National Drug Early Warning System (NDEWS) Weekly Briefing

NEW PSYCHOACTIVE SUBSTANCES (NPS)

New paper on fentanyl analogs in Italy: Multi-analytical characterization of 4-fluoro-furanyl fentanyl in a drug seizure

According to a paper published this week in Forensic Chemistry, two different fentanyl derivatives were identified in a seizure that took place in Italy. The white powder seized contained both isobutyrylfentanyl and 4-Fluoro-Furanylfentanyl (4F-FuF). 

While the first compound had been reported in previous seizures, 4F-FuF was an unexpected compound. According to the authors, "several analytical techniques have been used for its characterization, and the spectra obtained have been collected in a single paper, with the aim of providing to the scientific community tools to facilitate the identification and differentiation of 4F-FuF from other fentanyl derivatives with similar structures." Read the full article here.

Serious health incidents related to MDMB-4en-PINACA and other synthetic cannabinoids in New Zealand

An alert was released this week regarding a number of serious health incidents involving synthetic cannabinoids in New Zealand. The Institute of Environmental Science and Research (ESR) identified MDMB-4en-PINACA, 5F-MDMB-PICA, and a metabolite of MMB-2201 in the forensic analysis of several "serious harm events" and toxicological samples. Read the alert here.

RECENTLY PUBLISHED

Two new NCHS data briefs: Rates of alcohol-induced deaths in urban and rural areas in the US from 2000–2018, and increase in drug overdose deaths involving cocaine in the US from 2009–2018

The National Center for Health Statistics (NCHS) released two new data briefs this week on alcohol-induced deaths as well as drug overdose deaths involving cocaine using mortality data from the National Vital Statistics System. 

In the first data brief, which presents trends in alcohol-induced death rates from 2000 through 2018 by sex and urbanization level, researchers found that rates increased at a greater rate between 2000 and 2018 in rural areas compared with urban areas for both males and females aged 25 and over. Read the full brief here

The second data brief examines trends in cocaine-involved drug overdose deaths by sex, age group, race and Hispanic origin, concurrent involvement of opioids, urbanicity, and Census region from 2009 through 2018. Researchers found that the rate of drug overdose deaths involving cocaine "was stable between 2009 and 2013, then nearly tripled from 1.6 per 100,000 in 2013 to 4.5 in 2018." Read the full brief here

Steep increases in fentanyl-related mortality west of the Mississippi River: Recent evidence from county and state surveillance

An article recently published in Drug and Alcohol Dependence used publicly available fentanyl death data to examine changes in fentanyl-related mortality in the western US from 2018 to 2020. All seven jurisdictions included in the study reported increased fentanyl deaths over the study period, with available 2020 data showing an increase of 63 percent over 2019. The authors note that "fentanyl has spread westward, increasing deaths in the short-term and threatening to dramatically worsen the nation’s already severe opioid epidemic in the long-term." Read the full article here.

New UNODC Global SMART Update released

The United Nations Office on Drugs and Crime (UNODC) recently published a new Global SMART Update concerning the complexity of the global opioid crisis. The report describes the "emergence of a new generation of synthetic opioids" and the challenges involved in responding to the synthetic drugs market. The authors conclude that the emergence of these substances "underscores the importance of strengthening early warning systems, expanding public-private partnerships, and enhancing existing legal approaches to respond to the growing complexity of the opioid crisis." Read the full report here.

IN THE NEWS

CDC Health Alert: Recent HIV clusters and outbreaks across the US among people who inject drugs and considerations during the COVID-19 pandemic

The CDC released a new health alert this week to make public health departments and clinicians aware of several HIV clusters and outbreaks which have occurred primarily among people who inject drugs (PWID). The alert notes that the COVID-19 pandemic has complicated the delivery of essential services for PWID, "potentially hindering further efforts to address the increase in HIV transmission." Read the full health alert here.

DEA maintains placement of crotonyl fentanyl in Schedule I of the Controlled Substances Act with final order

The DEA has issued a final order regarding the placement of crotonyl fentanyl ((E)-N-(1-phenethylpiperidin-4- yl)-N-phenylbut-2-enamide) in Schedule I of the Controlled Substances Act (CSA), effective October 2, 2020. Crotonyl fentanyl received a temporary scheduling order in February 2018 as a fentanyl-related substance. The National Forensic Laboratory Information System (NFLIS) has recorded 143 reports involving crotonyl fentanyl since its first report in June 2017. Read the final order published in the Federal Register here.

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