National Drug Early Warning System (NDEWS) Weekly Briefing


NDEWS Hotspot Alerts November 3–9, 2022: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week's NDEWS Hotspot Alert​s ​report ​includes 5 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the report hereClick here to read more about NDEWS Hotspot Alerts.

Alert from the NDEWS Web Monitoring Team: Online mentions of Blue Bliss

Context: This alert follows identification of a Subreddit mention trend for the Borax Combo in NDEWS Briefing Issue 80. Drugs most commonly included in this combination, which typically involves a mixture of psychedelic and MDMA-like research chemicals, overlap with those included in Blue Bliss.

What was found? A subreddit mention trend for the drug term Blue Bliss emerged in Summer and Fall 2022, after sporadic mentions in past years.

What is Blue Bliss? Blue Bliss pellets are described as a combination of drugs designed to mimic the effects of MDMA. Blue Bliss most commonly contains a mixture of 5-MAPB, 2-FMA, and 5-MeO-MiPT. Blue Bliss often refers to the same drug combination as the Borax Combo.

How is Blue Bliss being discussed? Blue Bliss is frequently co-mentioned with MDMA in drug subreddits. Commenters describe the effects of the combination as similar to MDMA.

Drug Terms: Blue Bliss, 5-MAPB, 2-FMA, 5-MeO-MiPT, Borax Combo.


FDA alerts health care professionals of risks to patients exposed to xylazine in illicit drugs

Earlier this week, the FDA released an alert warning health care professionals of the risks to patients exposed to xylazine in illicit drugs. The alert indicates health care professionals should be cautious of xylazine inclusion in fentanyl, heroin, and other illicit drug use which could cause overdoses; the issue is that naloxone may not be able to reverse its effects. In a letter issued to stakeholders, the FDA explains what xylazine is, what the harms associated with xylazine use in humans are, why the FDA is communicating about xylazine, and what health care professionals can do. Read the alert hereRead the letter to stakeholders here.

Use of plant-based hallucinogens and dissociative agents: US time trends

A recently published study in Addictive Behaviors Reports assessed overall and age-specific time trends in the prevalence of lifetime and 12-month use of plant-based hallucinogens and dissociative agents. The study used data from the National Survey on Drug Use and Health. Results showed increases in lifetime use for psilocybin (20022019), tryptamine (2006–2014, 2015–2019), and ketamine (2006–2014, 2015–2019). Mescaline use decreased, while overall lifetime salvia use increased between 2006 and 2014. Participants aged 12 to 17 and 18 to 25 showed decreases in use of most types of hallucinogens, but those aged 26 and older generally showed increases. Read the full report here.

CDC clinical practice guideline for prescribing opioids for pain – US, 2022

The Centers for Disease Control and Prevention (CDC) recently released updated guidelines for clinicians providing pain care, including those who prescribe opioids for pain. The guidelines address the following four areas: 1) determining whether or not to initiate opioids for pain, 2) selecting opioids and determining opioid dosages, 3) deciding duration of initial opioid prescription and conducting follow-ups, and 4) assessing risks and addressing potential harms of opioid use. Read the guidelines here.

Continuing crisis: Drug overdose deaths in New York

The New York Office of Budget Policy and Analysis recently published a report concerning trends in drug overdose deaths in New York from 2010 to 2021. The report also provides projections for State and federal funding for prevention, treatment, harm reduction, recovery, and education programs. View the report here.

Opium cultivation in Afghanistan: Latest finding and emerging threats

The United Nations Office on Drugs and Crime (UNODC) has published a research brief on the cultivation of opium within Afghanistan since the takeover by the Taliban in August 2021. Key takeaways of the research brief include: a 32% increase in opium cultivation in Afghanistan over the previous year, as well as an increase in opium prices following the announcement of the cultivation ban in April 2022. Read the report here.


Drug maker Teva to pay over $500 million in New York drug case settlement

As part of a nationwide settlement, Teva Pharmaceuticals will pay up to $523 million to New York State after lawsuits alleged the company helped fuel the US opioid crisis. The funds are part of Teva's $4 billion-plus global settlement, with payments set to begin in 2023. Read the article here.

Join Virtual HealthStreet

Virtual HealthStreet is an online community of people who will periodically be asked to respond to confidential surveys on their lived experiences with drugs and information on new and emerging drugs. People with lived experience can help us garner a better understanding of emerging drug trends across the US and disseminate early warnings in near real time. Anyone over the age of 18 with lived experience with the use of drugs can participate. Please use the QR code above to sign up. To share this information with your network click here.

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