NDEWS Weekly Briefing readers wrote in to share their insight on shifts in the fentanyl supply, xylazine, and other drug-related trends in their area.

See what our readers had to say here in the full reader response report.

Are you aware of information NDEWS should know about related to substance use, overdoses (fatal or non-fatal), or other drug-related trends in your area? Share it via our submission form here!

In this State Report, NDEWS highlights opioid and non-opioid nonfatal overdose alerts for California from January 1 to October 31, 2024 . Alerts indicate days in which the number of nonfatal overdoses exceeds the expected number for that county. This expected count, or threshold, is calculated through biospatial, and accounts for population, seasonality, and other factors. Between January 1 and October 31, 2024, there were 30,275 opioid-involved nonfatal overdoses and 46,467 non-opioid-involved nonfatal overdoses identified by biospatial. The map above indicates the number of alerts for each overdose dispatch. Counties with three or more alerts during the reporting period are labeled.

Click here to read the full report.

Click here to read more about NDEWS Hotspot Alerts.

What is 7-OH? 7-hydroxymitragynine, or 7-OH, is an opioid-receptor binding alkaloid that occurs naturally in trace amounts in kratom leaves.

What was found? NDEWS has been consistently monitoring 7-OH since being alerted to it by Dr. Christopher McCurdy on June 21st 2024. Discussion concerning this substance has increased steadily since early May and is currently at an all-time high.

Previous reports:
      • August 16, 2024
      • June 21, 2024

How is it being discussed? Reddit users report that 7-OH provides subjective effects similar to prescription opioids. Some Reddit users report developing a dependence within just two weeks of use as well as severe and long-lasting withdrawal symptoms. Reddit users also report that single doses can be highly potent, and there are concerns about the safety and purity of 7-OH tablets as they may be cut with other substances. Many discussants report that they purchased 7-OH for chronic pain management. Commenters report ingestion methods that include liquid and tablet forms of 7-OH. Since the last web monitoring update, there have been increasing warnings from Reddit users about the differences between 7-OH and standard kratom products, including potency, respiratory depression, and increased withdrawal symptoms. There has also been increased discussion from Reddit users who employ 7-OH for chronic pain management based around concerns that 7-OH may become illegal.

Drug Terms: 7-hydroxymitragynine, 7-OH, 7HMZ, 7(omega)MZ

Click here to read more about NDEWS Online Monitoring.

The 2024 Novel Synthetic Drugs Threat Symposium presented by CFSRE and NPS Discovery was held as a hybrid symposium at the Science History Institute in Downtown Philadelphia from November 11 to November 13, 2024.

NDEWS Co-Investigator Dr. Bruce Goldberger was among the invited speakers of international experts who represented the latest work on novel synthetic drug pharmacology, laboratory approaches for early identification of new and emerging illicit substances, novel surveillance strategies for new drugs, harm reduction initiatives based on analytical drug checking data, and many other topics across ten panels.

In his presentation, titled "Cathinone Outbreaks in Florida," Dr. Goldberger discussed his research on the prevalence of N,N-Dimethylpentylone (DMP) in a case series from November 2021 – February 2024 in five Medical Examiner Districts in Florida. Of the cases submitted to the UF Forensic Toxicology Laboratory for analysis, 149 cases tested positive for DMP and/or its metabolite pentylone in the postmortem blood over the period of the study, which was done in collaboration with the Center for Forensic Science Research & Education (CFSRE) and NMS Labs. The talk also highlighted the trend of unique novel psychoactive substances (NSP) hotspots in the state of Florida, which includes newer trends concerning the recent reports of tusi ("pink cocaine"), rapid emergence of the stimulant N-isopropyl butylone, and emergence of carfentanil, ketamine, and nitazenes in decedents.

Other expert panelists at the symposium included NDEWS SAG member Dr. Barry Logan and NDEWS collaborator Dr. Alex Krotulski.

Learn more about Dr. Goldberger's work on identifying N,N-Dimethylpentylone (dipentylone) in postmortem forensic toxicology case series here.

Researchers from the Armed Forces Medical Examiner System’s Division of Forensic Toxicology published their results in the Journal of Analytical Toxicology. The study analyzed samples received between May 2020 and December 2023 from a combination of seized drug and toxicology results that mentioned blue lotus or valerian root. One-third of the products that had blue lotus as a listed ingredient contained synthetic cannabinoids, while all products featuring valerian root or calming root extract as listed ingredients contained synthetic cannabinoids. Read the article here for the most recently observed synthetic cannabinoids.

Rutgers University and Wayne State University researchers recently published a study in Drug and Alcohol Dependence titled “An examination of Black-White disparities in repeat nonfatal opioid overdose incidents, fatal drug overdose, and all-cause mortality in Detroit, Michigan.”

The study, which analyzed emergency medical services data linked to vital records to determine fatal drug overdose and all-cause mortality in Wayne County, Michigan, confirmed previous studies demonstrating that overdose incidents are increasing among older Black men. However, it also found that while Black individuals experienced a significantly greater number of nonfatal opioid overdoses than White individuals, they were 60% less likely to experience a fatal drug overdose. Meanwhile, all-cause mortality among Black individuals was approximately double that experienced by White individuals following a nonfatal opioid overdose.

Read the study here.

Researchers from The University of Sydney recently published an article in the International Journal of Drug Policy titled “Experiences of misuse and symptoms of dependence among people who use gabapentinoids: A qualitative systematic review.”

While gabapentinoids, such as pregabalin and gabapentin, were once thought to have a low potential for abuse, the review found a growing body of evidence of misuse and dependence worldwide. Many study participants reported that they were introduced to the drugs through a prescription from their doctor, often for off-label uses. Motives for misuse included getting high, self-medication, and substitution for other drugs, while symptoms of dependence included rapid development of tolerance and a severe withdrawal syndrome involving psychiatric symptoms.

Read the article here.

Photo credit: Viewfinder/Adobe Stock

NIDA Director Dr. Nora Volkow recently posted on her blog about NIDA’s efforts to improve meaningful community engagement in addiction research. NIDA is asking the National Advisory Council on Drug Abuse (NACDA) to assemble a working group of people who identify as having experience with substance use or a substance use disorder — as well as family members or caregivers of those who identify as such. NIDA is asking them to participate in the workgroup, which will meet virtually three or four times. Application statements are being accepted through January 10, 2025, and participants will be compensated for their time. Further information can be found here.

According to the DEA, nearly 630,000 lbs. of unused medications were turned in nationwide across 4,600 locations as part of the law enforcement agency’s biannual National Prescription Take Back Day, which was held on October 26.

More than 4,400 law enforcement partners participated in the event, which has resulted in the collection of 9,600 tons of unused medications to date in an effort to prevent the misuse of prescription medication.

Learn more about the program here.

Date: November 19, 2024, 4:30 – 6 p.m. EST

Location: Virtual

Learn more here. 

Organized by AIDS United, Black Harm Reduction Network, Drug Policy Alliance, Human Impact Partners, and the National Alliance of State & Territorial AIDS Directors (NASTAD), this webinar will feature experts who will share recent racial and ethnic trends in overdose mortality, including drug type, age, and gender variations.

Dates: January 13 – 17, 2025, 8:45 a.m. – noon ET daily

Location: Virtual

Learn more here. 

Date: December 5, 2024, 10 a.m. – 4:30 p.m. EST

Location: Virtual

Learn more here. 

Attendees will gain knowledge in how to strengthen seized drug analysis and reporting of drug-related substances; how the GUARDS method was developed and validated at the DEA Special Testing & Research Laboratory; how to adopt the GUARDS method at their laboratory; and how to confidently transition from helium to hydrogen as GC-MS carrier gas. 

You can share the NDEWS Weekly Briefing with friends, colleagues, and others who would benefit from information on recent and relevant news, articles, and data related to novel drug trends in the U.S. and globally by clicking here.

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If you miss or want to learn more about NDEWS Original Content, you can find our archived content on the NDEWS website:

     • NDEWS Hotspot Alerts using substance-related 911 EMS dispatch data
     • NDEWS Rapid Street Reporting (RSR) survey data reports
     • NDEWS Web Monitoring Team Reddit Alerts
     • NDEWS Sentinel Site Reports
     • Previous issues of the NDEWS Weekly Briefings

The Weekly Briefing is a newsletter published each week by the National Drug Early Warning System (NDEWS) Coordinating Center, which is funded by the National Institute on Drug Abuse (U01DA051126) to the University of Florida (PI: Cottler, Co-Is: Goldberger, Nixon, Striley), New York University (Deputy Director: Palamar), and Florida Atlantic University (Co-I: Barenholtz). Any item may be reproduced provided the source is acknowledged.