This Week’s Focus: NDEWS Early Warning in Action — Insights from the NDEWS Early Warning Network including Sentinel Sites Report and Rapid Street Reporting data

This week, the NDEWS Weekly Briefing focuses on our Sentinel Site Director (SSD) report and our newest Rapid Street Reporting (RSR) findings from our weekend visit to New York City, along with responses to our quarterly Medicolegal Death Investigator (MDI)-Network report.

NDEWS RSR is a monthly, venue-intercept study conducted across our national Sentinel Sites. RSR interviewers travel to sites on weekends to interview people about their use of substances in the past 12 months, including the frequency of use. The seven-minute interview covers common drugs as well as new psychoactive substances (NPS). With close to 8,000 participants surveyed to date, RSR complements traditional surveillance by capturing emerging trends in public settings.

Additionally, we highlight work from our NDEWS team and our Early Warning Network.

As always, we welcome your input.

The Rapid Street Reporting (RSR) team visited New York City from September 5th to 7th, 2025 and surveyed 239 individuals. After alcohol and marijuana for recreational use, the next most commonly reported substances used in the past 12 months were psilocybin (15.5%), powder cocaine (9.2%), delta-8 (7.9%), ecstasy/MDMA/Molly (7.9%) and poppers/nitrites (7.9%). Click here to read the full report.

Click here to read more about NDEWS Rapid Street Reporting.

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

As part of the July 2025 report, our Sentinel Site Directors reported on trends involving "pharmacological" adulterants, focusing on non-opioid sedatives, including those used in veterinary medicine, and local anesthetics (also known as “-caines”), along with other recent trends of note in their respective areas.

Below we have highlighted their insights on "pharmacological" adulterants-related trends. To read the full detailed report click here.

Click here to read more about NDEWS Sentinel Site Reports

The NDEWS Medicolegal Death Investigator (MDI)-Network encompasses those who are a part of the medicolegal death investigation system, including medical examiners/coroner (ME/C) or other staff affiliated with ME/C offices, such as toxicologists. These individuals offer a unique insight into identifying and monitoring novel psychoactive substances (NPS), combinations of drugs, patterns of use, adverse effects, and other consequences. In this quarterly survey, we collected general information (see above) and surveyed respondents on local drug-related trends, responses are anonymous and aggregated by reporting location. For the Summer 2025 report, we received 20 responses from 15 states, see their responses below addressing prevalence of fentanyl and sedatives in case work + other trends of note.

A recently published study in The Lancet Regional Health – Americas led by NDEWS Co-Director Joseph Palamar examined the illicit ketamine availability, use, and consequences of use. The study highlighted increases in nonmedical ketamine use among individuals aged 12 and older, ketamine-related poisonings, pharmaceutical diversions of undispensed ketamine, and law enforcement seizures. One decrease was found among 12th-grade students from 2000 to 2023, while the general population saw an increase. Read the full article here.

A recently published article in TIME, which features insight from NDEWS Co-Director Joseph Palamar and SAG member Alex Krotulski, explored the rise of nitazenes. The article describes nitazenes, discusses emerging trends, and explains the challenges with detection of the substance. Experts mention that nitazenes could potentially enter into the supply and replace fentanyl due to fentanyl being harder to find, more expensive and weaker, according to recent data. Read the full article here.

A recently published study in the Journal of Addiction Medicine, featuring NDEWS Sentinel Site Director Jeanmarie Perrone, used xylazine test strips (XTS) to detect xylazine in 85 urine samples. XTS demonstrated 86% sensitivity and 93% specificity using a XTS cutoff of 750 ng/ml that was previously established with synthetic urine samples. The study also produced six false negatives and three false positives, which suggests that XTS requires further refinement to achieve lab-quality performance. Read the full study here.

A new resource, developed by NDEWS Sentinel Site Director Dr. Caleb Banta-Green's team at the University of Washington's Addictions, Drug & Alcohol Institute, provides information on how to support and engage people who use stimulants in conversions about their health. The handout covers safer use tips, actions to improve health and treatment options. The guide can be accessed here.

A study in Substance Use & Addiction Journal, featuring NDEWS Sentinel Site Director Phillip Coffin, investigated the association between the perceived risk for opioid overdose and future overdose among opioid overdose survivors who used nonprescribed opioids. The key finding was that higher risk perception was associated with 2.65 times the adjusted odds of having a subsequent overdose compared to a lower risk perception. The study highlights the importance of incorporating risk perception assessments into opioid overdose prevention efforts to better prioritize and tailor prevention strategies. Read the full article here.

Are you committed to advancing the science of substance use and public health? The University of Florida’s NIDA-funded T32 Training Program offers predoctoral and postdoctoral scholars an exceptional opportunity to launch impactful research careers focused on NDEWS!

What We Offer:
- Interdisciplinary training at the intersection of addiction science, epidemiology, and surveillance
- Mentorship from leading UF faculty in epidemiology, public health, psychology, medicine, and more
- Hands-on research with landmark and important NIH-funded projects and access to rich data
- Career development support, including grant writing, publishing, and professional networking
- A collaborative, inclusive research community committed to reducing the burden of substance use

Eligibility:
- US citizens or permanent residents
- Interested in a PhD in Epidemiology, or early-stage postdoctoral fellows
- Demonstrated interest in substance use, addiction, or public health research

Location: Gainesville, Florida — a dynamic hub for scientific innovation with high quality of life and low cost of living.

📅 Date: Tuesday, September 23, 2025

🕑 Time: 12:00 pm - 1:00 pm ET

📍 Location: Online 

📅 Date: Thursday, September 25, 2025

🕑 Time: 4:30 pm - 6:00 pm ET

📍 Location: Online 

📅 Date: Friday, September 26, 2025

🕑 Time: 1:30 pm - 2:30 pm ET

📍 Location: Online 

📅 Date: Monday, September 29, 2025

🕑 Time: 3:00 pm - 4:00 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.

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