National Drug Early Warning System (NDEWS) Weekly Briefing


Past-year kratom use in the US: Estimates from a nationally representative sample  

NDEWS Co-Investigator Dr. Joseph Palamar published a paper yesterday in the American Journal of Preventative Medicine about kratom use. Using data from the 2019 National Survey on Drug Use and Health, Palamar found an estimated 0.7% of people in the US have used kratom in the past year. Among individuals with opioid use disorder, the number is higher, at 10%. Read the full paper here. The paper was featured in an article by HealthDay here.  

Alert from NDEWS Web Monitoring Team: Increases in Reddit discussions of Desmetramadol 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, Desmetramadol is one of the most frequently and consistently mentioned opioids in drug subreddit discussion. The drug is commonly referred to on Reddit as O-DSMT, and algorithmic monitoring of ~80 drug-oriented subreddits has revealed a sharp increase in mentions since late 2019. More unique Reddit commenters mentioned O-DSMT in April 2021 than any previous month. This online trend may signal an increase in real-world interest surrounding the drug. O-DSMT is available for purchase from gray market vendors, is marketed as a research chemical, and has previously been linked to accidental overdose deaths.

Have you heard of desmetramadol in your area? Let us know here!


Differential impacts of COVID-19 across racial-ethnic identities in persons with opioid use disorder 

A new study published in the Journal of Substance Abuse Treatment examined the ties between opioid use disorder (OUD) and health behaviors including social, physical, and mental well-being during the COVID-19 pandemic. Researchers surveyed over 100 participants engaged in a methadone maintenance program for OUD, and found that people with OUD experienced decreases in financial stability and reported increases in depression, anxiety, and loneliness. Along racial lines, minority populations felt direct effects of COVID-19 including struggling to get tested for the virus. Read the full study here.


Pharmacy-related buprenorphine access barriers: An audit of pharmacies in counties with a high opioid overdose burden 

Drug and Alcohol Dependence published a study this week amid evidence that pharmacies may be limiting access to buprenorphine. Using a telephone-based audit study, researchers identified one chain and one independent pharmacy in counties of the US that showed higher than average opioid overdose rates. The results found that approximately 30% of pharmacies audited reported limitations to filling and 20% of pharmacies audited would not fill buprenorphine in any circumstance. Read the full study here.


Community overdose surveillance: Comparing substances collected from the death scene investigation to toxicology results 

Another study from Drug and Alcohol Dependence this week examined postmortem toxicology data from 45 fatal overdose cases in coordination with drug samples found at the scene. Researchers found co-use between stimulants and opioids; and fentanyl commonly part of purported heroin samples. Researchers did not typically find fentanyl to be in purported stimulants. The full study can be found here.


NPS Discovery identifies two new substances: novel stimulant Methylenedioxy-PV8 and synthetic cannabinoid ADB-HEXINACA

NPS Discovery issued an alert regarding two identifications of Methylenedioxy-PV8 in the US this week. Methylenedioxy-PV8, which is classified as a novel stimulant and substituted cathinone is not explicitly scheduled in the US, but PV8 is a Schedule I substance. Read the full alert here.

NPS Discovery issued an alert regarding identification of ADB-HEXINACA in the US this week. ADB-HEXINACA, which is classified as a synthetic cannabinoid is not explicitly scheduled in the US, but ADB-PINACA is a Schedule I substance. Read the full alert here.


Schedules of controlled substances: Placement of 10 specific fentanyl-related substances in Schedule I

From the Federal Register: The DEA placed 10 fentanyl-related substances permanently in Schedule I of Controlled Substances this week, per the February 6, 2018 temporary scheduling order. Through the Temporary Reauthorization and Study of the Emergency Scheduling of Fentanyl Analogues Act, which became law on February 6, 2020, Congress extended the temporary control of fentanyl-related substances until May 6, 2021. Read more from the Federal Register here. Read the rule from the DEA here.

HHS releases new buprenorphine practice guidelines, expanding access to treatment for opioid use disorder 

The Department of Health and Human Services (HHS) released new guidelines relating to the treatment of opioid use disorder (OUD). The guidelines allow eligible physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives to treat up to 30 patients with buprenorphine without the federal certification process. The practitioners must work in collaboration with a DEA registered physician. The exemption does not apply to prescribing Schedule II medications such as methadone. Read the HHS guidelines in the Federal Register here. The HHS press release is here.


DEA launches Project Wave Breaker to stop illegal fentanyl market  

The DEA announced a new initiative to reach high-impact areas and disrupt the flow of fentanyl in the US. The eleven areas participating include: Phoenix, New York, San Diego, New England, Los Angeles, Chicago, Detroit, St. Louis, San Francisco, Houston, and El Paso. Project Wave Breaker will deploy intelligence assets to target Mexican cartels and their proliferation of fentanyl among these US communities. The press release from the DEA can be found here.


Biden administration expected to announce plan to ban menthol cigarettes 

The Food and Drug Administration (FDA) announced yesterday it will begin the process of banning menthol tobacco cigarettes. Experts expect that menthol cigarettes will be available for at least 2 more years, while regulatory processes allow the transition. Menthol is used to reduce irritation in the throat, making it easier to smoke. Menthol cigarettes are favored by Black smokers and Black men have the highest lung cancer death rate in the country. Read the article in The Washington Post here.

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