National Drug Early Warning System (NDEWS) Weekly Briefing


Early signal alert: Emergence of online mentions of Protonitazepyne

What was found? First online mentions of the novel substance protonitazepyne emerged on Reddit in July 2022. This trend signals interest in and potential availability of a new nitazene drug.

To what does protonitazepyne refer? While little is known about this novel drug term, the naming of protonitazepyne suggests similarity with a class of benzimidazole-opioid drugs called nitazenes, which includes protonitazene and etonitazepyne.

How is it being discussed? Commenters refer to protonitazepyne as "zene" drug, compare the drug to other nitazenes, and discuss a rumor that the drug has 80% the potency of etonitazepyne.

Drug Terms: Protonitazepyne, "zenes", nitazenes, protonitazene, etonitazepyne.


NPS Discovery: Q2 2022 recommended scope for NPS testing in the US

NPS Discovery and the SOFT NPS Committee have published their Q2 2022 recommended scope for NPS testing in the US this week. This report provides guidance in developing an appropriate analytical scope of testing for NPS in the US. Read the full report here.


Estimating weekly national opioid overdose deaths in near real time using multiple proxy data sources

A recent study of the CDC published in JAMA Network Open used near-real-time proxy data sources to estimate national opioid overdose mortality trends. Statistical models using health, law enforcement, and online data sources estimated national opioid overdose death rates for 2018 and 2019 with an approximate 1% error. The authors suggest that proxy administrative data sources can be used to estimate national opioid overdose mortality trends to provide a more timely understanding of this public health problem. Read the full study here.

Information bulletin: Benzodiazepines and nitazenes presence in lab data in the Washington Baltimore HIDTA area

The Washington Baltimore HIDTA Investigative Support Center conducted a proactive analysis of random samples submitted by law enforcement agencies between April 1, 2021 and March 31, 2022. Etizolam and alprazolam were the most frequently identified benzodiazepine drugs in Maryland, while in Virginia, alprazolam was identified in the highest number of submitted samples. Isotonitazene was identified in a small number of samples by law enforcement agencies in Maryland and Virginia. Metonitazene was identified in a higher number of samples reported in Virginia. No nitazene-type drugs were found in random samples of syringes analyzed in DC.

At-a-glance: The emergence of nitazenes and brorphine in Canada since 2019

This month, The Government of Canada published their report on the emergence of nitazenes and brorphine in Canada since 2019. Isotonitazene was the most frequently detected nitazene/brorphine in Canada, representing 46.8% of all nitazene/brorphine detections. Detections were most often reported from Ontario (43.5%) and Quebec (38.5%). Brorphine, etodesnitazene, and metonitazene were mainly detected in powder form, while isotonitazene and protonitazene were most frequently found in tablet form. Read the full report here.

3-Methylmethcathinone (3-MMC) poisonings: Acute clinical toxicity and time trend between 2013 and 2021 in the Netherlands

A study published in Annals of Emergency Medicine examined self-reported 3-MMC poisonings to the Dutch Poisons Information Center from 2013 to June 2021. Results showed the number of poisonings increased from 1 in 2013 to 70 in the first half of 2021. In 84 poisonings reportedly involving only 3-MMC (46%), sympathomimetic symptoms were commonly reported, including tachycardia, hypertensions, and agitation. Read the full study here.


Federal Register Notice: Withdrawal of proposed placement of 4-OH-DiPT, 5-MeO-AMT, 5-MeO-MiPT, 5-MeO-DET, and DiPT in Schedule I

As of Wednesday, July 27, 2022, the DEA has withdrawn a proposed rule that was published in the Federal Registrar on January 14, 2022. The rule had proposed to place five tryptamine hallucinogens in Schedule I of the Controlled Substances Act. The DEA has determined that it is appropriate to submit a new request to the Department of Health and Human Services for an updated scientific and medical evaluation and scheduling recommendation for these substances. Read the full notice here.

King County, Washington declares fentanyl a public health crisis

After a 46% increase in the number of people who have died from a drug overdose compared to last year, King County, Washington has now declared fentanyl a public health crisis. Most of the recent overdoses and deaths have been linked to illegally manufactured fentanyl, and this year, 268 people have died so far. Caleb Banta-Green, principal research scientist with the University of Washington's Addictions, Drug, and Alcohol Institute and NDEWS Sentinel Site Director, said, "I think we can all agree that we want to keep people alive," "and that for people currently using drugs we need to do everything we can to engage them and give them a safe space to be and people to connect to." Read the article here.

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