Mount Sinai Secures $3.8 Million NIH Grant for Synthetic Opioid Research

The Icahn School of Medicine at Mount Sinai has been awarded a substantial grant of $3.8 million from the National Institute on Drug Abuse (NIDA), a branch of the National Institutes of Health (NIH), to conduct pivotal research on drug overdose cases associated with novel synthetic opioids. This grant, which will be disbursed over five years, is designed to equip emergency department physicians with enhanced tools for identifying the substances involved in overdoses, assessing the severity of these cases, and determining the most effective treatments for patients affected by previously unknown or emergent drugs.

According to Dr. Alex Manini, MD, MS, Principal Investigator and Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai, “Front-line doctors urgently need better tools and information to manage overdose cases, especially involving synthetic drugs. Our study will give them real-time data and insights from across the country, enabling faster and more accurate care.”

The opioid epidemic in the United States has escalated dramatically, with drug overdose deaths doubling from 2015 to 2023. For the first time, these deaths surpassed 108,000 in 2023, with over 70% of cases involving opioids. The economic burden of the opioid crisis is staggering, costing the U.S. economy more than $1 trillion annually and leading to nearly 3 million emergency department visits each year, as reported by the National Center for Health Statistics in 2023.

Historically, the majority of opioid overdoses were linked to heroin; however, the rise of synthetic opioids, particularly fentanyl analogues, has transformed the landscape of drug-related fatalities. The introduction of these potent substances has led to a toxic drug supply characterized by new and unfamiliar drugs that many healthcare providers have not encountered. Consequently, the difficulty in identifying these drugs complicates the treatment of overdose cases, with naloxone—typically used to reverse opioid overdoses—raising concerns among physicians regarding its efficacy against newer synthetic opioids and their potential adulterants.

Mount Sinai's research initiative will involve collaboration with 10 high-volume hospital systems across the United States, all part of the national Toxicology Investigators Consortium. This consortium, affiliated with the American College of Medical Toxicology, aims to advance the detection of new and emerging drugs of abuse, assess adverse effects from new medications, and identify emerging toxicological threats. The study will focus on patients arriving at emergency departments due to opioid overdoses, examining their clinical presentations, confirmation of ingested substances, risk factors, and treatment requirements.

Utilizing state-of-the-art molecular identification technology, toxicologists will investigate the presence of novel fentanyl analogs and nitazenes—opioids noted for their potency and increasing prevalence in the U.S. illicit drug supply. Furthermore, the research team will disseminate critical information regarding overdose trends to the public in partnership with the Centers for Disease Control and Prevention (CDC). Dr. Manini emphasized the goal of this collaboration: “We aim to predict the effects of emerging synthetic opioids and get ahead of regional outbreaks, delivering timely alerts to doctors, public health agencies, and the public.”

The anticipated outcomes of this study are significant, with potential implications for improving the management of opioid overdoses and enhancing public health responses to the ongoing opioid crisis. As the research unfolds, it is expected to propel advancements in the field of drug abuse treatment and may establish a framework for predicting medical consequences for countless individuals affected by the opioid epidemic in the United States.