This Week’s Focus: NDEWS Hotspot Alert, Web Monitoring Report & Recently Related Substance Use Publications

This week’s NDEWS weekly briefing focuses on the most recent NDEWS Hotspot Alert, NDEWS Web Monitoring Report, and recent publications on related substance use.

The NDEWS Hotspot Alert highlights US counties with alerts for nonfatal opioid and non-opioid overdoses in the US from July 1 to 31, 2025, while the NDEWS Web Monitoring Report focuses on the first individual experience reports for MXE-PCP (MXPCP). MXPCP is a novel arylcyclohexylamine dissociative that combines structural elements from methoxetamine (MXE) and phencyclidine (PCP). Reddit commenters have expressed significant concern about a lack of human safety data for the substance.

Other updates in this week’s briefing include the report on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2024 National Survey on Drug Use and Health (NSDUH) and an update from the mass overdose event provided by the Baltimore City Mayor’s Office of Overdose Response.

This week, NDEWS highlights US counties with alerts for nonfatal overdoses involving opioids and non-opioids in July 2025. There were a total of 13 alerts from 13 different counties across eight states that had non-suppressed (greater than or equal to ten) EMS encounters. For the month of July, across all 13 alerts, a total of 156 EMS encounters for nonfatal drug-related overdoses were reported. The data shows that most counties with alerts were located in the western and the southeastern region of the US.

To view the entire Special Report from our Weekly Briefing, click here.

Click here to learn more about NDEWS Hotspot Alerts

Why are we reporting on this? The first individual experience reports for MXE-PCP (MXPCP) have emerged in online communities within the past month. Despite the recency, MXE-PCP posts were often in the top five most highly upvoted posts for many of our monitored substance use subreddits. Prior discussions consisted primarily of commenters theorizing about potential effects based on structural similarities to MXE and PCP. Public health concerns include the complete absence of safety data, unknown dosing parameters, confusion around nomenclature that could lead to dangerous mistakes, and the high NMDA receptor binding affinity of these compounds, suggesting potential for intense dissociative effects and possible neurotoxicity.

What is MXE-PCP? MXPCP is a novel arylcyclohexylamine dissociative that combines structural elements from MXE (methoxetamine) and PCP (phencyclidine). Reddit users report that this compound acts as an NMDA receptor antagonist, producing dissociative anesthetic effects.

Public Health Impacts Reddit discussants express significant concern about the complete lack of human safety data for MXPCP. Commentors report uncertainty about dosing, with experienced dissociative users recommending extreme caution. Some commenters mention that the high binding affinity suggests potential for intense and prolonged dissociative states. Limited harm reduction information is available, with commenters relying on extrapolation from ketamine and MXE experiences.

How is it being discussed? Reddit users report obtaining samples of MXPCP and planning to experiment with it, often mentioning it alongside other dissociatives they are acquiring. Discussants actively seek information about MXPCP's effects, dosing, and safety profile, but acknowledge the absence of established user reports or harm reduction guidelines. Some discussants mention planning to combine MXPCP with psychedelics, particularly 2C-series compounds, despite acknowledging the lack of safety data for such combinations. The compound is discussed in the context of commenters seeking novel dissociatives following the disappearance of MXE from the market.

Drug Terms: MXE-PCP, MXPCP, 3-MeO-2'-Oxo-PCP, MXP (this term was not part of the search due to it also being a term for another substance)

Click here to read more about NDEWS Online Monitoring.

A recent report by SAMHSA released the findings of the 2024 NSDUH. The detailed survey includes mental health, substance use, and access to treatment. Data indicate that this is the first time since 2020 that SAMHSA has gathered four straight years of comparable data, enabling meaningful trend analyses across key indicators. Read the full report here.

A recently published study in Drug and Alcohol Dependence by Bonar et al. describes baseline risk/protective factors related to opioid misuse among at-risk adolescents and young adults (AYAs). 1,155 people aged 16 to 30 years old who recently visited an emergency department and self-reported past-year prescription opioid use along with a risk factor for misuse and heroin or prescription opioid misuse were enrolled. Key factors differentiating AYAs who misused opioids from those at risk for future misuse included social determinants of health, other substance use, social support, and self-efficacy. Read the full article here.

A recently published study in Drug and Alcohol Dependence by Smith et al. aimed to determine whether xylazine enhances or prolongs the mu-opioid mediated discriminative stimulus effects of fentanyl. The study used male and female Long-Evans rats that were trained to discriminate the prototypical mu-opioid agonist, morphine, from saline. Substitution tests were conducted with fentanyl, xylazine, and fentanyl-xylazine combinations. The data gathered indicated that xylazine does not produce discriminative stimulus effects like prototypical mu-opioid agonists but prolongs the mu-opioid mediate discriminative stimulus effects of fentanyl. Read the full study here.

A recent letter to the editor in Addiction by Zheng Ng et al. discussed the acute psychiatric manifestations associated with e-cigarettes and highlighted testing methods that can be used to detect the presence of etomidate. Case reports documented severe psychiatric disturbances linked to etomidate-laced e-cigarettes, including aggression, agitation, mood lability, and suicidal behavior, amongst others. The authors noted that detecting recent etomidate is challenging but possible and discussed the methods such as targeted liquid chromatography–tandem mass spectrometry analysis. Read the full letter here.

The Emergency Department Drug Surveillance Program presented data on drug exposures from 2023 to 2024, compiled in collaboration 22 HCA hospitals across 12 states. The program has interactive data dashboards for each hospital that includes electronic health record extracts for emergency department visits involving adults 18 years of age and older. Read the full bulletin here.

An article in The Slice discussed a six-month investigation into the rise of nitazenes in a London borough, and what the area was doing to avoid an opioid crisis. Interviews were conducted with medical professionals, academics, politicians, and people with lived experiencet to establish the scale of the crisis and what strategies could be implemented to reduce deaths. Read the full article here.

As a follow-up to the Baltimore City mass overdose events (July 10 & 18), from previous briefings (July 18 & 25),  NDEWS is sharing information provided by the Baltimore City Mayor’s Office of Overdose Response. It was erroneously shared that the information came from the Washington/Baltimore High Intensity Drug Trafficking Area (HIDTA) sources. HIDTA put us in touch with the Mayor’s Office, and we thank them for their prompt response.

Testing results from samples taken from the area on the days of the events were collected by local harm reduction programs or from a study van from the Johns Hopkins School of Public Health, which has a mobile FITR machine that allows for community drug testing. The findings are being shared with community outreach teams and Syringe Service Programs as public health messaging.

The findings are being shared with community outreach teams and SSP programs as public health messaging. The samples tested from the July 10 event included high concentrations of N-Methyclonazepam mixed with fentanyl, which differs from presumptive testing done by HIDTA on scene. Finally, the samples tested from the July 18 event included a combination of fentanyl and quinine, which is fairly common in Maryland.

📅 Date: Wednesday, August 13, 2025

🕑 Time: 3:00 pm ET

📍 Location: Online 

📅 Date: Wednesday, August 20, 2024

🕑 Time: 1:00 pm - 2:00 pm ET

📍 Location: Online 

The NDEWS Weekly Briefing curates emerging data and findings from across the Early Warning Network, which includes three core components: our Scientific Advisory Group (SAG), comprised of national experts and federal partners; our Sentinel Site Directors (SSDs), who lead local surveillance in key geographic regions; and our Community-Based Health Experts, who provide on-the-ground insights from populations most impacted by drug trends. Together, these contributors generate timely, multidisciplinary and impactful information, ranging from peer-reviewed research findings to local surveillance data. These contributions inform public health and research communities.

More about The NDEWS Early Warning Network
- Issue 230: Early Warning in Action — Insights from the NDEWS Early Warning Network
- Issue 234: Early Warning in Action — Insights from the NDEWS Early Warning Network

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.

Share your research, news, and events through our submission form.

Share your comments on our newsletter through our feedback form.

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

Follow NDEWS on Twitter/X: @NDEWSnews

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), NYU Langone Health (MPI: Palamar), and Florida Atlantic University (Co-I: Barenholtz). Any item may be reproduced provided the source is acknowledged.