In this week’s report, NDEWS highlights observations from biospatial detailing
the utilization of naloxone among fentanyl-involved nonfatal overdoses. Among counties with at least 75% coverage, the ten with the highest rate of nonfatal fentanyl overdose dispatches per 10,000 population are shown above. The table shows the percent of the time naloxone was administered among the ten counties with the highest rate of nonfatal fentanyl overdose dispatches per 10,000 population. 

Click here to read the full report.

What is N-ethylpentedrone? N-ethylpentedrone, also known as NEP, is a synthetic psychoactive chemical in the substituted cathinone class. N-ethylpentedrone is the N-ethyl analog of pentedrone. 

What was found? Analysis of online discussions indicates that interest in and use of N-ethylpentedrone has been on a consistent upward trend since February.  

Previous reports:
      • August 30, 2024
      • May 19, 2023  

How is it being discussed? Online discussions describe N-ethylpentedrone as a euphoric stimulant with a short duration of action, typically lasting only a few hours. Reddit users report that snorting is the preferred route of administration due to higher bioavailability compared to oral use or vaping. Some undesirable effects mentioned include multi-day periods of nasal irritation, breathing difficulties, multi-day periods of wakefulness, and extreme hyperfocus, especially when redosing. Some discussants report insomnia and depressive symptoms upon cessation of use. Some conversation focuses on mixing N-ethylpentedrone with depressants like benzodiazepines to ease comedowns and reduce compulsive redosing. Since the last web monitoring report there has been dramatically increased discussion concerning the potential “addictive qualities” of N-ethylpentedrone.

Drug Terms: N-ethylpentedrone, NEP, α-EAPP, α-ethylamino-valerophenone, N-ethylnorpentedrone 

Click here to read more about NDEWS Online Monitoring.

Jim Hall, BA, a retired epidemiologist who worked for 20 years at Nova Southeastern University in Davie, Florida, recently sat down with NDEWS to share his experience serving as the Florida representative to the NIDA Community Epidemiology Work Group (CEWG), the predecessor to NDEWS. Hall, a member of the Scientific Advisory Group for NDEWS, also shared his thoughts on the value of NDEWS to the field of epidemiology and discussed how the data published in the NDEWS Weekly Briefing is used by the United Way of Broward County’s Commission on Behavioral Health and Drug Prevention, where he previously served as a consultant.

Read the Q&A here. 

NDEWS Sentinel Site Director Annick Bórquez, PhD, and colleagues, recently published a study in Addiction titled “Early detection and prediction of non-fatal drug-related incidents and fatal overdose outbreaks using the Farrington algorithm.”

Using county-level data containing fatal overdoses and non-fatal overdose counts that were collected between 2015 and 2021 in California and Florida, the study found that aberration detection methods were useful in supporting the early detection of fatal drug overdose outbreaks, especially when assessing data from multi-county regions rather than single counties. The study also determined that early detection is improved when multiple methods are used in conjunction.

Read the study here.

NDEWS Sentinel Site Director Jeanmarie Perrone, MD, and colleagues, recently published a report in JAMA Dermatology, titled “Wound Characteristics Among Patients Exposed to Xylazine,” that may help identify xylazine exposure and guide research on the cause and management of associated wounds.

The study reviewed 59 wounds among 29 hospitalized patients with confirmed xylazine exposure, finding that wounds were commonly located on the extensor surfaces of limbs. Chronic wounds were more likely to be larger and feature necrotic tissue, suggesting that untreated wounds might progress from small multifocal blisters into larger confluent areas of dead tissue.

Read the study here.

The National Safety Council, a nonprofit organization that promotes safety, reported that emergency medical services were activated 42,393 times between 2022 and 2023 for nonfatal workplace overdoses. Additionally, naloxone, the opioid overdose reversal medication, was used in 66% of these activations. The data, published as part of the nonprofit’s annual statistical report Injury Facts, was obtained from the National Emergency Medical Services Information System (NEMSIS). The reported incidents involved both employees of organizations and members of the public.

Read the report here.

The Substance Abuse and Mental Health Services Administration’s (SAMSHA) Drug Abuse Warning Network (DAWN) recently published it’s Network Watch report, which tracks emerging drug street names collected from emergency department health records related to recent substance use. The report lists 15 drug street names that first appeared in its data between January 2023 and August 2024. The new terms included Tranq (xylazine), Monkey Dust (synthetic cathinones), Fetty and Freddy (fentanyl), and Q-ball (cocaine with quetiapine).

Download the report here.

Preliminary data from the Centers for Disease Control and Prevention (CDC) reveals a 14.5% decrease in fatal drug overdoses over the 12-month period ending in June 2024 compared to the previous year. Approximately 97,000 fatal overdoses occurred during this period, down from 113,000 in the prior 12 months and continuing a downward trend that began in September 2023. While overdose deaths decreased in 45 states, five states saw increases — Alaska, Nevada, Oregon, Utah, and Washington.

View the data here.

The Centers for Disease Control and Prevention (CDC) has updated its Nonfatal Overdose Emergency Department and Inpatient Hospitalization Discharge Data dashboard, known as the DOSE Discharge Dashboard, to include national nonfatal drug overdose data from 2018 to 2023. The CDC also announced plans for additional improvements to the dashboard over the next 3 to 6 months.

Additionally, the Fentalog Study dashboard, which provides estimates of substances detected in samples from patients involved in suspected opioid overdoses at participating sites, has been updated to include data from February 2020 to August 2024. Furthermore, the Overdose Prevention website has been updated to reflect 2023 retail pharmacy prescription data.

The U.S. Drug Enforcement Administration (DEA) announced a significant decrease in the potency of fentanyl pills for the first time since 2021. According to the latest DEA laboratory testing, only 5 out of 10 fentanyl pills tested in 2024 contained a potentially lethal dose, down from 7 out of 10 pills in 2023. This reduction in potency marks progress in the fight against fentanyl, which has been a key focus of DEA’s efforts. The announcement was made at the Third Annual National Family Summit on Fentanyl, a two-day event held in Washington, D.C., where families impacted by fentanyl overdose and poisoning gathered to collaborate with the DEA in combating the fentanyl crisis.

Read the article here. 

Date: Monday, November 25, 2024, 9 – 10 a.m. EST

Location: Virtual

Learn more here. 

Date: Tuesday, December 3, 2024, noon – 4 p.m.

Location: Virtual

The goal of this virtual workshop is to bring together research communities in the forefront of leveraging geospatial data in drug use and addiction research and inspire new directions in methodology and advancing practice.

Learn more here. 

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

Location: Virtual

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. 

Learn more here. 

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

Location: Virtual

This year’s symposium, which features presentations by scientists from academia, government, and industry, will focus on knowledge, best practices, and advances in science that can help improve effectiveness and efficiency.

Learn more 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.