National Drug Early Warning System (NDEWS) Weekly Briefing


Alert from NDEWS Web Monitoring Team: Increases in Reddit discussions of bromazolam in April 2021

According to the NDEWS Web Monitoring Team, led by Dr. Elan Barenholtz and PhD candidate Paul Morris of the Machine Perception and Cognitive Robotics (MPCR) Lab at Florida Atlantic University, the benzodiazepine bromazolam has been discussed on Reddit more frequently in April 2021 than previous months. Bromazolam belongs to a trend of designer benzodiazepines sold in drug markets. While bromazolam discussion has grown on Reddit since its first mention in 2016, algorithmic monitoring of ~80 drug-oriented subreddits has revealed an uptick in mentions by new users ("unique commenters") in April 2021 who had not previously mentioned the drug. Online mentions cannot be directly linked to real-world use, but this recent trend indicates elevated awareness of bromazolam among drug subreddit commenters. 

Have you heard anything about bromazolam? Let us know here.


2021 Q1 report from DEA TOX 

The Drug Enforcement Administration’s Toxicology Testing Program (DEA TOX) released their Q1 report for 2021 this week. The program identified and confirmed 325 drugs that consisted of 60 new psychoactive substances (NPS) detections, 99 traditional illegal drug detections, and 166 prescription or over-the-counter drug detections. Of the 60 NPS detections, there were 20 different NPS from nine classes of drugs. DEA TOX provides this service to health departments, law enforcement, poison control, and other medical facilities to offer testing of leftover or previously collected samples for analysis of synthetic drugs. Read the full report here.

Study on co-involvement of opioids in drug overdose deaths involving cocaine and psychostimulants 

NDEWS Scientific Advisory Group member Dr. Margaret Warner and fellow researchers from the CDC published a data brief this week with results from a study on the prevalence of opioids in overdose deaths involving cocaine and psychostimulants. The data were acquired from the National Vital Statistics System from 2009-2019. The rate of drug overdose deaths involving both cocaine and opioids increased nearly 5.5 times from 2009 to 2019. In 2019, 54% of overdose deaths involving psychostimulants also involved an opioid. Read the brief here.

2020 drug supply report from Toronto – isotonitazene identified 

Toronto’s Drug Checking Service published their annual 2020 report of drug checking results this week. The service was launched in 2019 to offer participants detailed content of the unregulated drug supply. Samples are collected at five harm reduction agencies in Toronto. During 2020,1,657 samples were collected, and fentanyl was the most commonly detected substance. Fentanyl was found in one of 61 purported to be MDMA substances, three of 103 purported to be methamphetamine substances, and four of 29 purported to be benzodiazepine substances. The service also released an alert yesterday that isotonitazene was identified in two expected fentanyl samples for the first time. The alert is here. Read the full report here.  


Public health alert: Phenacetin 

The Fredric Rieders Family Foundation and the Colombo Plan, with NPS Discovery, released a public health alert this week regarding phenacetin. Phenacetin is an analgesic discovered in 1887 which was withdrawn from drug markets in 1983 due to hazardous side-effects. It is now being seen as a frequent adulterant in cocaine. In a study reviewing cocaine adulterants in blood samples, phenacetin was identified in 19% of the samples. The alert urges health providers consider phenacetin when treating patients with cocaine toxicity. Read the full alert here.


Clinical trials for nasal nalmefene

Opiant Pharmaceuticals announced clinical trials studying nasal nalmefene compared to nasal naloxone. Using their investigational opioid antagonist OPNT003, the study will evaluate the effectiveness of 4mg of naloxone and 3mg of nalmefene to reverse the respiratory depression produced by remifentanil.  The article in Yahoo Finance is here and details on the clinical trial is here. 

Schedules of controlled substances: Removal of samidorphan from control 

From the Federal Register: The DEA removed samidorphan (3-carboxamido4-hydroxy naltrexone) and its salts from the schedules of the Controlled Substances Act this week. Read more from the Federal Register here. 

New York Times: How bad is our pandemic drinking problem? 

The New York Times Magazine published a feature this week on alcohol use during COVID-19. The writer noted that consumption and alcohol-related deaths had already been increasing since 1999, particularly for women. A study in February 2021 by the American Psychological Association found that nearly one in four adults reported drinking more to manage pandemic stress. Another study published in October in The Journal of Addiction Medicine found that between February and April 2020, women had a greater increase in excessive drinking than men did. Read the full article here.

Follow NDEWS on Twitter: @NDEWSnews