Our Sentinel Site Directors are an integral part of NDEWS. They inform us of signals of drug use in their local areas and sometimes for their state. Each month we send the Sentinel Site Directors questions that are of interest to the field or questions that are either suggested by them or our NDEWS team. Occasionally readers of our briefing will also suggest questions.

In this briefing, we are sharing the responses from our Sentinel Site Directors about notable trends in drug use from 2024 as well as any other relevant information.

We are always looking for YOUR input. You may have questions of your own that you would like answered or you may want to express interest in becoming a Sentinel Site Director. 

The NDEWS Early Warning Network comprises Sentinel Sites spanning urban, suburban, and rural areas in the US. They regularly collect community-level indicators of drug use, morbidity, and mortality.

In March 2025, we surveyed our Sentinel Site Directors and asked them to report on substance use, overdoses (fatal or nonfatal), or other drug-related trends in their respective areas.

Click here to read more about NDEWS Sentinel Site Reports

As a follow up to the last week’s briefing on Medetomidine and Xylazine, we are alerting our readers to this important webinar.

📅 Date: Wednesday, April 23, 2025

🕑 Time: 12:00 pm ET

📍 Location: Online

Learn more here.

 A recently published analysis in The Lancet Regional Health – Americas by Escobar et al. examined U.S. county-level substance use disorder mortality from 2005 to 2020 using Kulldorff’s spatial scan statistics. The study identified 27 significant spatiotemporal clusters of elevated mortality, with the epicenter of the SUD epidemic shifting from the western to eastern U.S. around 2016—coinciding with the rise of synthetic opioids like fentanyl. Mortality rates within clusters were nearly double those outside, averaging 25.94 per 100,000 person-years. Urban counties were more frequently affected in the East, while rural counties were more commonly clustered in the West.

Read the study here.

A recent New York Times report by Jan Hoffman highlights a sharp rise in methamphetamine use in Portland, Maine, as fentanyl supply declines. The article documents a shift toward high-purity, cartel-produced methamphetamine, sometimes associated with severe psychiatric effects including hallucinations, paranoia, and violent behavior. Unlike opioids, there is no overdose reversal medication for meth. In 2023, nearly 35,000 U.S. overdose deaths involved stimulants, marking an 870% increase since 2013. In Maine, meth-involved deaths rose from 12 in 2013 to 194 in 2023, signaling a growing stimulant-driven public health crisis. 

Read the article here.

You are invited to attend the NDEWS Summit at the College on Problems of Drug Dependence (CPDD) 87th Annual Scientific Meeting on Saturday, June 14th (06/14/2025) from 4:00 pm -6:00 pm CT in Bayside Ballroom AB, 4th floor. The Summit will be open to all CPDD meeting attendees. 

We hope to see you there!

NDEWS Posters and Presentations at CPDD

In June, the NDEWS team will be traveling to attend the 87th College on Problems of Drug Dependence (CPDD) Annual Meeting in New Orleans, Louisiana. Along with posters, the NDEWS team will be presenting a late-breaking abstract, an oral presentation and two invited symposia. We invite you to join us for these presentations. Please find the presentation information below:

Sunday, June 15
3:30 pm - 4:45 pm CT Late-Breaking Abstract
Anesthetics (“-Caines”) Adulterate the Illicit Fentanyl Supply: A National Drug Early Warning System (NDEWS) Alert
Joseph Palamar, Joshua DeBord, Alex Krotulski, Bruce Goldberger

5:00 pm - 6:30 pm CT Poster Session 1 (Napoleon Ballroom CD, 3rd Floor)
Trends in Nonfatal Fentanyl Poisonings Involving Stimulants in the United States, 2015–2023
Nicole Fitzgerald, Joshua Black, Linda Cottler, Silvia Martins, Joseph Palamar

Monday, June 16
10:45 am - 12:15 pm CT Invited Symposium
Found in Translation: Coordinated Preclinical, Human Laboratory and Epidemiological Approaches to Understanding Polydrug Use
William Stoops, Lori Knackstedt, Linda Cottler, Christa Corley

3:30 pm - 4:30 pm CT Oral Session: Sex Matters: Translational Evaluations of Sex-Specific Factors in Substance Use
Sex Differences in Problematic Substance Use, Mental Health, and Social Determinants of Health among Middle-Aged and Older Adults in the All of Us Research Program
Vijaya Seegulam, Bia Whipp, Liva LaMontagne, Linda Cottler

5:45 pm - 7:15 pm Poster Session 2 (Napoleon Ballroom CD, 3rd Floor)
Natural Language Processing Analysis of 7-Hydroxymitragynine Reddit Discussion
Daniel Van Zant, Kirsten Smith, Oliver Grundmann, Catherine Striley, Elan Barenholtz, Christopher McCurdy, Linda Cottler

Tuesday, June 17
3:45 pm- 4:45 pm CT Mini Symposium: The Current Landscape of Medical and Recreational Ketamine Use
Shahar Almog, Meredith Berry, Joseph Palamar 

5:30 pm - 7:00 pm CT Poster Session 3 (Napoleon Ballroom CD, 3rd Floor)
Reported Use of Recreational and Medical Cannabis, Delta-8, and Delta-10: Findings from NDEWS Sentinel Sites and Hotspots (2022–2023)
Tamara Millay, Vijaya Seegulam, Monica Bhargavi Kodali, Linda Cottler

Wednesday, June 18
2:00 pm - 3:30 pm CT Poster Session 4 (Napoleon Ballroom CD, 3rd Floor)
Alcohol Polysubstance Use among past 30-Day Opioid Users in Northern Florida: A Model for Back Translational Research
Christian Conger, Linda Cottler

📅 Date: Wednesday, April 30, 2025

🕑 Time: 2:00 pm ET

📍 Location: Online

Learn more here.

📅 Dates: May 29 - May 30, 2025

📍Location: UF Academic and Research Center at Lake Nona, Orlando, FL

Learn more here.

📅 Dates: June 2 - 4, 2025

📍 Location: University of Puget Sound, Tacoma, WA

Learn more here.

📅 Date: Thursday, June 12, 2025

🕑 Time: 12:00 pm ET

📍 Location: Online

Learn more here.

📅 Date: Friday, June 20, 2025

📍 Location: New Orleans

Learn more here.

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 US and globally by clicking here.

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For more information on NDEWS' efforts, visit our website.

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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 EMS 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 (MPI: Cottler (contact), Co-Is: Goldberger, Nixon, Striley), New York University (MPI: Palamar), and Florida Atlantic University (Co-I: Barenholtz). Any item may be reproduced provided the source is acknowledged.