launch of a new center for "Research on Emerging Substances, Poisoning, and Overdose, for New Discoveries," to be known as the RESPOND Center. Its research findings could lead to major advances in this area of medicine, including better treatments for patients with drug overdoses in emergency departments across the United States.
"Each day, clinicians on the front lines bear witness to devastating impacts from the current epidemic of substance use and illicit opioid overdose, not just to individuals, but to their families and communities. RESPOND Center researchers are making significant contributions to the field by focusing on the identification of emerging substances, the treatment of addiction as well as nonfatal overdose, and the prevention of adverse events to our patients," says Alex Manini, MD, MS, the Director of the RESPOND Center, and a Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai.
"Research is a team sport, and the RESPOND Center focuses on multidisciplinary approaches to problem-solving, bringing together experts from various fields, including toxicology, addiction, psychiatry, pharmacology, emergency medicine, and public health," Dr. Manini adds. "Through important collaborations with the American College of Medical Toxicology, the Centers for Forensic Science Research Education, the National Institutes of Health, and the Centers for Disease Control and Prevention, among others, we hope our efforts will result in a significant reduction in overdose-related deaths in the United States."
More than 100,000 people in the United States died from drug-involved overdoses in 2021, the majority from opioid drugs. In 2022, 3,026 New Yorkers died of a drug overdose, a 12 percent increase from 2021 and the highest number since reporting began in 2000. Fentanyl is one of those deadly opioids, and 25 percent of the fentanyl supply includes xylazine, an animal sedative. This has become a recent, growing threat that is leading to increased rates of addiction and adverse events such as severe skin lesions, hypothermia, and heart and respiratory issues. A subclass of opioid drugs called nitazenes are now emerging in the illicit opioid supply in the United States and are even more potent than fentanyl. According to a recent study in JAMA led by Dr. Manini, nitazenes add a layer of complexity to the dangers of illicit drug use, leading to a significantly increased rate of cardiac arrest in overdose cases and requiring significantly higher doses of naloxone for in-hospital treatment when compared to fentanyl overdoses. The RESPOND Center will prioritize researching these new threats.
This new center will conduct clinical research on a wide range of topics focused on opioids, synthetic opioids, hallucinogens, stimulant drugs including cocaine and methamphetamines, emerging drugs, and health services. Researchers will collect and analyze data from patients across emergency departments within the Mount Sinai Health System to advance knowledge and understanding of overdose, poisonings, and substance use disorders and discover new treatments.
Researchers from the RESPOND Center will draw from $14 million in grants from various institutions including the National Institute on Drug Abuse; the National Heart, Lung and Blood Institute; and the National Institute of Mental Health to study non-deadly drug overdose, fentanyl analogues, opioid use disorders, and emergency room patient management. The work of the RESPOND Center also involves collaboration between Mount Sinai's Department of Emergency Medicine, the Medical Toxicology Division, the Addiction Institute of Mount Sinai, and the American College of Medical Toxicology.
"Through this center, we hope to establish best practices for addressing the needs of patients who are exposed to the continuous flow of new drugs of abuse. We aim to define the unique risks of each of these substances and develop and deploy programs to mitigate these risks in a way that keeps people safe and alive," says Ethan Cowan, MD, Professor of Emergency Medicine at Icahn Mount Sinai. "Given the severity of the overdose epidemic, this work will be critical to stemming the flow of opioid overdose deaths. The center will also offer mentorship and training for a new generation of emergency medicine researchers who have a passion for improving the care and treatment for our most vulnerable patient populations."
