National Drug Early Warning System (NDEWS) Weekly Briefing


Characteristics of poisonings involving ketamine in the US, 2019–2021

In a recently published study by NDEWS investigators and RADARS collaborators, recent trends in adverse effects related to ketamine use were examined using US National Poison Control Center data. The study found that poisonings involving ketamine, although still rare, increased 81% from 2019 Quarter 1 through 2021 Quarter 4. Polydrug use, especially the use of ketamine with opioids or GHB, appeared to be a particular risk factor for more serious adverse effects. Read the study here.

Alert from the NDEWS Web Monitoring Team: Increases in online mentions of FXE

What was found? In November 2022, "FXE" became the second most highly mentioned drug term in drug Subreddits, behind "fent". Mentions of fluorexetamine and FXE reached a new peak in December 2022. The trend of fluorexetamine mentions began in Summer/Fall 2021 and has grown from dozens to hundreds of mentions per month in 2022.

What is Fluorexetamine? Fluorexetamine is a dissociative NPS of the arylcyclohexylamine family.

How is Fluorexetamine being discussed? Fluorexetamine is most often abbreviated as FXE on Reddit. Commenters describe the effects of FXE as similar to ketamine. Recent comments continue to report mania as an effect of FXE.

Drug Terms: Fluorexetamine, FXE, Ketamine.

Please note the dotted line above indicates when an alert was last published on this drug by the Web Monitoring Team.

What was found? Online mentions of ketamine began to increase in Summer 2021, at the same time as the emergence of mentions for fluorexetamine (FXE).

What is Ketamine? Ketamine is a dissociative anesthetic used recreationally.

How is Ketamine being discussed? Subreddit commenters discuss ketamine use in both recreational settings and for depression treatment.

Drug Terms: Ketamine, Fluorexetamine, FXE.

NDEWS Rapid Street Reporting: Rates of past 12-month reported ketamine use by order of visit (November 2021–November 2022)

NDEWS Hotspot Alerts December 17, 2022: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week's NDEWS Hotspot Alert​s ​report ​includes 23 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. View the full report hereClick here to read more about NDEWS Hotspot Alerts.


UNODC Global SMART Update 2022, Vol. 27

The United Nations Office on Drugs and Crime (UNODC) recently published a Global SMART Update on the expansion of novel forms of presentation of drug products containing ketamine, such as "happy water," "k-powdered milk," and "tuci" ("pink cocaine"). Read the report here.

Exploring potential bellwethers for drug-related mortality in the general population: A case for sentinel surveillance of trends in drug use among nightclub/festival attendees

A recently published study led by NDEWS Co-Investigator Dr. Joseph Palamar examined use among nightclub/festival attendees to explore whether this population can serve as a potential indicator for use-related mortality in the general population. Read the study here.

Recreational use of nitrous oxide – a growing concern for Europe

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) recently published a which examines the current situation, risks, and responses to the recreational use of nitrous oxide in Europe. Read the report here.


Columbia's infamous 'pink cocaine' is on the rise in Europe

A recently published VICE World News article reports on the "pink cocaine" drug known to buyers as "tusi." The drug, which is alleged to be a mix of ketamine, MDMA, and pink food coloring, has been increasingly seized by authorities in Europe and Spain. Read the article here.

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