It's a lofty goal for Dr. Phillip Randy Torralva but a new hurdle has been cleared for the local researcher to further his fight against fentanyl overdose.
CODA has announced that Dr. Torralva, the center's Associate Director of Research, Anesthesiologist, and Addictionologist, was recently awarded funding from the National Institute on Drug Abuse for his project, “Drug Discovery for Fentanyl-Induced Respiratory Effects Syndrome," to create a medication to counteract fentanyl’s fatal effects.
“I really want to make sure that these drugs are readily available to anyone that needs them. And I want these drugs to be the aspirin and the ipecac syrup of the 21st century," Dr. Torralva told KATU News.
Dr. Torralva has been working with Dr. Aaron Janowsky at the Portland VA on recent publications explicating the mechanisms of fentanyl that lead to an often-fatal respiratory failure known as wooden chest syndrome.
Their paper “Fentanyl but not Morphine Interacts with Non-Opioid Recombinant Human Neurotransmitter Receptors and Transporters,” was recently published in the Journal of Pharmacology and Experimental Therapeutics.
The abstract they published explains that anesthesiologists in the United States were introduced to fentanyl in the early 1970s when it revolutionized surgical anesthesia. "However, they quickly had to master its unique side effect. [Fentanyl and fentanyl analogs] can produce profound rigidity in the diaphragm, chest wall and upper airway within an extremely narrow dosing range. This clinical effect was called wooden chest syndrome by anesthesiologists and is not commonly known outside of anesthesiology or to clinicians or researchers in addiction research/medicine. WCS is almost routinely fatal without expert airway management."
Torralva has made it his mission to try and reverse the overdose and deadly effects of fentanyl on the human body. He's trying to fill the gaps where the life-saving, opioid overdose-reversal nasal spray Naloxone might not be as effective when dealing with high doses of fentanyl, he said.
“Naloxone is an opioid-reversal drug. So what it’s able to do is antagonize or block the effects of opioids on opioid receptors in the brain. High doses of opioids cause respiratory depression and that’s what leads to overdose and death. So Naloxone is a very effective treatment. It’s saved many lives for morphine-derived drugs like heroin or oxycodone," Torralva said. “Fentanyl is a fully synthetic opioid. So it is unrelated to morphine. IT’s a completely different molecule. The research that we’ve done shows clearly that fentanyl has different effects because it not only binds opioid receptors, but it also binds these adrenaline receptors that cause not respiratory depression but acute respiratory failure by causing the vocal cords to slam shut and the chest wall to freeze.”
Dr. Torralva said the federal funding will help his research stay on its timeline to gather data on fighting fentanyl overdose in the next 6-12 months. CODA explained the funding will give Torralva's project a federal-driven drug development team to advise and assist him in developing of a drug to counteract fentanyl and ideally, prevent thousands of deaths.
His goal is to have a life-saving drug in the marketplace by 2025-2026.
“The goal really is just to save lives. The hope is we can decrease the number of lethal overdoses from fentanyl-related drugs,” Torralva said.