National Drug Early Warning System (NDEWS) Weekly Briefing

NDEWS ORIGINAL CONTENT

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

Context: This alert was prompted by algorithmic detection on Reddit.

What was found? Mentions of Fluorexetamine (FXE) have trended upward on Reddit since Fall 2021. In April 2022 alone, mentions by unique commenters reached more than double their previous peak.

What is Fluorexetamine? Fluorexetamine (FXE) is a dissociative NPS of the arylcyclohexylamine family.

How is Fluorexetamine being discussed? Commonly referred to as FXE, the drug has been discussed sporadically on Reddit in previous years. r/FXE, a Subreddit dedicated to FXE discussion, has existed since 2018. Commenters indicate the drug is currently available for purchase.

Drug Terms: Fluorexetamine, FXE.

NOVEL PSYCHOACTIVE SUBSTANCES

Public Alert: Synthetic stimulant N,N-dimethylpentylone replaces eutylone

NPS Discovery issued a public alert this week with recommendations for public health, laboratories, clinicians, and medical examiners and coroners. While the substituted cathinone eutylone was the most commonly encountered synthetic stimulant in forensic casework in 2020 and 2021, increases in N,N-dimethylpentylone are now being seen in toxicology testing. To date, NPS Discovery has identified N,N-dimethylpentylone in at least 32 forensic cases originating from various states and regions across the US. Read the full alert here.

RECENTLY PUBLISHED

Community urinalysis and self-report project: Cross-Canada report on the use of drugs from the unregulated supply, 2019-2021 data

The Canadian Centre on Substance Use and Addiction published a new report on results from the Community Urinalysis and Self-Report project, which collected data from people who use drugs in Canada about reported substance use (through a self-report survey) and detected drug contents (through urinalysis) between 2019 and 2021. When comparing the self-report and urinalysis results, investigators found regional variations in the concordance between reported and detected fentanyl use. The use of benzodiazepines was also unexpected based on urinalysis results among at least one third of participants across all sites. Read the full report here.

Alcohol-related deaths during the COVID-19 pandemic

A study published in JAMA compared numbers and rates of alcohol-related and all-cause deaths among all individuals 16 years or older in 2019 and 2020. Results showed the number of deaths involving alcohol increased between 2019 and 2020 from 78,927 to 99,017, as did the age-adjusted rate. Deaths from all causes had smaller relative increases in number and rate. The authors note that possible contributing factors include increased drinking to cope with pandemic-related stressors, shifting alcohol policies, and disrupted treatment access. Read the full study here.

Naloxone administration among opioid-involved overdose deaths in 38 United States jurisdictions in the State Unintentional Drug Overdose Reporting System, 2019

A study published in Drug and Alcohol Dependence analyzed 2019 data from 37 states and the District of Columbia to estimate the percentage of decedents, by sociodemographic subgroup, who experienced a fatal opioid-involved overdose and had no evidence of naloxone administration. Results showed a total of 77.3% of 33,084 opioid-involved overdose deaths had no evidence of naloxone administration. Read the full study here.

IN THE NEWS

DC Department of Forensic Sciences (DFS): Presence of fentanyl in plant-like material

The DC Department of Forensic Sciences released a bulletin last week to inform public health organizations, first responders, and law enforcement agencies of a change in the drug supply in Washington DC. The Forensic Chemistry Unit analyzed a plant-like material that was initially suspected to contain synthetic cannabinoids. Instrumental analysis confirmed the presence of fentanyl and phencyclidine (PCP). The sample was recovered in February 2022 and submitted to the laboratory in March 2022. The bulletin notes this is the first laboratory-confirmed sighting of fentanyl and PCP in plant-like material.

HIDTA Alert: Isotonitazene situational awareness in the Washington/Baltimore region

Last week, the Washington/Baltimore High Intensity Drug Trafficking Area (HIDTA) released a bulletin announcing the identification of isotonitazene in the Washington/Baltimore region, with 17 cases in the State of Maryland and two incidents in Washington, DC. One syringe with isotonitazene was found mixed with fentanyl, 4-ANPP, caffeine, and diphenhydramine. Another syringe was found mixed with fentanyl, methamphetamine, and xylazine.

Temporary placement of seven synthetic benzimidazole-opioid substances in Schedule I

The Drug Enforcement Administration issued a temporary order to schedule seven synthetic benzimidazole-opioid substances in Schedule I of the Controlled Substances Act, including butonitazene, etodesnitazene, flunitazene, metodesnitazene, metonitazene, N-pyrrolidino etonitazene, and protonitazene. This temporary scheduling order is effective April 12, 2022, until April 12, 2024. Read the full scheduling order here.

NDEWS Rapid Street Reporting: Call for local site interviewers

The NDEWS Rapid Street Reporting (RSR) study is looking for graduate students at our 17 sentinel sites to help with data collection. The RSR initiative allows us to see what substances people are currently using in different parts of the country and any adverse effects people may be experiencing. We are recruiting three graduate students at each site who have experience with fieldwork and interviewing and who would be able to work one weekend. We would start the data collection of people “in the field” on Friday morning and work through Sunday afternoon. Interviewers will be paired with interviewers from UF for each site visit. Pay is $15-20 per hour (depending on their qualification) for up to 26 hours per weekend. Interviewers must be at least 21 years of age and in good academic standing.

If you are interested, please apply at https://redcap.link/RSRX.

Upcoming site visit schedule is below:

New York City, NY May 13-15, 2022. Apply by April 25th

Denver, CO June 24-26. Apply by May 15th

Cleveland, OH July 29-31. Apply by June 15th

St. Louis, MO August 19-21. Apply by July 5th

Philadelphia, PA September 9-12. Apply by August 5th

Los Angeles, CA October 7-9. Apply by August 31st

Phoenix, AZ November 4-7. Apply by September 30th

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