National Drug Early Warning System (NDEWS) Weekly Briefing


2021 Q4 Report: Alcohol-related 911 EMS responses per 10k population, October 2021December 2021

In provisional Quarter 4 (Q4) data for 2021, 275,478 alcohol-related EMS responses were recorded by for NDEWS Sentinel Sites. Of those EMS responses, men and women aged 60+ accounted for 29.9% and 36.2% of dispatches across our sentinel sites, respectfully. Within our Sentinel Site Network, Georgia had the highest rate of 911 responses with 45.56 responses per 10k, followed by Colorado with 43.50 per 10k and Michigan with 28.80 responses per 10k. Click the image above or view the full report here.

Alert from the NDEWS Web Monitoring Team: Online mentions of bromoketamine

What was found? A discussion trend for the drug Bromoketamine has recently emerged on Reddit, following sporadic mentions in recent years.

To what does Bromoketamine refer? Bromoketamine is a designer ketamine analog in which the chlorine atom has been replaced with a bromine atom.

How is it being discussed? Bromoketamine is also referred to as "2BDCK". Bromoketamine is often co-mentioned with 2FDCK, another ketamine analog. The drug's effects are described as being less potent and shorter-lasting than ketamine. 

Drug Terms: Bromoketamine, 2BDCK, 2-Bromodeschloroketamine, 2-BDCK, 2-Bromoketamine, 2-Br-DCK.

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 information is incorporated in this monitoring process. For more methodological details, see our recent publication.

Florida Atlantic University NDEWS Press Release

Florida Atlantic University issued a press release this week on an NDEWS study that was published in the International Journal of Drug Policy last month. The study examined the relationship between online mentions of NPS on Reddit and their involvement of toxic exposures or overdoses. The eight NPS selected were carfentanil, U-47700, eutylone, flualprazolam, N-ethylpentylone, 5F-MDMB-PICA, isotonitazene, and brorphine. Results showed distinct increases and decreases in number of mentions and number of exposures. For most substances, a rise in Reddit mentions was soon followed by a corresponding rise in toxicology positivity. Peak positivity for carfentanil and flualprazolam, however, preceded peak Reddit mentions.

"Results from our study confirm that activity on drug use forums in the virtual world can help predict changes in exposures associated with new or re-emerging novel psychoactive substances in the real world, which has the potential to be used as a strategy for inclusion in early warning systems,” said Elan Barenholtz, NDEWS Co-Investigator. “An advanced early warning system should include capabilities to capture a signal that is concurrent with, or even predates, the observed exposures themselves. Read the full press release here.

New Substances Survey

Is bromoketamine being used in your area?

Tell NDEWS what you have heard about bromoketamine use in your area. Click here.


Increased incidence of fentanyl-related deaths involving para-fluorofentanyl or metonitazene — Knox County, Tennessee, November 2020–August 2021

This week's MMWR reported an increased incidence of fentanyl-related deaths involving para-fluorofentanyl or metonitazene in Knox County, Tennessee, November 2020–August 2021. The Knox County Regional Forensic Center (KCRFC) in Knoxville, Tennessee first identified para-fluorofentanyl in toxicology results of victims of drug overdoses in November 2020, and metonitazene, either alone or in combination with fentanyl and para-fluorofentanyl, in January 2021. During November 2020–August 2021, KCRFC reported 770 total unintentional drug overdose deaths. Among these deaths, 73% of cases received postmortem positive test results for fentanyl, including 192 fentanyl-positive cases reported in the absence of other substances, 188 that involved fentanyl and methamphetamine, 48 that involved para-fluorofentanyl, and 26 that involved metonitazene. Read the full report here.

HIDTA Alert: Several counties in Maryland have reported fentanyl in a variety of colors since 2018

In October 2021, the Carroll County Heroin Coordinator reported a traffic stop on a vehicle traveling from Baltimore County resulting in a seizure of 33 clear gel caps containing a pink colored powder. The lab analysis identified fentanyl. This is the fifth incident since 2018 of a seizure involving tinted fentanyl and the third incident involving pink fentanyl. Other incidents involving tinted fentanyl were reported in Kent County, Wicomico County, and Frederick County. An overdose spike was reported during the period of 03/10/2020 - 03/13/2020 there were four non-fatal and one fatal overdose. All six of these overdoses had suspected ties to gel caps containing light pink powder coming from Baltimore City, MD.

Postdoctoral Fellowships Available Immediately!

The University of Florida Substance Abuse Training Center in Public Health T32 is seeking applicants for two postdoctoral fellowship openings! 

- Fellowships are sponsored by the National Institute on Drug Abuse, and postdocs receive an annual stipend and health benefits for 2 years. 

- An annual allowance is offered to facilitate attendance at conferences.

- Fellows would work on NDEWS, the ABCD study or other NIDA funded studies with internationally known mentors.

- UF resources include: CTSA; McKnight Brain Institute; Center on Addiction Research and Education; Arts in Medicine; Pain Research and Intervention Center of Excellence; UF Health Cancer Center; Emerging Pathogens Institute; Institute on Aging

- The T32 program is directed by Dr. Linda Cottler, and co-directed by Dr. Sara Jo Nixon.

Questions should be directed to Ms. Tamara Millay at Applications are considered on a rolling basis; the program values the diversity of its applicants.

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