National Drug Early Warning System (NDEWS) Weekly Briefing

Issue 4: September 18, 2020


New national study of electronic health records (EHR) links substance use disorders to COVID-19 susceptibility

Published this week in Molecular Psychiatry, an EHR-based study co-authored by Dr. Nora Volkow, the Director of the National Institute on Drug Abuse (NIDA), found that people with substance use disorders (SUDs) are more susceptible to COVID-19 and its complications.

While individuals with SUD made up 10.3% of the total study population, they constituted 15.6% of COVID-19 cases. Those with a recently recorded SUD diagnosis, particularly those with an opioid or tobacco use disorder, were more likely to develop COVID-19 and more likely to experience worse COVID-19 outcomes, including hospitalization or death, than those without an SUD. According to the authors, "the study findings underscore the need to screen for, and treat, SUDs as part of the strategy for controlling the pandemic." Read the news release here, and the full article here.

Results from the 2019 National Survey of Drug Use and Health (NSDUH) 

SAMHSA has just released findings from the 2019 National Survey of Drug Use and Health (NSDUH), which focuses on substance use and mental health in the United States. The 2019 Key Substance Use and Mental Health Indicators report provides a summary of substance use, initiation of use, perceived risk, SUDs, mental illness, suicide, and substance use treatment and mental health service use in the US. Among select age groups, opioid 'misuse' and use disorder decreased, heroin initiation declined, and daily marijuana use and use disorder has increased. Read the full report here, and access detailed tables and methodology here. A recorded presentation of the NSDUH data is also available.

Trends in mortality from drug poisonings, suicide, and alcohol-induced deaths in the United States from 2000 to 2017

A recently published article outlines mortality trends in the US by geography and demographic characteristics. Researchers found that drug poisoning death rates were clustered in the Northeast through Appalachia, but high rates of suicide and alcohol-induced death were found mostly in the West. These death rates were not concentrated around any single group or geographic location. This lack of concentration identifies a need for specialized interventions tailored to the underlying drivers of each cause of death. Read the full article here.

The association between opioid discontinuation and heroin use: A nested case-control study

Opioid prescribing guidelines recommend reducing or discontinuing opioids for chronic pain if the harm begins to outweigh the benefit. The risks of this discontinuation have not yet been fully evaluated. A new study published in Drug and Alcohol Dependence aimed to assess if there was an association between opioid discontinuation and heroin use. The authors found that among patients prescribed chronic opioid therapy, there was an increased risk of heroin use after opioid discontinuation. Read the full article here.

Kava decreases the stereotyped behavior induced by amphetamine in mice

Kava (Piper methysticum) is a plant that has been used ethobotanically as an anxiolytic. To date, there has not been investigation on kava's effects on models of psychosis-like symptoms. A recently published study tested the effectiveness of kava extract on behavioral changes induced by amphetamine and its possible relation to changes in MAO activity in an animal model. The findings proved the hypothesis that kava would decreases the stereotypical behavior induced by amphetamine, which could be useful to help patients minimize amphetamine-driven psychotic symptoms in a clinical setting. Read the full article here.

Evaluation of the rewarding effects of mitragynine and 7‐hydroxymitragynine in an intracranial self-stimulation procedure in male and female rats

Kratom has been used in Southeast Asia for hundreds of years for its ability to increase energy, aid in relaxation, and assist in opioid withdrawals. A new study investigated the rewarding properties of mitragynine and its metabolite 7-hydroxymitragynine. The authors discovered that these compounds were not rewarding in the ICSS procedure, which suggests that these kratom alkaloids do not have abuse potential. Read the full article here.


DEA NFLIS-Drug 2019 Annual Report now available

The U.S. National Forensic Laboratory Information System (NFLIS) has released its 2019 Annual Report. Methamphetamine, cannabis/THC, cocaine, and heroin accounted for 68% of all drugs analyzed. Methamphetamine reports have also increased steadily from 2011 through 2019. From 2018 to 2019, reports of fentanyl and buprenorphine increased significantly, while reports of alprazolam, oxycodone, hydrocodone, and amphetamine decreased significantly.

The report also included a GIS analysis comparing acetyl fentanyl and eutylone by location. As evidenced by the graphs provided, acetyl fentanyl has spread primarily from the New England area in 2017 into the Mid-Atlantic states and Appalachia in 2019. Eutylone was likewise found in New England in 2017, but primarily in the Chesapeake and Southern regions in 2019. Read the full report here.

New DEA Bulletin: Fentanyl used in vape pens

A new DEA Bulletin was just released by the San Diego Field Division regarding the use of fentanyl in vape pens. The DEA San Diego Division was contacted by local authorities regarding a suspected fentanyl overdose death in September 2019, and the San Diego County Medical Examiner (SDCME) reports that this was the first case in which they had found fentanyl in vape pens. "While the presence of fentanyl powder (lethal in doses as small as two milligrams) poses a public safety threat, the ingestion of fentanyl via vaping poses a threat of unknown consequences to the user and those nearby." Read the full Bulletin here.

Report on impacts of COVID-19 on people who use illicit stimulants in Australia from NDARC

The National Drug & Alcohol Research Centre (NDARC) just released a new Drug Trends Bulletin using data from the Ecstasy and Related Drugs Reporting System (EDRS), which annually interviews a sentinel sample of people who regularly use ecstasy and other illicit stimulants in Australia. In 2020, interviews were adapted to collect data on individuals' experiences during COVID-19. Reported findings include: 37% of participants reported a change in main drug use in the past month, 69% reported a change in frequency of use of ecstasy/MDMDA, and 32% were currently worried about contracting COVID-19. Read the full report here.

COVID-19 could make 2020 Canada's worst year for overdoses

According to a new article from VICE News, 2020 could be one of the worst years for drug overdoses in Canada. The news outlet requested 2020 overdose death data from all 13 Canadian provinces and territories, as well as non-fatal overdose data in major cities, and found that at least 2,450 people have died of drug overdoses so far this year. Saskatchewan is reporting a nearly 40% increase in overdose deaths. Read the full article here.


EMCDDA virtual event: Release of the European Drug Report 2020

On Tuesday, Sept. 22 at 5:00 am EST (11:00 am CET), the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) will be live-streaming the release of the European Drug Report 2020 in an online media event. The report will include information on how the COVID-19 pandemic is affecting drug use, supply, and services, the health costs of drug use in Europe, and drug production and trafficking trends. Register to watch the event here.

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