National Drug Early Warning System (NDEWS) Weekly Briefing


2022 Q1 Report: Overdose-related 911 EMS responses per 10k population, January 2022 â€” March 2022

In Quarter 1 (Q1) of 2022, 62,817 overdose-related 911 emergency medical services (EMS) responses were recorded for our NDEWS Sentinel Sites using data. Of those 911 responses, a majority of persons were white (53.9%), and male (65.5%). Within our Sentinel Site Network, Kentucky had the highest rate of overdose-related responses with 7.57 per 10k residents (3,383 total responses), followed by Florida with 6.31 per 10k (829 total). Total overdose-related EMS responses have declined since Q3 2021. The majority of overdose incidents occurred at private residences (28,311), and Naloxone was the most commonly administered medication (33,944). View the full report here

Alert from the NDEWS Web Monitoring Team: Online Mentions of Borax Combo

Context: This alert was prompted by algorithmic detection of the Borax Combo and related drugs on Reddit.

What was found? Drug subreddit discussion indicates trends of growing interest in the Borax Combo in late 2020 and late 2021. The drug term was only mentioned sporadically before 2019.

What is the Borax Combo? The Borax Combo is a mix of psychedelic and MDMA-like research chemicals used to mimic the effects of MDMA. The most commonly affiliated substances are the entactogen 5-MAPB and the psychedelic 5-MeO-MiPT.

How the Borax Combo being discussed? Subreddit commenters discuss the drug as a substitute for MDMA. Augmentations of the Borax Combo are often discussed. For instance, the stimulant 2-FMA is commonly recommended as part of the combination.

Drug Terms: Borax Combo, 5-MAPB, 5-MeO-MiPT, 2-FMA.


NPS Discovery Q1 2022 Trend Reports

Earlier this week, NPS Discovery published their Q1 2022 Trend Reports. The most prevalent NPS in Q1 2022 by class consisted of: etizolam (NPS benzodiazepines), carfentanil (NPS opioids), eutylone (NPS stimulants and hallucinogens), and MDMB-4en-PINACA (synthetic cannabinoids). View the full reports here.


Trends in drug overdose deaths among US adolescents, January 2010 to June 2021

A study published in JAMA this week assessed shifts in drug overdose deaths in the US between January 2010 and June 2021 among adolescents aged 14 to 18years. Results showed there were 518 deaths among adolescents in 2010, 954 in 2020, and 1146 in 2021. Among adolescents, fentanyl-involved fatalities increased from 253 in 2019, to 680 in 2020, and then to 884 in 2021. American Indian and Alaska Native adolescents experienced the highest overdose rate in 2021, followed by Latinx adolescents. Read the full study here.

Assessment of patient-reported naloxone acquisition and carrying with an automated text messaging system after emergency department discharge in Philadelphia

A study published in JAMA Network Open assessed whether an automated text messaging system could capture patients’ self-reported naloxone acquisition and carrying after an emergency department (ED) encounter. In a cohort of patients discharged from two urban EDs, 88% reported acquiring naloxone from the ED and 66% planned to continue carrying naloxone. The authors suggest that this automated text messaging offers and opportunity to interact with persons at high risk for overdose and to support ED-based naloxone distribution efforts. Read the full study here.


DEA & MPD issue public safety alert on mass overdose events across DC metro area

Yesterday, the Drug Enforcement Administration Washington Division and the Metropolitan Police Department issued a Public Safety Alert warning residents in the DC metropolitan area of the alarming increase in fentanyl-related mass overdose events across the city. This week, 17 individuals overdosed, 10 of whom died, in Northeast DC. This follows 10 individuals who overdosed on January 28, 2022, 9 of whom died, in the Southeast Washington DC area. Read the full press release here.

Workforce drug test positivity climbs to highest level in two decades, finds Quest Diagnostics Drug Testing Index analysis

A recent analysis by Quest Diagnostics based on more than 11 million deidentified urine, hair, and oral fluid drug test results collected between January and December 2021 found a 30% increase in the rate of positive drug test results in the combined US workforce in 2021 from an all-time low in 2010-2012. Read the full news release here.

DEA Final Rulings, April 2022

The Drug Enforcement Agency recently published two notices in the Federal Register. Effective April 7, 2022, five synthetic cannabinoids were permanently placed in Schedule I of the Controlled Substances Act. 5 F-EDMB-PINACA, 5F-MDMB-PICA, FUB-AKB48, 5F-CUMYL-PINACA, and FUB-144. On April 11, the DEA also published a notice of proposed rulemaking to place two phenethylamine hallucinogens, 2,5-dimethoxy-4-iodamphetamine (DOI) and 2,5-dimethoxy-4-chloroamphetamine (DOC), in Schedule 1. Read the first notice here. Read the second notice here.

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