National Drug Early Warning System (NDEWS) Weekly Briefing


NDEWS Hotspot Alerts December 29 – January 4: Opioid, heroin, methamphetamine, and non-opioid 911 dispatches

This week's NDEWS Hotspot Alert​s ​report ​includes 33 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.

Alert from the Web Monitoring Team: Online mentions of tianeptine

An alert on tianeptine was previously included in our last issue using our drug term classifier for the month of November. This week's alert combs through all historical comment data using additional drug terms that were not included in our initial alert.

What was found? The drug has had consistent discussion online with a historical peak in March 2022. The trend has fluctuated quite dramatically from month to month, but the overall growth has been a steady uptick in mentions over time since early 2020.

What is Tianeptine? Tianeptine is a tricyclic antidepressant that is capable of mimicking the effects of opioids.

How is Tianeptine being discussed? Tianeptine is often referred to as 'Zaza' online. Commenters describe the effect of tianeptine as similar to opioids at high doses, and as an antidepressant at lower doses. Recent comments warn of overdosing as well as potential for addiction with repeated use.

Drug Terms: Tianeptine, zaza red, gas station heroin, tianna, td red, pegasus

Quote on tianeptine from our Atlanta, GA Sentinel Site Director

"Last month, I reported little to no activity with tianeptine in this area. Georgia has considered this to be a Schedule I drug since July 1st. However, in the last month, I have become aware of a few investigations actively pursuing gas stations who are continuing to illicitly sell 'Zaza' from behind the counter. Some user reports describe it as highly addictive and costly. The recent limitation in supply (due to being scheduled) has required users to go from place to place (mostly head shops and gas stations) looking for who still has it available."

- Matt Myers, Assistant Chief of Police, Peachtree City Police Department


‘Gas station heroin' was just banned in another state

On December 22, 2022, Ohio Governor Mike DeWine signed an executive order to suspend the normal rulemaking process to allow the State of Ohio Board of Pharmacy to consider all products containing tianeptine as a Schedule I controlled substance. Vendors and consumers who violate the ban face penalties that range from mandated drug treatment, fines, or 6 to 12 months of jail time. This makes Ohio the fifth state to ban the drug. Read the article here. Read the news release here.


NPS Discovery: N-desethyl isotonitazene new synthetic opioid identified in the US

NPS Discovery announced the identification of a newly identified novel psychoactive substance, N-desethyl isotonitazene, which is classified as a synthetic opioid. Read about its structure and appearance, among other details, here.


Schedules of controlled substances: Temporary placement of etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam in Schedule I of the Controlled Substances Act

The Drug Enforcement Administration published a temporary order to schedule five synthetic benzodiazepine substances in Schedule I of the Controlled Substances Act effective December 23, 2022. The five substances include etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam. Read the full scheduling here.

The increase in benzodiazepine-laced drugs and related risks in Canada: The urgent need for effective and sustainable solutions

A recently published study in the International Journal of Drug Policy describes the increase in benzodiazepine-laced drugs and related risks in Canada. The authors note the need for policies that address the evolving overdose epidemic, including increased knowledge and education on specific harms of opioid and benzodiazepine co-use, increases in harm reduction measures, and the elimination of the toxic drug supply. Read the full article here.

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