National Drug Early Warning System (NDEWS) Weekly Briefing


Mortality from drug overdoses, homicides, unintentional injuries, motor vehicle crashes, and suicides during the pandemic

Research published in JAMA this week examined death certificate data from the National Center for Health Statistics from March through August 2020. Data showed that deaths from some but not all external causes increased during the pandemic, exceeding pre-pandemic trends. Drug overdose deaths numbered 48,032 and suicide deaths were 23,172 during this time. Read the full paper here.



The rise of methamphetamine use among people who use heroin 

A paper published in Drug and Alcohol Dependence documented recent trends in methamphetamine use among people who use heroin. The researchers, including NDEWS Scientific Advisory Group member Dr. Jennifer Havens, found a sustained increase in methamphetamine use among people using heroin. Read the full study here.

Trends and characteristics of manufactured cannabis product and exposures

A study published in JAMA used data from the National Poison Data System to determine the number of cannabis exposures reported to US poison centers from January 2017 through December 2019. Researchers found that calls about manufactured cannabis products to US poison centers increased during this period. They also found higher rates of calls in states where marijuana is legalized. Read the full study here.

CDC: Costs of the opioid epidemic in lives and dollars

The Centers for Disease Control and Prevention (CDC) published a new report in JAMA this week on the cost of the opioid epidemic. The cost surpassed $1 trillion in 2017 and nearly 500,000 people have died in the past 20 years. For the full breakdown by state and region, read the report here.

Report on opioid overdoses from the Toxicology Investigators Consortium (ToxIC) Fentalog Study Group

NPS Discovery and collaborators from the American College of Medical Toxicology (ACMT) and the Center for Forensic Science Research and Education (CFSRE) published a new report on opioid overdoses across the US this week. Although geographical differences were noted, fentanyl was the most common opioid detected. Combined opioid and stimulant use was also common throughout all regions. Read the report here.


NPS Discovery identifies novel opioid protonitazene in the US

NPS Discovery issued an alert regarding the identification of protonitazene. Protonitazene is classified as a novel opioid of the benzimidazole sub-class and is structurally dissimilar from fentanyl. Read the full alert here.

Public health alert: Dipyrone (metamizole) 

The Fredric Rieders Family Foundation (FRFF) in conjunction with the Colombo Plan recently released a bulletin regarding the public health risk of dipyrone. Dipyrone is a non-opioid analgesic with antipyretic activity. Co-use with morphine increases the antipyretic effects and more administrations of naloxone to reverse overdose may be required. More information can be found here.

Public health alert: Increasing presence of xylazine in heroin and/or fentanyl deaths

The Philadelphia Department of Public Health issued a public health alert regarding the increased presence of xylazine in overdose deaths. Researchers used data from the Medical Examiner’s Office over a 10 year period and found a strong association between xylazine and overdose deaths. Read the report here.



FDA: Seizure of adulterated dietary supplements containing kratom

The Food and Drug Administration (FDA) announced this week that US Marshals seized 207,000 units of adulterated dietary supplements and bulk dietary ingredients that contain kratom in Florida. The FDA has had an import alert on kratom since 2014. For more information from the FDA on kratom, see here.

Arizona lawmakers legalize syringe service programs

The Arizona legislature passed a bill to legalize syringe service programs this week. The bill intends to reduce overdose deaths. An Arizona Public Health Association study showed overdose deaths in Arizona increased over the past two decades across all categories of race, ethnicity, and gender. Read an article from Arizona Public Media on the topic here

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