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View the NDEWS Weekly Briefing Issue 276 ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏
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This Week’s Focus: NDEWS Early Warning in Action — Insights from the NDEWS Early Warning Network including Sentinel Site Directors Report
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The NDEWS Weekly Briefing focuses on our Sentinel Site Directors (SSD) report, which highlights trends involving carfentanil in the local drug supply. This report revisits earlier NDEWS findings from the May 2025 SSD report in addition to our most recent findings from our latest NDEWS Special Report that was published in Issue 271.
Additionally, we feature our NDEWS Funeral Directors Network Winter 2026 Quarterly Report. For this report, we collected insight on the number of calls taken and shifts in the caseloads from the Funeral Directors Network over the past 6 months.
As always, we welcome your input.
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Sentinel Site Directors Report: Trends involving carfentanil in the local drug supply
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Our Sentinel Site Directors were recently asked about trends involving carfentanil in the local drug supply. This report represents a follow up of the May 2025 SSD report on carfentanil featured in Issue 240 of the NDEWS Weekly Briefing.
At that time, there were sporadic reports of carfentanil detections across the US signaling a possible reemergence of the fentanyl analog. Similar reports have continued into this year, which we explored more recently in February's Issue 271 of the NDEWS Weekly Briefing. While its prevalence is rarer in some places than others, all site directors (n=14) noted presence of carfentanil in the current report. Click here to see the overview in full.
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Responses from Sentinel Sites in the Western region of the US
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Responses from Sentinel Sites in the Midwest region of the US
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Responses from Sentinel Sites in the Southern region of the US
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Responses from Sentinel Sites in the Northeastern region of the US
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Other trends reported by Sentinel Site Directors
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San Francisco, CA: Phillip Coffin, MD, MIA Overall trends suggest that San Francisco witnessed a spike in mortality in 2023, which returned to previous (2021 or 2022) levels in 2024 and has remained there since that time, through January 2025.
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San Diego, CA: Annick Bórquez, PhD Recently there have been multiple law enforcement drug seizures in the local area which might affect the unregulated drug supply including methamphetamine and one that consisted of multiple drugs as reported by the DEA: 60,000 counterfeit Adderall pills, 550,000 vape cartridges, 270 pounds of concentrated butane hash oil (BHO) extracts, 88 pounds of cannabis, 4 kilograms of cocaine, 50 pounds of psilocybin mushrooms, and 22 pounds of ketamine and tusi (also known as 'pink cocaine').
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Nebraska: Patrick Habecker, PhD Lincoln wastewater surveillance indicated an increase in medetomidine in late January through early March that has since returned to baseline by mid-March. Participants in our cohort study continue to report highly variable consistency and potency of the substances in the drug supply. They have also reported frequent concern about fentanyl in the local methamphetamine supplies and a few concerned about cocaine mixtures. Reports about concern about xylazine being mixed into supplies increased around the same time that the city detected medetomidine in the wastewater system. Our current interview does not specifically ask bout medetomidine so the xylazine reports may actually be attributed to medetomidine.
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St. Louis, MO: Heidi Israel, PhD, FNP, LCSW, CCRG Most of the substances available have multiple drugs in them. At the end of 2025 most fatal overdoses had multiple drugs in the decedents. While overdoses may be described as fentanyl or other opioids, symptoms for many atypical.
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Texas: Dayong Lee, PhD Fentanyl continues to be the primary synthetic opioid detected in both seized drug cases and drug‑overdose deaths. However, according to Texas Health Data, fentanyl‑related deaths statewide decreased by 37% over a 12‑month interval when comparing 10/01/2023–09/30/2024 to 10/01/2024–09/30/2025. Over the same period, the overall number of unintentional drug‑related deaths in Texas decreased by 20%.
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Matthew Myers, MS, MPA
Minor shifts in trends over Q1, nothing novel or prominent aside form the downshift in fentanyl.
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Florida, Bruce Goldberger, PhD A new cathinone identified in the state of Florida in toxicology samples: N-isopropyl butylone.
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New York City, NY: Ellenie Tuazon, MPH NYC Drug Checking provisional drug checking dashboard can be viewed here. Fentanyl positive cases are stable, representing over 80%.
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Funeral Directors – Network Quarterly Report, Winter 2026: Anecdotes from the field (4 responses, across 4 states)
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The tables below provide insight on the number of calls taken and shifts in the caseloads from the Funeral Directors network over the past 6 months. The type of geographic jurisdiction respondents work in evenly split with 50% working in urban areas, while the other 50% working in mix of urban and rural.
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Drug positivity, co-detection patterns, and demographic predictors in patients seeking substance use disorder treatment, United States, 2023
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A recently published study in Addictive Behaviors led by Joohyun Park, co-authored by NDEWS Co-Investigator and Sentinel Site Director Bruce Goldberger, examined drug positivity, co-detection patterns, and demographic associations across 14 drug categories in patients seeking substance use disorder (SUD) treatment. The cross-sectional study analyzed 2023 urine drug testing data from 99,224 patients and screened for 14 drug categories. This study highlights variations in substance presence and co-detection across 14 drug categories in SUD treatment patients. Click here to read the full study.
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Join the UF T32 Training Program in Substance Abuse and Public Health as a Pre or Postdoc! Work with the NDEWS Team!
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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.
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UPCOMING WEBINARS & EVENTS
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Dear friends of NDEWS,
Have you ever been to a College on Problems of Drug Dependence meeting? If not, you are missing an opportunity to learn about drugs from the bench to the community. Many of us have made lifelong friends by attending the annual meeting. This year, the conference will be in delightful Portland, Oregon! If you have never been before and want to learn more about the meeting and organization, click here.
We’d also love to see you at the NDEWS Summit on June 13, at 2 pm.
We hope to see you there!
The NDEWS team
Register for CPDD here.
📅 Date: Saturday, June 13, 2026
🕑 Time: 2:00 pm - 6:00 pm PT
📍 Location: Oregon Convention Center & Hyatt Regency Portland
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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.
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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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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.
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