National Drug Early Warning System (NDEWS) Weekly Briefing


Two alerts from the NDEWS Web Monitoring Team: Detection of new signal and results of query from NDEWS network

Context: The NDEWS Web Monitoring Team found two alerts this week: 1) the emergence of discussion of etomethazene, which was detected for the first time with algorithmic monitoring, and 2) increases in discussion of tapentadol, which was examined  based on a reader's query. We invite readers to send requests for monitoring through links provided below and request that you disseminate this information to your community. 

Early signal alert: Emergence of online mentions of etomethazene

What was found? Subreddit discussion for the novel substance Etomethazene emerged on Reddit in Spring/Summer 2022. This trend indicates awareness of a novel substance that should be monitored for increasing interest.

To what does Etomethazene refer? Etomethazene is a novel opioid substance discussed on Reddit and listed for purchase online. It is a derivative of benzimidazole opioid nitazenes (Etonitazene, Metonitazene, etc.) previously mentioned on Reddit.

How is it being discussed? Commenters refer to Etomethazene as another "zene" drug and discuss a rumor that the drug has two times the potency of fentanyl.

Drug Terms: Etomethazene, "zenes", nitazenes.

Report: Increase in online mentions of tapentadol

What was found? Subreddit discussion for the drug Tapentadol has gained prevalence in recent years. Total mention counts for the drug in 2022 are twice as high as pre-2020 levels.

To what does Tapentadol refer? Tapentadol is a prescription opioid drug with the common brand name Nucynta.

How is it being discussed? Tapentadol has been discussed for years on Reddit as a substance that is both prescribed and used recreationally. Discussion of Tapentadol in drug Subreddits overlaps with discussion in mental health and pain management Subreddits.

Drug Terms: Tapentadol, Nucynta.


Click here to let our Web Monitoring team know what substances you would like us to query next.


Quinine & quinidine: Toxic adulterants found in illicit street drugs

Last week, the Center for Forensic Science Research & Education (CFSRE) and the Colombo Plan published a public health alert on the presence of quinine and its naturally occurring stereoisomer, quinidine, in the illicit drug supply. The report describes the history of quinine's role as an adulterant, quinine's adverse effects, and new data on quinine positivity in seized drug cases and deidentified postmortem toxicology samples in the US. Recommendations are provided for clinicians, medical examiners and coroners, and forensic and clinical laboratories. Read the full report here.


Identification of a novel opioid, N-piperidinyl etonitazene (etonitazepipne), in patients with suspected opioid overdose

A case series recently published in Clinical Toxicology described a local outbreak of N-piperidinyl etonitazene, a novel "nitazene" opioid not previously reported in human exposures. Three patients tested positive for N-piperidinyl etonitazene at a site in New Jersey over a three-day period in July 2021. Two patients reported the use of cocaine; one reported the use of heroin and alprazolam. Read the full study here.

UNODC: World Drug Report 2022

Earlier this week, the United Nations Office on Drugs and Crime (UNODC) published their 2022 World Drug Report, which consists of five separate booklets. This report examines policy implicationsdrug demand and drug supplycannabis and opioids;  cocaine, amphetamine-type stimulants, and new psychoactive substances; and drugs and the environment. The report concludes with the UNODC's goal to strengthen international cooperation to counter the impact of the world drug problem. Read the full report here.


ONDCP announces report on improving telehealth services for substance use disorder

Last week, the White House Office of National Drug Control Policy (ONDCP) announced the release of the Telehealth and Substance Use Disorder Services in the Era of COVID-19: Review and Recommendations. This report outlines several recommendations to improve access to telehealth, including expanding and making consistent current state and federal telehealth policies. Read the press release here.

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