ORIGINAL NDEWS CONTRIBUTIONS

To our readers,

This is our 50th issue of the NDEWS Weekly Briefing. Thanks for joining us this year. In this issue we reveal emerging drug trends with a new NDEWS alert and new NDEWS data from across the US, with a focus on the state of Florida. We would also like to remind everyone that August 31 is International Overdose Awareness Day. Join NDEWS in spreading the message that overdose deaths are preventable. 

The United States experienced over 94,134 drug overdose deaths in the 12 months leading up to May 2021, the highest number of overdose deaths ever reported in a 12-month period according to the Centers for Disease Control and Prevention (CDC).

The National Drug Early Warning System (NDEWS) is housed at the University of Florida, and Florida ranked third in the US for opioid-involved overdoses per 10,000 within the last 30 days. Additionally, Florida leads the nation for the overall count of opioid-involved 911 overdose calls for year-to-date, with 26,299 (data acquired from biospatial, inc). Nearly one-third (31.5%) of overdoses that were responded to by 911 calls were among 20 to 39-year-olds; 72% were among persons identified as White. Counties in the state with the highest rates of 911 calls for opioid-involved ODs are shown below. 

NEW PSYCHOACTIVE SUBSTANCES 

Carfentanil circulating in Toronto

Among already high rates of overdose deaths in Toronto, Toronto’s drug checking service found four instances of carfentanil being present in tested drugs. Carfentanil is purported to be 100 times more potent than fentanyl. They also continue to detec5t nitazene opioids including isotonitazene, etonitazene, metonitazene, etodesnitazene and etonitazepyne in samples around Toronto. Nitazene opioids can be 40 times more potent than fentanyl. Read the full alert here.

The Emerging Drugs Network of Australia: A toxicosurveillance system of illegal and emerging drugs 

This week Emergency Medicine Australasia published the first report from the Emerging Drugs Network for Australia (EDNA). The EDNA aims to bring together emergency physicians, toxicologists and forensic laboratories to establish an emerging drug toxicosurveillance system in Australia. The first three years of the project (2021–2023) will implement uniform mechanisms to collect, store, and analyze blood samples from eligible patients and clinical data collection. Read the full study and presentation here.

COVID-19 AND DRUG RELATED TRENDS

A global survey on changes in the supply, price, and use of illegal drugs and alcohol, and related complications during the 2020 COVID-19 pandemic

A cross-sectional survey published in Frontiers in Psychiatry was performed by the International Society of Addiction Medicine (ISAM) network and revealed increases in alcohol, cannabis, prescription opioids, and sedative/hypnotics use among participants during COVID-19. They recommend analyzing the availability, price, and use patterns, effects on presentations of substance use disorders (SUDs), and demand for treatment to inform effective policies. Read the full report here.

RECENTLY PUBLISHED

Study identifies possible antidote for club drug GHB overdose

A new study published in Biopharmaceutics and Drug Disposition showed that non‐steroidal anti‐inflammatory drugs (NSAIDs) may limit the passage of gamma hydroxybutyric acid (GHB) to the brain, decreasing the potential for fatal overdose. The full study is here.

2021 Chicago mid-year opioid report

The Chicago Health Action Network (HAN) released a health alert stating there were at least 467 opioid-related deaths in Chicago in January – June 2021. Of these opioid-related deaths, 90% were found to involve fentanyl and 40% involved cocaine. There were also 5,517 opioid-related EMS responses. The Chicago HAN urged the community to distribute and administer Naloxone to reverse opioid overdoses. More treatment suggestions are found in the report here.

IN THE NEWS

Thailand legalizes kratom, popular plant-based painkiller

This week, the Associated Press reports that Thailand has legalized kratom. Legal cases for the possession or sale of kratom are being dropped, and 121 inmates convicted in such cases will be released immediately. Read the full article here.

Schedules of Controlled Substances: Placement of mesocarb in Schedule I

From the Federal Register, the Drug Enforcement Administration proposes placing the substance mesocarb (N-phenyl-N'-(3-(1-phenylpropan-2-yl)-1,2,3-oxadiazol-3-ium-5-yl)carbamimidate), including its salts, isomers, and salts of isomers, in schedule I of the Controlled Substances Act. The drug is marketed in Russia for attention-deficit disorder. See the Federal Register here.

Emergency departments and substance use disorders. 

NPR featured a new report by the Legal Action Center and the Bloomberg American Health Initiative regarding evidence-based practices under which hospital emergency departments could be held liable under four federal laws if not adopted. The three measures are substance use disorder screening and diagnosis, offer to administer opioid agonist medications, and facilitated referral to community-based treatment. Read the NPR article here and the report here.

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