National Drug Early Warning System (NDEWS) Weekly Briefing


The next generation of synthetic cannabinoids: Detection, activity, and potential toxicity of pent-4en and but-3en analogs including MDMB-4en-PINACA 

A new publication by NDEWS Scientific Advisory Group Member Dr. Barry Logan and colleagues on the next generation of synthetic cannabinoids, including MDMB-4en-PINACA, is now available. This new class of synthetic cannabinoids contains "alkene modifications to the tail region of the synthetic cannabinoid core structure," and the analogs are denoted as pent-4en or but-3en species. Of the substances studied, MDMB-4en-PINACA, MDMB-4en-PICA, and MDMB-3en-BINACA were found to be "highly potent and efficacious."  

Researchers also conducted sample-mining and data-mining on toxicology samples and identified MDMB-4en-PINACA in 25 forensic toxicology cases throughout the US. "Results from toxicology testing paired with case history show the potential for MDMB-4en-PINACA to cause or contribute to impairment or death. Forensic scientists, public health and public safety officials, law enforcement, clinicians, medical examiners, and coroners should consider involvement of emergent synthetic cannabinoids in their work and that new analogs containing an alkene tail can retain similar or increased potency and toxicity." Read the full article here. 


Availability of substances for use in personal vaporizers on three online cryptomarkets 

As the popularity of personal vaporizers increases, online cryptomarkets provide a unique platform to purchase substances marketed for vaporized use. A new article published in Drug and Alcohol Dependence collected data across 1,929 listings from 201 unique sellers to establish top products on the listing marketplaces Agartha, Cryptonia, and Tochka. According to their analyses, they found that cannabis oil was the most common substance advertised (96.1%), followed by synthetic cannabinoids (3.7%) and psychedelic substances (0.2%). Read the full article here. 

New EMCDDA report: Impact of COVID-19 on drug markets, use, and services in east European Neighborhood Policy countries 

A new trendspotter briefing from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) was released this week regarding the effects of the COVID-19 pandemic on drug markets, drug use, drug-related harms, and responses in the European Neighborhood Policy (ENP) countries between March and May 2020. From the report regarding the long-term impacts of COVID-19 on drug use: "The situation requires ongoing monitoring given reports of the reduced availability and use of some drugs such as heroin and cocaine, combined with the emergence of the home-based production of amphetamines in some countries and the increased use of other, more readily available, psychoactive substances." Read the press release here, and the full report here. 

New RAND study: Alcohol consumption rises sharply during pandemic shutdown

Results from a new RAND Corporation study on changes in adult alcohol use and consequences during the COVID-19 pandemic were published this week. The national survey found that the overall frequency of alcohol consumption increased by 14% among adults over the age of 30 compared to the same time last year, and women were found to have increased their heavy drinking episodes by 41%. Higher population-level changes in alcohol consumption for women, younger, and non-Hispanic white individuals "highlight the need for primary care providers, behavioral health providers, and family members to be aware of the risks of increased alcohol use and heavy drinking during the pandemic." Read the news release here, and the full article here.


FDA orders stronger warnings on benzodiazepines 

The US Food and Drug Administration (FDA) is now requiring an updated Boxed Warning for all benzodiazepine medicines that will reflect their potential for misuse, addiction, physical dependence, and withdrawal reactions. According to the FDA's recent safety communication, the current prescribing information for benzodiazepines "does not provide adequate warnings about these serious risks and harms associated with these medications so they may be prescribed and used inappropriately." In addition to updating the Boxed Warning, the FDA is also requiring revisions to the prescribing information for all benzodiazepine medicines and to the patient medication guides. Read the news release here, and the full safety communication here. 

DEA press release: National Health Care Fraud and Opioid Takedown results in charges against 345 defendants responsible for more than $6 billion in alleged fraud losses

The largest health care fraud and opioid enforcement action in the history of the Department of Justice was announced on Wednesday, which involved 345 defendants charged across 51 federal districts, including more than 100 doctors, nurses, and other licensed medical professionals.

Charges involved submitting more than $6 billion in false and fraudulent claims to federal health care programs and private insurers––including more than $4.5 billion related to telemedicine, more than $845 million related to substance use disorder treatment facilities, and more than $806 million related to other health care fraud and opioid distribution schemes. Read the full press release here.

New NHTSA 2019 fatality data and special report on drug and alcohol prevalence in seriously and fatally injured road users during COVID-19

The National Highway Traffic Safety Administration (NHTSA) has released a preview of 2019 data from the Fatality Analysis Reporting System. Traffic deaths nationwide have decreased by 2% from 2018. Additionally, a special report was released that suggests that driving patterns have changed during the current national public health emergency. Drivers on the road are engaging in riskier behavior, including speeding and driving while under the influence of drugs and alcohol.  

A second special report on a study of five participating trauma centers found that between mid-March and mid-July, two-thirds of drivers tested positive for at least one drug. Compared to the previous six months, testing positive for opioids doubled after mid-March, while marijuana use increased 50%. "Overall, the results of this study suggest the highway safety community should be concerned about the impact of other drugs as well as alcohol." Read the full report here.

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