National Drug Early Warning System (NDEWS) Weekly Briefing

Photo L to R: Andrew McCabe, Paul Morris, Linda Cottler, Nicole Fitzgerald, Andrew Mike, Nae Won; not pictured: Marsha Lopez and Anna Wang

Message from Linda B. Cottler re: NDEWS

Dear Colleagues, as we begin our 3rd year of NDEWS, we want to reimagine and reassess our impact in communities across the US. We now have many interested investigators who are following us, BUT we need to reach communities of focus: people who can help reduce the harm associated with drug use; people who need to help intervene; and people who can share our alerts with others in need. Please help us by sending the link to subscribe to this Weekly Briefing. It is the orange button at the top of the screen on our home page. Or send the name and email by clicking the “share your thoughts” link below. We will add their name to the Weekly Briefing. Share the data with your DOHs and other agencies.

Also, we just returned from a very successful meeting of the College on Problems of Drug Dependence. Many interesting and exciting talks and posters were presented. One I wish to highlight is from our NDEWS team. “New and Emerging Substances Presented by New and Emerging Scientists”. This presentation involved our predocs from our Epidemiology Department at UF—predocs on the NIDA T32 here at UF. Another presenter was a doctoral candidate from FAU. Stay tuned for their work that is presented each week in the Briefing as they lead multiple efforts with NDEWS.

We are excited to work with you all on NDEWS and look forward to hearing from each of you.



NPS Discovery Public Alert: Bromazolam prevalence surging across the US driven in part by increasing detections alongside fentanyl

Earlier this week, NPS Discovery sent out a public alert regarding the new benzodiazepine, bromazolam. This public alert details their results and recommendations for public health entities, medical examiners and coroners, laboratories, and clinicians. View the full alert here.


Findings from the NDEWS Web Monitoring team corroborate this week's NPS Discovery report on bromazolam.  A Subreddit discussion trend for the drug Bromazolam has grown in 2022, matching pace with human toxicology case trends. Mention counts in drug Subreddits have multiplied since identification of the drug in NDEWS Briefing Issue 32 (April 2021). In recent mentions, many Subreddit commenters discuss taking bromazolam intentionally and without other substances.

Trends in characteristics of fentanyl-related poisonings in the US, 2015-2021

A study published this week in The American Journal of Drug and Alcohol Abuse by NDEWS researchers, led by Dr. Joseph Palamar, and co-written by Dr. Linda Cottler, Dr. Bruce Goldberger, Dr. Stevan Geoffrey Severtson, David Grundy, Dr. Janetta Iwanicki, and Dr. Daniel Ciccarone, examined trends in characteristics of fatal and nonfatal fentanyl-related poisonings ("exposures") in the US from 2015 to 2021. The proportion involving inhalation increased from 6% to 30%. The proportion also increased for co-use of meth and cocaine. Read the full study here.

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

Context: This alert was found by algorithmic monitoring of 80+ drug-oriented Subreddits.

What was found? A Subreddit discussion trend for the slang term "GGs" spiked in May to June 2022. Mentions of the term previously reached a peak in June to July 2020 in the early months of the COVID-19 pandemic.

To what does "GGs" refer? "GGs" is a plural slang term referring to Alprazolam (Xanax) pills imprinted with the letters "GG".

How is it being discussed? Many Redditors recognize the "GGs" slang term and view the "GG" imprint as a mark of authenticity. The counterfeit status of pills associated with this recent trend can not be determined.

Drug Terms: "GGs", "GG's", Alprazolam, Xanax.


Montana state, local officials report alarming number of fatal overdoses in recent weeks

Last week, the Department of Public Health and Human Services and the Montana Department of Justice, in conjunction with local law enforcement reported at least 8 fatal overdoses likely due to opioids in the period between May 22 and June 1, 2022. Fatalities occurred in Cascade, Custer, Gallatin, Lake, Lewis and Clark, and Yellowstone counties. Initial reports note the presence of blue M30 pills, which likely contain illicitly manufactured fentanyl. Read the full news release here.


European Drug Report 2022: Trends and Developments

Earlier this week, the European Monitoring Centre for Drugs and Drug Addiction published their European Drug Report 2022. This report presents the latest analysis on illicit drug use, related harms, and drug supply; a comprehensive set of national data across these themes; and key harm-reduction interventions. Read the full report here.

Emergency department visits due to new psychoactive substances and other illicit drugs in Taiwan: preliminary results of the Taiwan Emergency Department Drug Abuse Surveillance (TEDAS) project

A study published in Clinical Toxicology assessed the patterns of recreational drug use in patients presenting to emergency departments across the country. Results showed between February and November 2019, a total of 2,649 patients were enrolled for urine drug analysis, a total of 675 cases older than 12 years had novel psychoactive substances (NPS) or other illicit drugs detected in their urine. Overall, there were 1,271 counts of drugs among which 717 were NPS. At least one NPS was detected in 340 patients, and 292 cases were positive for multiple drugs. Read the full study here.

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