Please submit any information concerning shifts in the fentanyl market supply dynamics in your area here.

This week's NDEWS Hotspot Alerts report shows counties with higher-than-expected EMS alert counts for nonfatal methamphetamine-, opioid-, and non-opioid-involved overdoses between October 8 – 14, 2024. During this time span, there were 230 alerts across 13 states and 31 counties.

Click here to read the full report.

Click here to read more about NDEWS Hotspot Alerts.

What is 2-MMC? 2-Methylmethcathinone (2-MMC) is a substituted cathinone derivative that is closely related to other stimulant drugs such as 3-methylmethcathinone and 4-methylmethcathinone (mephedrone). 2-MMC is a recreational designer drug with stimulant and euphoric effects.

What was found? Analysis of online discussions indicates a significant increase in interest and activity related to 2-MMC. Discussion activity has been on the rise since June and is currently at an all-time peak. This surge in online conversations about 2-MMC suggests a growing awareness and potentially increased use of the substance, which could have implications for public health monitoring and intervention strategies.

How is it being discussed? Reddit users describe 2-MMC as a mild stimulant with significant euphoria when taken orally, while intranasal administration is reported to result in weak classical cathinone stimulation and euphoria. Some commenters mention pairing low doses of 2-MMC with psychedelics. Discussants report feeling less negative after-effects the next day compared to substances like 4-MMC, 3-MMC, or 3-CMC. Reddit users warn about strong potential for addiction, psychological effects of serotonin depletion, potential long-term neurological damage, and they caution against ingesting 2-MMC more than once a week.

Drug Terms: 2-MMC, 2-Methylmethcathinone, ortomephedrone.

National Institute on Drug Abuse (NIDA) Epidemiology Research Branch Chief Marsha Lopez, Deputy Branch Chief MeLisa Creamer and Program Official Erin Parker co-authored a review published in Focus, titled "Substance Use Epidemiology as a Foundation for Prevention." 

The article suggests that traditional methods of epidemiology combined with innovative data-collection methods could provide better insight into an evolving drug use landscape — especially one that features an increase in novel substances — by producing indicators that large-scale surveys are unable to capture. The authors cited NDEWS as an example of such methods, highlighting the Web Monitoring Team's work in scanning Reddit to identify early signals that may precede widespread use or exposure to new psychoactive substances.

Read the article here. 

A study from the Ohio State University College of Public Health that was recently published in JAMA Network Open, titled "Layperson-Administered Naloxone Trends Reported in Emergency Medical Service Activations, 2020-2022," determined that naloxone delivered by bystanders increased nationwide over a two-year period.

Using data from the National Emergency Medical Services Information System (NEMSIS), researchers were able to determine that of the nearly 750,000 patients that received naloxone, about 25,000 received the life-saving medication from a bystander prior to the arrival of emergency medical services (EMS) — a 43.5% increase over the study period. This increase, however, only accounted for 3.4% of total EMS encounters involving naloxone administration.

Read the study here. 

The Center for Forensic Science Research & Education (CFSRE) develops quarterly trend reports associated with novel psychoactive substance (NPS) occurrence in the United States. These trend reports are intended to provide near real-time information regarding NPS prevalence, positivity, and turnover.

Follow the links below to view each individual trend report:

     • NPS Benzodiazepines
     • NPS Opioids
     • NPS Stimulants & Hallucinogens
     • Synthetic Cannabinoids

A study by NDEWS collaborators, titled "Time course of kratom effects via ecological momentary assessment, by product type, dose amount, and assayed alkaloid content," that was published in Drug and Alcohol Dependence combined observational research and laboratory analysis to evaluate kratom dose-effect relationships.

The study team noted that the effects of kratom were stronger in those who used more on average. Additionally, the effects of whole-leaf powder appeared to decrease over a three-hour period, while the effects of extracts were more powerful but also decreased more rapidly. Researchers were unable to obtain enough information about dose-effect relationships, however, as participants tended to consume consistent amounts. Alkaloid content was also found to be consistent, though higher levels of corynoxine alkaloids were associated with slightly stronger effects.

Read the study here.

Photo credit: Laryssa Suaid/pexels.com 

The Guardian recently reported on nitazenes, a group of novel synthetic opioids that have been appearing in the drug supply in multiple countries. While the substances were first identified in the U.S. in 2019, the distribution of nitazenes has been increasing. The substance has also been detected in drug supplies in Canada, the Netherlands, and the United Kingdom, where numerous overdose deaths have been reported over the past year.|

Due to concerns about nitazenes — many of which are reported to be far more potent than fentanyl — appearing in other illicit substances, test strips have been made available for sale. A recent study found that the strips can detect most circulating nitazenes, though ‘des’-nitazenes may yield false negatives while trace amounts might be undetectable.

Read more here.

Photo courtesy of the Drug Enforcement Agency

Date: Thursday, October 31, 2024, 4:30 – 6 p.m. EDT

Location: Virtual

Learn more and register here. 

Ashley Jordan, PhD, Director of Research and Program Evaluation at the New York State Office of Addiction Services and Supports will discuss a study that examined overdose death risk among people who were terminated from addiction treatment in New York City. 

Date: Monday, November 11 – Wednesday, November 13, 2024

Location: Philadelphia, Pennsylvania, USA

Learn more here. 

Date: Thursday, November 14, 2024, 2 – 3 p.m. ET

Location: Virtual

Learn more and register here. 

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NDEWS Weekly Briefing Issue 201: September 27, 2024

NDEWS Sentinel Site Report, July 2024: We asked our Sentinel Site Directors to report on substance use, overdoses (fatal or nonfatal), or other drug-related trends in their area — view their responses here.

NDEWS Hotspot Alert: Counties with higher-than-expected nonfatal heroin-involved overdoses, January 1 – September 30, 2024 — click here to read the full report.

NDEWS Rapid Street Reporting: Substance use over a
12-month period in Tampa, Fla. — click here to read the full report.

NDEWS Weekly Briefing Issue 203: October 11, 2024

NDEWS Hotspot Alert: Counties with higher-than-expected nonfatal methamphetamine-involved overdoses August 1 – September 30 — click here to read the full report.

As a reminder, if you miss or want you 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.