{"id":17448,"date":"2024-06-08T18:25:14","date_gmt":"2024-06-08T17:25:14","guid":{"rendered":"https:\/\/drugprevent.org.uk\/ppp\/?p=17448"},"modified":"2024-10-12T19:01:07","modified_gmt":"2024-10-12T18:01:07","slug":"the-fentanyl-death-crisis-in-america","status":"publish","type":"post","link":"https:\/\/drugprevent.org.uk\/ppp\/2024\/06\/the-fentanyl-death-crisis-in-america\/","title":{"rendered":"The Fentanyl Death Crisis in America"},"content":{"rendered":"<div class=\"blog-entry--header\">\n<div class=\"blog-entry--header-second\">\n<h6 class=\"blog-entry__topic--full text-uppercase-primary-large\"><a href=\"https:\/\/www.psychologytoday.com\/us\/basics\/psychopharmacology\" hreflang=\"en-us\">PSYCHOPHARMACOLOGY<\/a><\/h6>\n<h2 class=\"blog-entry__subtitle--full\"><span style=\"font-size: 14pt;\">Medication for reversing overdose is life-saving\u2014if used quickly and correctly.<\/span><\/h2>\n<p><a href=\"https:\/\/drugprevent.org.uk\/ppp\/2024\/06\/the-fentanyl-death-crisis-in-america\/mark-gold\/\" rel=\"attachment wp-att-17449\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17449 alignleft\" src=\"https:\/\/drugprevent.org.uk\/ppp\/wp-content\/uploads\/2024\/06\/mark-gold.png\" alt=\"\" width=\"157\" height=\"190\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<div class=\"profile-card__photo\"><\/div>\n<div class=\"profile-card__profile-copy\">\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div><\/div>\n<div class=\"h3 profile-card__profile-name\"><a href=\"https:\/\/www.psychologytoday.com\/us\/contributors\/mark-s-gold-md\" hreflang=\"en\">Mark S. Gold M.D.<\/a><\/div>\n<div class=\"profile_card__blog-title\"><a href=\"https:\/\/www.psychologytoday.com\/us\/blog\/addiction-outlook\" hreflang=\"en\">Addiction Outlook<\/a><\/div>\n<\/div>\n<p class=\"blog-entry__date--full fine-print\">Posted\u00a0<span class=\"blog_entry--date\">June 4, 2024<\/span><\/p>\n<\/div>\n<\/div>\n<div class=\"blog-entry--body\">\n<div class=\"blog-entry--body-second\">\n<div class=\"blog_entry__key-points\">\n<h3><\/h3>\n<h3 class=\"blog_entry__key-points-title\">KEY POINTS<\/h3>\n<ul class=\"blog_entry__key-points-item-list\">\n<li class=\"blog_entry__key-points-item\">Fentanyl is a major threat causing overdose deaths in the United States.<\/li>\n<li class=\"blog_entry__key-points-item\">Young people are unknowingly taking fentanyl and dying.<\/li>\n<li class=\"blog_entry__key-points-item\">Fentanyl smoking is contributing to overdose and speedballing deaths.<\/li>\n<li class=\"blog_entry__key-points-item\">Government and private agencies are cracking down on illegal fentanyl, but it&#8217;s an uphill fight.<\/li>\n<\/ul>\n<\/div>\n<div>\n<table style=\"border-collapse: collapse; width: 100%;\">\n<tbody>\n<tr>\n<td style=\"width: 35.2233%;\">\n<div class=\"caption\" style=\"text-align: left;\"><strong>Seized Fentanyl Pills<\/strong><\/div>\n<div class=\"insertArea--origin subtext\" style=\"text-align: left;\">Source: National Institute on\u00a0<a class=\"basics-link\" title=\"Psychology Today looks at Drug Abuse\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/addiction\" hreflang=\"en-US\">Drug Abuse<\/a><\/div>\n<p><a href=\"https:\/\/drugprevent.org.uk\/ppp\/2024\/06\/the-fentanyl-death-crisis-in-america\/fentanyl-pills\/\" rel=\"attachment wp-att-17450\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17450 alignleft\" src=\"https:\/\/drugprevent.org.uk\/ppp\/wp-content\/uploads\/2024\/06\/fentanyl-pills.png\" alt=\"\" width=\"399\" height=\"416\" \/><\/a><\/td>\n<td style=\"width: 64.7767%;\">\u201cIt is the deadliest drug threat our country has ever faced.\u201d says Anne Milgram, Administrator, Drug Enforcement Administration (DEA), referring to the threat of fentanyl in the United States. She should know.<\/p>\n<p>We still have record deaths, and that\u2019s\u00a0<em>after<\/em>\u00a0the DEA seized more than\u00a0<em>80 million fentanyl-laced fake pills<\/em>\u00a0and nearly 12,000 pounds of fentanyl powder so far in 2024 . The fentanyl seizures represent more than 157.6 million deadly doses; 70% of the counterfeit pills contain a lethal dose of fentanyl. Sometimes, the drug is smoked and as with intravenous injection, speeds access to the brain, further endangering users.<\/p>\n<p>The best new prevention approach, the \u201cOne Pill Can Kill\u201d initiative led by the DEA, is amplified by the Community Anti-Drug Coalitions of America (CADCA) and other volunteers educating the public and seeking to prevent flooding of the U.S. with fentanyl and fentanyl-laced fake pills resembling Xanax, Oxycontin,\u00a0<a class=\"basics-link\" title=\"Psychology Today looks at Adderall\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/adhd\" hreflang=\"en-US\">Adderall<\/a>, Vicodin and other popular prescription medications\u2014but with a deadly twist. The counterfeit pills, more often than not, contain a lethal dose of fentanyl.<\/p>\n<p>\u201cCADCA and its 7,000 coalition members across the nation have worked tirelessly to address the issue of fentanyl-laced fake pills that are poisoning our nation\u2019s youth by planning and implementing comprehensive, data-driven strategies, with multiple public and private partners to address community conditions causing this problem,\u201d said CADCA\u2019s president and CEO, retired Army general Barrye L. Price.<\/p>\n<p>Across the country, fentanyl has largely fueled a more than <a href=\"https:\/\/www.washingtonpost.com\/dc-md-va\/2024\/05\/22\/fentanyl-youth-overdoses-increase\/\">doubling of overdose deaths among children ages 12-17<\/a>\u00a0since the start of the pandemic. The deaths were inadvertently hidden by \u201cgood news\u201d reported by the CDC on May 15, 2024, announcing that there were an estimated 107,543 drug overdose deaths in the U.S. during 2023\u2014a\u00a0<em>decrease<\/em>\u00a0of 3% from the 111,029 deaths estimated in 2022.<\/p>\n<p>Fentanyl is killing adolescents and people of color, many with no idea they are taking fentanyl. The counterfeit drugs are easy to obtain from friends or buy through <a class=\"basics-link\" title=\"Psychology Today looks at social media\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/social-media\" hreflang=\"en-US\">social media<\/a>. Sold online for $2 to $10 apiece, their lethal potency caught policy leaders, emergency rooms, addiction experts, family health providers, and pediatricians nationwide by surprise.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"field-name-body\">\n<div class=\"insertArea\">\n<div class=\"image-article-inline-half\">\n<div class=\"insert-inner\">\n<div class=\"insert-image\">\u00a0Such is the fentanyl crisis as of June 2024. As i will describe in this blog post, there are treatments of last resort and medications designed to reverse the effects of fentanyl when <a class=\"basics-link\" title=\"Psychology Today looks at education\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/education\" hreflang=\"en-US\">education<\/a>, prevention, and treatment have failed. An estimated 80,000 deaths per year are attributed to opioid-induced respiratory\u00a0<a class=\"basics-link\" title=\"Psychology Today looks at depression\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/depression\" hreflang=\"en-US\">depression<\/a>\u00a0(OIRD) caused by fentanyl alone. Wonder medicines that counter the effects include the widely-used naloxone (Narcan) and much-less-used (but also effective) opioid overdose reversal drug nalmefene<strong>\u00a0<\/strong>(Opvee).<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"markup-replacement-slot markup-replacement-slot-5\" data-slot-position=\"5\"><\/div>\n<p><strong>The Life-Saving Role of Naloxone<\/strong><\/p>\n<p>Naloxone has gained\u00a0<a class=\"basics-link\" title=\"Psychology Today looks at attention\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/attention\" hreflang=\"en-US\">attention<\/a>\u00a0as a wonder drug capable of reviving a person who has overdosed, appeared to have died, or nearly died. I adminishtered, intravenously, my first dose of naloxone in 1975 while working in the Yale New Haven Hospital emergency room.. At the time, naloxone was most often given intravenously by anesthesiologists during surgery to reverse the sedative effects of opioids doctors had administered earlier. When naloxone was approved by the FDA in 1971, total drug overdose deaths in the U.S. were 6,771, rare enough that there was no national call to add it to emergency rooms to reverse overdoses. Since then, the number of overdoses has catastrophically escalated.<\/p>\n<p><strong>When Individuals Overdose on Opioids<\/strong><\/p>\n<p>What are signs of an opioid overdose? They include unconsciousness, very small eye pupils, slow or shallow breathing, vomiting, inability to speak, faint heartbeat, limp arms and legs, pale skin, and purple lips and fingernails. When a person overdoses on opioids, breathing slows or altogether stops. The overdosed person appears\u00a0<a class=\"basics-link\" title=\"Psychology Today looks at sleepy\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/sleep\" hreflang=\"en-US\">sleepy<\/a>\u00a0and is unresponsive.<\/p>\n<div id=\"block-adblock-19\" class=\"pt-ad pt-ad--300x250 d-block d-none d-md-block d-lg-block d-xl-block block\"><\/div>\n<p>Opioids<\/p>\n<p>interfere with receptors in the brain, slowing breathing so that insufficient oxygen reaches the brain and other vital organs like the heart; the heart rate may slow or even stop. As breathing slows, oxygen levels fall, which may trigger abnormal heart rhythms. Blue lips and fingernails signal the lack of oxygen. Because insufficient oxygen reaches the brain and heart, the consequences are coma, brain damage, or death.<\/p>\n<p>The antidote, naloxone, attaches to opioid receptors, reversing and blocking effects of opioids. Naloxone can quickly restore normal breathing. Naloxone is so safe we give it immediately to anyone with signs of opioid overdose or when an overdose is suspected. However, the drug has no effect on someone with no opioids in their system.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-9\" data-slot-position=\"9\"><\/div>\n<p><strong>Reversing Respiratory Depression<\/strong><\/p>\n<p>The specific mechanism that drives opioid death by overdose is stimulation of one class of endogenous opioid receptors\u2014mu-opioid receptors\u2014in cells in the brainstem; it inhibits breathing. Respiratory depression, or decreased (or terminated) breathing, is a direct effect of opioid use, and, in the case of fentanyl, it appears extremely quickly.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-10\" data-slot-position=\"10\"><\/div>\n<p>Intravenous naloxone is not available in the community, where first responders depend on intranasal or intramuscular administration. Yet naloxone must be administered much sooner for fentanyl than for heroin because the window for saving the overdosed person is much shorter than with heroin. So, the right dose of naloxone must be given by a friend, loved one, or first responder almost immediately.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-11\" data-slot-position=\"11\"><\/div>\n<p>Other opioid antagonists, like nalmefene, may be expected to do a better job in\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10920112\/\">fentanyl overdoses<\/a>. After the person recovers, they should be offered long-term treatment resources, including the ability to initiate treatment for opioid use disorder in the emergency department, as Yale\u2019s Brian Fuerhlein described in an earlier blog post.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-12\" data-slot-position=\"12\"><\/div>\n<p><strong>Renarcotization<\/strong><\/p>\n<p>Researchers, addiction experts, and other healthcare providers have documented that when fentanyl is taken chronically,\u00a0<a href=\"https:\/\/escholarship.org\/content\/qt55h6z90h\/qt55h6z90h.pdf?t=se8ywz\">the drug may be absorbed into fat tissue and stay there<\/a>, accumulating and forming a reservoir of fentanyl. Naloxone might reverse a \u201cnormal\u201d fentanyl overdose, but due to the \u201cdepot effect,\u201d after a person becomes conscious, they may lose consciousness again and stop breathing. This event is called re-narcotization.<\/p>\n<div id=\"block-adblock-16\" class=\"pt-ad pt-ad--300x250 d-block d-none d-md-block d-lg-block d-xl-block block\"><\/div>\n<p>If it is suspected that someone has overdosed on fentanyl and they are given naloxone, they may start breathing again and become conscious. With less potent opioids, naloxone can cover someone for 60 minutes. But someone with a supply of fentanyl in body fat depots can renarcotize several times. It is important to call 911. Additional doses of naloxone may be given as the patient is transported to the ER or hospital, where oxygen and other life support is available.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-14\" data-slot-position=\"14\"><\/div>\n<p><strong>Narcan Nasal Spray<\/strong><\/p>\n<p>Naloxone can now be administered by non-health professionals via nasal spray to save lives. Intranasal naloxone works within two to three minutes. If the person has not responded after three minutes, another dose should be given. After administering naloxone, it\u2019s very important to always call 911 because experts need to determine whether respiratory support, more naloxone, or other measures are necessary to reverse the overdose.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-15\" data-slot-position=\"15\"><\/div>\n<p>The FDA approved Narcan (naloxone) as a nasal spray for over-the-counter use because it is safe, easy to use, and saves lives. In 2021, the Food and Drug Administration approved an 8-mg intranasal naloxone product, twice the amount than the usual 4-mg dose. The FDA also granted a second over-the-counter naloxone agent in early 2024. This drug, RiVive, is a generic naloxone nasal spray available from\u00a0<a class=\"basics-link\" title=\"Psychology Today looks at Harm Reduction\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/harm-reduction\" hreflang=\"en-US\">Harm Reduction<\/a>\u00a0Therapeutics, a nonprofit pharmaceutical organization. Nasal naloxone is currently available in 3mg (Revive), 4mg (Narcan), and 8mg (Kloxxado) dosages.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-16\" data-slot-position=\"16\"><\/div>\n<p>Making naloxone available without a prescription expands its availability to people with an opioid-dependent loved one or who themselves have opioid use disorder (OUD). To save someone from an opioid overdose, you need naloxone or nalmefene. Steps for responding to an opioid overdose can be found\u00a0<a href=\"https:\/\/www.samhsa.gov\/resource\/ebp\/overdose-prevention-response-toolkit\">her<\/a>e.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-17\" data-slot-position=\"17\"><\/div>\n<p><strong>Another Opioid Overdose Reversal Drug: Nalmefene<\/strong><\/p>\n<p>Nalmefene has been saving lives from opioid overdoses since May 2023, when the FDA approved nalmefene hydrochloride nasal spray (Opvee).\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37496452\/\">Nalmefene<\/a>\u00a0is a long-duration opioid antagonist first approved for injection in 1995. The original injectable nalmefene was removed from the market for commercial reasons in 2008. However, the dramatic rise in opioid overdose deaths and the emergence of powerful synthetic opioids catalyzed the development of an intranasal (IN) form of nalmefene for emergency treatment of opioid, and especially fentanyl, overdoses.<\/p>\n<div id=\"block-adblock-17\" class=\"pt-ad pt-ad--300x250 d-block d-none d-md-block d-lg-block d-xl-block block\"><\/div>\n<p>Nalmefene is an opioid receptor antagonist particularly well-suited for fentanyl overdoses. One reason is it has a longer half-life than naloxone, which means it stays in the body longer. This may protect against re-intoxication but may also make withdrawal symptoms last longer in those with opioid use disorders.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-19\" data-slot-position=\"19\"><\/div>\n<p>Synthetic opioids like fentanyl are now the most common drugs involved in drug overdose deaths in the U.S. Nalmefene is 10 times more potent than naloxone and has an 8- to 10-fold longer half-life (8 to 11\u2009hours), reducing the likelihood of re-overdosing from long-acting opioids.<\/p>\n<p>Xylazine<strong>\u00a0<\/strong>and other adulterants illegally added to opioids in the U.S. have also received attention for generating zombie-like behavior in people. Such additives make overdose reversal more difficult. However, the key to harm reduction is reversing the effects of synthetic opioids on the heart, lungs, and brain.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-20\" data-slot-position=\"20\"><\/div>\n<p>The efficacy of frontline, community-based reversal of poisoning events with antidotes such as naloxone has been questioned due to the rise of highly potent synthetic opioids, primarily illicitly manufactured fentanyl (IMF), which causes 90% or more of opioid deaths in the U.S.<\/p>\n<p>In many cases today, community-based first responders have improvised or evolved strategies to cope with fentanyl. Typically, multiple naloxone doses are given to individuals who overdosed on opioids. That was definitely not the case when I was giving naloxone to patients in the Yale emergency department in the 1970s or even back when the opioid crisis was primarily either a prescription-opioid or heroin crisis.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-21\" data-slot-position=\"21\"><\/div>\n<p>However, it\u2019s unclear whether giving opioid overdose patients more doses sequentially is the optimal strategy in dealing with fentanyl. A very nice study by\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10807299\/\">Strauss<\/a>\u00a0suggests it\u2019s a good idea to have higher doses of intranasal naloxone available, as it appears that a large first dose at once is superior to the same dose given sequentially.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-22\" data-slot-position=\"22\"><\/div>\n<p>Some overdoses might be relatively naloxone-resistant and more easily respond to nalmefene. Additional research is needed to determine the optimal naloxone-dosing schedule for fentanyl overdose reversal. Multi-site studies directly comparing nalmefene to naloxone in the community setting are needed.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-23\" data-slot-position=\"23\"><\/div>\n<p><strong>Conclusion<\/strong><\/p>\n<p><a href=\"https:\/\/ajph.aphapublications.org\/doi\/abs\/10.2105\/AJPH.2023.307550?role=tab&amp;journalCode=ajph\">More than 1 in 8 Americans have had their lives disrupted by a drug overdose<\/a>. Nearly 49 million Americans (more than 17%) age 12 and older have a substance use disorder. Among young adults aged 18-25, the share jumps to 28%. More than 6 million people had an opioid use disorder, and another 1.8 million had a methamphetamine use disorder in 2022.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-24\" data-slot-position=\"24\"><\/div>\n<p>The evolving opioid epidemic has morphed into a counterfeit-pill, multi-drug crisis centered on fentanyl, often paired\u2014knowingly or unknowingly\u2014with other illicit drugs.\u00a0<a class=\"basics-link\" title=\"Psychology Today looks at Smoking\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/smoking\" hreflang=\"en-US\">Smoking<\/a>\u00a0fentanyl is the newest opioid crisis or problem we have not prevented.<\/p>\n<p>Overdose deaths are only one measure of the drug epidemic&#8217;s severity. An estimated 321,566 children lost a parent to drug overdose between 2011 and 2021.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-25\" data-slot-position=\"25\"><\/div>\n<p>Since 2000,\u00a0<a href=\"https:\/\/www.rand.org\/pubs\/external_publications\/EP70412.html\">more than 1.1 million overdose deaths<\/a>\u00a0have been reported in the U.S. Overdose reversal with intranasal anti-opioids like naloxone and nalmefene has made a big difference but should not be the centerpiece of opioid crisis strategy. Education and prevention are needed and, as we develop new and better treatments for OUDs, so are overdose reversal and\u00a0<a class=\"basics-link\" title=\"Psychology Today looks at relapse\" href=\"https:\/\/www.psychologytoday.com\/us\/basics\/relapse\" hreflang=\"en-US\">relapse<\/a>\u00a0prevention. Some very effective means to reverse opioid overdoses are available today, and future research should provide further information on the best medication and dosages for fentanyl overdose situations.<\/p>\n<div class=\"markup-replacement-slot markup-replacement-slot-last\" data-slot-position=\"last\"><strong>References<\/strong><\/div>\n<\/div>\n<div class=\"blog-entry-references\" data-hide-large-count-items=\"true\">\n<div class=\"blog-entry-references-content-items\">\n<div class=\"blog-entry-references-content\">\n<p>Skolnick P. On the front lines of the opioid epidemic: Rescue by naloxone. Eur J Pharmacol. 2018 Sep 15;835:147-153. doi: 10.1016\/j.ejphar.2018.08.004. Epub 2018 Aug 7. PMID: 30092179.<\/p>\n<\/div>\n<div class=\"blog-entry-references-content\">\n<p>Ellison M, Hutton E, Webster L, Skolnick P. Reversal of Opioid-Induced Respiratory Depression in Healthy Volunteers: Comparison of Intranasal Nalmefene and Intranasal Naloxone. J Clin Pharmacol. 2024 Mar 4. doi: 10.1002\/jcph.2421. Epub ahead of print. PMID: 38436495.<\/p>\n<\/div>\n<div class=\"blog-entry-references-content\">\n<p>Crystal R, Ellison M, Purdon C, Skolnick P. Pharmacokinetic Properties of an FDA-approved Intranasal Nalmefene Formulation for the Treatment of Opioid Overdose. Clin Pharmacol Drug Dev. 2024 Jan;13(1):58-69. doi: 10.1002\/cpdd.1312. Epub 2023 Jul 27. PMID: 37496452; PMCID: PMC1081801<\/p>\n<\/div>\n<p><em><strong>Source:\u00a0 https:\/\/www.psychologytoday.com\/us\/blog\/addiction-outlook\/202406\/the-fentanyl-death-crisis-in-america<\/strong><\/em><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>PSYCHOPHARMACOLOGY Medication for reversing overdose is life-saving\u2014if used quickly and correctly. &nbsp; Mark S. Gold M.D. Addiction Outlook Posted\u00a0June 4, 2024 KEY POINTS Fentanyl is a major threat causing overdose deaths in the United States. Young people are unknowingly taking fentanyl and dying. Fentanyl smoking is contributing to overdose and speedballing deaths. Government and private [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[73,9,64,19],"tags":[],"class_list":["post-17448","post","type-post","status-publish","format-standard","hentry","category-addiction","category-drug-specifics","category-health","category-usa"],"_links":{"self":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/17448","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/comments?post=17448"}],"version-history":[{"count":0,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/17448\/revisions"}],"wp:attachment":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/media?parent=17448"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/categories?post=17448"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/tags?post=17448"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}