National Drug Early Warning System (NDEWS) Weekly Briefing

ORIGINAL NDEWS CONTRIBUTIONS

Alert from NDEWS Web Monitoring team: Recent growth in online discussions of mephedrone

What was found? 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, a trend of rapid growth in online discussion for mephedrone has emerged on Reddit.

What is mephedrone? Mephedrone (4-MMC) is a stimulant NPS and Schedule I controlled substance in the United States. Mephedrone has similar structure to cathinones such as metaphedrone (3-MMC), which also saw increased mentions on Reddit this year. Mentions of terms referring to mephedrone on drug Subreddits have increased sharply each month from July through September 2021.

What is it being used for? Recent mentions highlight the drug’s use as an aphrodisiac. This online trend may signal emerging real-world interest in mephedrone and other synthetic cathinones.

Methodological note: Data are based on word counts derived from algorithmic monitoring of ~80 drug-oriented Subreddits. No personally identifiable or post-specific information is incorporated in this monitoring process. For more methodological details, see our recent publication.

NDEWS Alert: Above-threshold rates of substance-related 911 calls for Sentinel Sites/counties, 9/17/21–9/23/21

Counties in several NDEWS Sentinel Sites saw above-threshold rates of 911 calls involving opioid overdoses, alcohol-related incidents, and methamphetamine-related incidents over the last week, based on real-time 911 dispatch data from biospatial. States with counties that had observed 911 calls with unexpected increases for the week included Florida for opioid-involved overdoses, Florida, Texas, and New York for alcohol-related incidents, and Florida for methamphetamine-related incidents.

NDEWS Alerts involve a dynamic notification system that calculates a score to quantify the degree to which observed counts of 911 calls deviate from the expected range of values. These alerts are provided by the anomalous alert system from biospatial. More information and past alerts can be found here.

RECENTLY PUBLISHED

Methamphetamine use, methamphetamine use disorder, and associated overdose deaths among US adults

A new study by the National Institute on Drug Abuse (NIDA) published in JAMA Psychiatry estimated national trends and correlates of methamphetamine use in the US. Mortality data from the National Vital Statistics System showed that from 2015 to 2019, overdose deaths involving psychostimulants other than cocaine increased 180%. Using data from the 2015 to 2019 National Survey on Drug Use and Health (NSDUH), the research team estimated increases in methamphetamine use (43%), frequent use (66%), co-use with cocaine (60%), and prevalence of methamphetamine use disorder without injection (105%) among adults over the same period. Read the full study here and the NIH press release here.

Literal text analysis of poly-class and polydrug overdose deaths in North Carolina

In a recent study published in Drug and Alcohol Dependence, researchers incorporated literal text methodology in their analysis of death certificate data to enable the identification of trends in specific drugs and drug combinations involved in North Carolina overdose deaths. From 2015 to 2019, polydrug involvement in overdose deaths increased, with opioid involvement shifting from heroin and/or oxycodone to predominantly fentanyl and increasing involvement of both cocaine and methamphetamine. The most common polydrug combinations in 2019 included fentanyl and cocaine (15% of overdose deaths) and fentanyl and heroin (10%). Read the full article here.

National prevalence of alcohol and other substance use disorders among emergency department visits and hospitalizations

A recent retrospective cohort study estimated the prevalence and characteristics of emergency department (ED) visits and hospitalizations of adults with alcohol use disorder (AUD) and other substance use disorders (SUDs) using data from the National Hospital Ambulatory Medical Care Survey. Researchers estimated that from 2014 to 2018, the annual average prevalence of AUD or SUD was 9.4% of ED visits and 11.9% of hospitalizations. Both of these estimates increased over time, with ED visits seeing a 30% relative increase and hospitalizations seeing a 57% relative increase. Read the full study here.

NEW PSYCHOACTIVE SUBSTANCES (NPS)

NPS Discovery announces identification of novel opioid metodesnitazene in the US

NPS Discovery released a new drug monograph this week announcing the identification of metodesnitazene, which was detected in one case in Ohio in July 2021. Metodesnitazene is described as a novel opioid of the benzimidazole sub-class and structurally dissimilar from fentanyl. While metodesnitazene is not explicitly scheduled in the US, structurally similar compounds etonitazene and isotonitazene are Schedule I substances. Read the full report here.

Clinical withdrawal symptom profile of synthetic cannabinoid receptor agonists and comparison of effects with high potency cannabis

A new study published in Psychopharmacology aimed to characterize the withdrawal symptom profile of synthetic cannabinoid receptor agonists (SCRAs) and compare their effects with high-potency cannabis. Using data from the 2015 and 2016 Global Drugs Survey, investigators found that participants reported an average of four withdrawal symptoms after not using SCRAs for more than a day. Compared to high-potency cannabis, SCRAs were described as having a faster onset and development of tolerance, shorter duration of effects, and more severe withdrawals. Read the full article here.

Wastewater analysis for psychoactive substances at music festivals across New South Wales, Australia

In a study recently published in Clinical Toxicology, researchers paired wastewater analysis with a self-report survey to determine the range of new psychoactive substances used at music festivals in New South Wales, Australia. Between March 2019 and March 2020, 15% to 100% of temporary, unfixed toilet facilities were sampled at six music festivals, and wastewater samples were screened for 98 psychoactive substances. Almost all samples contained a wide range of drugs and drug classes, with a higher than expected detection frequency for synthetic cathinones, which no survey participant reported intentionally using. Read the full article here.

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