National Drug Early Warning System (NDEWS) Weekly Briefing

ORIGINAL NDEWS CONTRIBUTION

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

What was found? A trend of online mentions of fluclotizolam has emerged in Fall 2021, following sporadic discussion of the drug in recent years. First mentions of the drug by unique commenters indicate growing interest as of November 2021.

To what does fluclotizolam refer? Fluclotizolam is a derivative of thienotriazolodiazepine. It has been sold as a designer drug since 2017.

How is it being discussed? Qualitative word cloud visualization reveals negative sentiment in comments discussing the drug.

Drug Terms: Fluclotizolam

Methodological Note: Data was collected and analyzed by 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. Metrics 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.

Word Cloud Note: The Subreddit word cloud presents an aggregate summary of common terms in comments mentioning fluclotizolam.

NEW PSYCHOACTIVE SUBSTANCES (NPS)

ADB-FUBIATA: Announcement of newly identified novel psychoactive substance (NPS) in the United States

NPS Discovery announced a newly identified novel psychoactive substance earlier this week. ADB-FUBIATA is classified as a synthetic cannabinoid. View the full report here.

IN THE NEWS

Drug overdose deaths in the United States have topped 100,000 for the first time

Drug overdose deaths in the United States have topped 100,000 for the first time, according to new data from the Centers for Disease Control & Prevention. This represents a 28.5% increase compared to the year prior. Dr. Nora Volkow, Director of the National Institute on Drug Abuse, of the National Institutes of Health, said "[overdoses] are driven both by fentanyl and also methamphetamine," "they are among the most addictive drugs that we know of and the most lethal." She predicted the surge of fatalities would continue because of the spread of more dangerous street drugs. View the CDC data report here and the NPR article here.

White House releases state model law to help make access to naloxone consistent across the country

The Office of National Drug Control Policy (ONDCP), directed by Dr. Rahul Gupta, announced the release of a model law for states to help expand access to naloxone, which saves lives by reversing opioid overdoses. His press release said, "this model law provides states with a framework to make naloxone accessible to those who need it – an evidence-based solution that, according to research, would have a significant effect on reducing opioid-related overdose deaths." View the full model law here, and the press release here.  

RECENTLY PUBLISHED

Social, psychological, and substance use characteristics of US adults who use kratom: Initial findings from an online, crowdsourced study

In a study published in Experimental and Clinical Psychopharmacology, authors conducted an online, crowdsourced survey to examine the social, psychological, and substance use characteristics of US adults who use kratom. Results showed that 13% of people who use drugs in the sample reported ever using kratom. The study suggests that addiction researchers and clinicians who assess substance use histories, particularly for diagnosing SUDs, need to assess kratom use and disordered use, especially given that kratom is not readily detected via urine analysis. Read the full study here.

NB: NDEWS Co-investigator Catherine Striley, PhD, and her lab recently interviewed 80 current kratom users to consider the consequences of use. To accomplish that aim, a DSM-5 compatible diagnosis of Kratom Use Disorder (KUD) with diagnostic algorithms was created and added to the DIS + SAM, a structured psychiatric diagnostic interview. Twenty six, or 32.5% met criteria for KUD; one half of the users (50%) endorsed continuing to use despite having a psychological or physical problem caused or exacerbated by kratom.

Sedation and acute encephalopathy in a pediatric patient following ingestion of delta-8-tetrahydrocannabinol gummies

A case report recently published in the American Journal of Case Reports by authors affiliated with the Drug Enforcement Administration's Toxicology Testing Program (DEA TOX) describes the treatment of a pediatric patient following ingestion of approximately 15 mg/kg of delta-8 THC gummies. On arrival, the patient was minimally responsive and required intubation for encephalopathy. Collaboration with DEA TOX allowed for the detection and confirmation of delta-8 THC in the serum and urine, which is not routinely available with common testing modalities. Read the full case report here.

NFLIS-Drug 2020 Annual Report now available

The National Forensic Laboratory Information System (NFLIS) recently released the NFLIS-Drug 2020 Annual Report. The total number of cases submitted to and analyzed by NFLIS-Drug reporting laboratories is noticeably lower in 2020 than in previous years, and the report cautions against comparing 2020 data with previous years. Highlights include methamphetamine as the most frequently identified drug and a dramatic increase in fentanyl reports from 2014 to 2020. Read the full report here.

Medication harms leading to emergency department visits

A study published in JAMA used three years of surveillance data on nearly 100,000 patients from 60 geographically diverse United States hospitals to calculate national estimates of emergency department (ED) visits for acute harms related to therapeutic and nontherapeutic medication use. Results showed that annually, more than 1 in 200 people had ED visits related to medication harm. Approximately two thirds of visits resulting from medication-related harm were due to therapeutic use while one third were due to nontherapeutic use, and nearly 40% of such patients were hospitalized. Read the full study here.

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