National Drug Early Warning System (NDEWS) Weekly Briefing


Seeking information on the synthetic opioid etonitazepyne

According to the NDEWS Web Monitoring Team, led by Dr. Elan Barenholtz at the Machine Perception and Cognitive Robotics (MPCR) Lab at Florida Atlantic University, online discussion of the synthetic opioid etonitazepyne on the social media platform Reddit emerged for the first time in December 2020 and has continued to grow in January 2021.  

Etonitazepyne belongs to a class of benzimidazole opioids that also includes the Schedule I drug etonitazene. Etonitazepyne was recognized as a potentially relevant drug keyword through algorithmic monitoring of ~80 drug-oriented subreddits. Mentions were quantified and aggregated by week to obtain a relative metric of discussion over time (see graph above). Etonitazepyne is currently listed for purchase on multiple web-based drug marketplaces. While little is known about its potency, online mentions of the drug include self-reported overdoses.

The location and demographic makeup of discussion participants and potential for harm cannot be determined from this preliminary metric. Thus, information should be matched to trends in real-world data to evaluate the relevance of the potential emergence of etonitazepyne and related NPS opioids.

Have you heard anything about etonitazepyne? Let us know here.


Comparing actual and forecasted numbers of unique patients dispensed select medications for opioid use disorder, opioid overdose reversal, and mental health during the COVID-19 pandemic in the United States, January 2019 to May 2020

A study published in Drug and Alcohol Dependence assessed dispensing of select substance use and mental health medications during the pandemic in the US. The study found that numbers of dispensed antidepressants and benzodiazepines were significantly above forecasted estimates in March 2020. Read the full study here.


Quarterly trends in past-month cannabis use in the United States, 2015-2019

NDEWS Co-Investigator Dr. Joseph Palamar and his team published a study in Drug and Alcohol Dependence estimating quarterly trends in cannabis use in the US. The research sought to understand seasonal variation of use using data from the National Survey on Drug Use and Health. The authors found that the prevalence of cannabis use dips early each year and then increases throughout the year, independently of annual increases. Read the article here.

The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017

Another study published in Drug and Alcohol Dependence analyzed the costs of the opioid epidemic and estimated the societal costs for opioid use disorder and fatal overdose from all opioids in 2017. Costs for opioid use disorder and fatal opioid overdose in 2017 were estimated to be $1.02 trillion. The majority of the economic burden was due to reduced quality of life from opioid use disorder and the value of life lost due to fatal opioid overdose. Read the study here.

Buprenorphine physician-pharmacist collaboration in the management of patients with opioid use disorder: results from a multisite study of the National Drug Abuse Treatment Clinical Trials Network

A study published in Addiction investigated the feasibility and acceptability of a new collaborative care model involving buprenorphine-waivered physicians and community pharmacists. The study found high rates of treatment retention and adherence and concluded that the collaborative care model for people with opioid use disorder appears to be feasible to operate in the US, with high acceptability among patients. Read the full study here.


HHS expands access to treatment for opioid use disorder by eliminating X-waiver requirement for DEA-registered physicians 

The US Department of Health and Human Services (HHS) announced yesterday that it is lifting the X-waiver requirement for DEA-registered physicians to prescribe buprenorphine for opioid use disorders. According to the press release, this policy change is in response to the more than 83,000 drug overdose deaths that occurred in the US in the 12 months ending in June 2020, the highest number of overdose deaths ever recorded in a 12-month period, which highlights the need for access to and availability of medication-assisted treatment for opioid use disorder. An interagency working group will monitor the results of these new practice guidelines. Read more here. 

CBP, FDA seize counterfeit, unauthorized e-cigarettes

The FDA issued a news release this week that announced that the agency, in collaboration with US Customs and Border Protection (CBP), seized 33,681 units of counterfeit e-cigarettes. Officers and agents were looking to intercept counterfeit or other violative e-cigarettes that did not meet the Federal Food, Drug, and Cosmetic Act (FD&C Act) requirements. In fiscal year 2020, CBP seized 93,590 units of e-cigarettes that did not meet US federal regulations. Read the press release here.


NDEWS is currently recruiting for a NIDA T32 Postdoctoral Fellow, available immediately. Visit this link to apply.

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