National Drug Early Warning System (NDEWS) Weekly Briefing

Issue 5: September 25, 2020


Seeking information on the synthetic opioid AP-238

According to the NDEWS Web Monitoring Team, led by Dr. Elan Barenholtz at the Machine Perception and Cognitive Robotics (MPCR) Lab at Florida Atlantic University, discussion of the synthetic opioid AP-238 appeared online in drug-related social media communities around June 2020 and has grown in recent months. 

AP-238 is a derivative of Bucinnazine (AP-2371-butyryl-4-cinnamyl-piperazine), which has been used clinically in China and is currently listed for purchase on popular web-based drug marketplaces. AP-238 was recognized as a potentially relevant drug keyword through algorithmic monitoring of communities dedicated to drug discussion on the social media platform Reddit. Mentions of “AP-238” in the past 18 months across ~70 drug-oriented subreddit communities were quantified and aggregated by month to obtain a relative metric of discussion over time (see graph above).  

The location and demographic makeup of discussion participants, availability of the drug, and potential for harm cannot be determined from this preliminary metric. Thus, this information should be matched to trends in real-world data to evaluate the relevance of the potential emergence of AP-238 and related opioids.  

Have you heard anything about AP-238? Let us know here.


From the NDEWS team: Introducing NIDA's new National Drug Early Warning System 

Our NDEWS team recently published a new letter in Drug and Alcohol Dependence introducing our new iteration of NIDA's NDEWS, which describes our goal of incorporating real-time surveillance to detect early signals of potential drug trends and utilizing novel surveillance methods with an expanded Early Warning Network. The letter also outlines our COVID-19 supplement, as well as our dissemination and training plans. Read the free full article here.

Now available from the EMCDDA: European Drug Report 2020

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) released the European Drug Report 2020 this week, which provides a comprehensive analysis of patterns emerging across Europe regarding drug supply, illicit drug use, and associated public health problems, as well as how the COVID-19 pandemic is affecting drug use, supply, and services. Of note, 53 new psychoactive substances (NPS) were discovered for the first time in Europe in 2019 at a rate of around one per week, mostly synthetic cathinones. Two of the eight new synthetic opioids discovered were fentanyl analogs.  Check out the following links for: the full reporta summary of main findingsstatistical bulletin, and news release. 

Lyophilized kratom tea as a therapeutic option for opioid dependence

Kratom has been used as a substitute for opium in physically-dependent subjects. A new study set out to evaluate user dependence produced by kratom tea, as well as to determine if the tea improved withdrawal in opioid physically-dependent subjects. Using animal modeling, the authors determined that the study confirmed the therapeutic effect of lyophilized kratom tea for the treatment of pain and opioid physical dependence. Read the full article here.

Trends in stimulant dispensing by age, sex, state of residence, and prescriber specialty 

While stimulant medications are commonly prescribed for the treatment of ADHD, their potential for diversion and misuse is high. A new article published in Drug and Alcohol Dependence investigated stimulant dispensing in the US and found that stimulant dispensing increased from 2014 through 2019, particularly among females and older adults. Dispensing rates also varied strongly between states, ranging from 1.0 per 100 persons in Hawaii to 13.6 per 100 persons in Alabama. Read the full paper here.


New DEA intelligence report: Counterfeit controlled prescription drug availability in Pennsylvania and Delaware 

The DEA Philadelphia Field Division released a new report advising of increased availability of counterfeit controlled prescription drugs. Eleven percent of DEA fentanyl and fentanyl-related compounds seizures in Pennsylvania and Delaware were in tablet form, an increase from .05 percent the previous year. According to statewide reporting, fentanyl and fentanyl-related compounds have been most frequently identified in overdose deaths since 2016. The report asserts that as the availability of counterfeit controlled prescription drugs rises, so does the danger to users. Read the full report here.  

Justice Department: 179 arrested and more than $6.5 million seized in darknet opioid takedown 

According to ABC News, more than a year after taking down Wall Street Market, law enforcement officials arrested 179 people (121 in the US) involved in darknet drug trafficking and seized more than $6.5 million in cash and virtual currency as part of a coordinated international effort called Operation DisrupTor. About 275 kilograms of drugs were seized in the US, including fentanyl, heroin, cocaine, ecstasy, and other opioids. Deputy Attorney General Jeffrey Rosen was quoted saying that "there will be no safe haven for drug dealing in cyberspace." Read the DEA press release here.

FDA issues warning on "Benadryl Challenge"

On Thursday, the Food and Drug Administration issued a warning about a trend on the social media platform TikTok called the "Benadryl Challenge," which allegedly involves consuming high doses of diphenhydramine, marketed under the brand-name Benadryl, to induce hallucinations. The FDA said in the warning that it is "aware of news reports of teenagers ending up in emergency rooms or dying" after participating in the challenge, and that it is "investigating these reports and conducting a review to determine if additional cases have been reported." Read more about this story from NBC News.

Share your research, news, and events through our submission form

Share your comments on our newsletter through our feedback form

Follow NDEWS on Twitter: @NDEWSnews