Earlier this week, NDEWS received a media request asking if we are aware of captagon use in the United States. This amphetamine-based stimulant is mainly produced in Syria, where it gained popularity in 2011. It has since spread through other parts of the Middle East and may be entering drug markets in Europe. Its affordability makes it highly accessible across income levels. 

If you have any knowledge regarding captagon use or other related trends in the U.S., please submit that information here.

Read more about captagon here.

This week, NDEWS highlights 50,572 nonfatal fentanyl-involved overdoses from January 1 to September 30, 2024. The line graph above
shows nonfatal fentanyl-involved overdoses by month and
race. All dispatch types figured above follow the guidelines set by the National
Emergency Medical Services Information System (NEMSIS). Data is
limited to 28 U.S. states/districts with statewide partnerships with biospatial.io.

Click here to read the full report.

Click here to read more about NDEWS Hotspot Alerts.

A NIDA-funded study published in Drug and Alcohol Dependence, which was co-authored by NDEWS Scientific Advisory Group member Daniel Ciccarone, shows how preferred routes of opioid administration have changed over a 21-year period.

The study, titled “Decrease in injection and rise in smoking and snorting of heroin and synthetic opioids, 2000-2021,” reviewed data of more than 7.8 million admissions from SAMHSA's Treatment Episode Data Set (TEDS). Findings showed a significant decline in injection use among those who use heroin and synthetic opioids, with smoking rates increasing in the western region of the U.S. and snorting becoming more prevalent in the eastern region. The largest year-over-year change was observed from 2020 to 2021, marking a major shift in how opioids are consumed

Read the study here.

This week, NDEWS Deputy Director Dr. Joseph Palamar was quoted in an article published on the Verywell Health website titled "What Is Pink Cocaine? The New Designer Drug Linked to Liam Payne's Death."

In the article, Palamar talks about how some people who use cocaine will often drink alcohol to "balance out" the effects. “If someone is desiring that effect from regular cocaine, and somebody hands them ‘pink cocaine’ and it’s more of a ketamine concoction, they’re not going to feel very well,” he said. “Combining a dissociative anesthetic with alcohol is not a great mix. You’ll probably get very sick to your stomach. Mentally, you’re not going to feel well, either.”

Read the Verywell Health article here.

Palamar was also quoted in an article published in The Week, which can be found here.  

Photo Illustration: Joules Garcia for Verywell Health; Getty Images.

Johns Hopkins University School of Medicine researchers recently published a NIDA-funded study in JAMA Network Open titled "Fentanyl, Heroin, Methamphetamine, and Cocaine Analyte Concentrations in Urine Drug Testing Specimens."

This cross-sectional study examined more than 920,000 urine samples collected by drug-testing laboratory Millennium Health between 2013 and 2023. The study found that concentrations of fentanyl, methamphetamine and cocaine increased — though the latter did so minimally — while heroin decreased.

Read the study here.

Researchers at the University of Puerto Rico’s Department of Pharmacology and Toxicology and Texas Southern University released a review titled “Xylazine abuse, the growing risk: A review of its effects, upsurge use and associated fatalities in the USA and Puerto Rico” in the Journal of Forensic and Legal Medicine.

The review states that Xylazine, a veterinary anesthetic, has been associated with more than 4,000 overdose deaths over the last four years, yet only half of U.S. states perform tests that can detect the substance or monitor for xylazine-involved overdose deaths, of which about 95% were also associated with fentanyl or its analogs.

Read the review here.

A study titled “Communities That HEAL Intervention and Mortality Including Polysubstance Overdose Deaths,” co-authored by Associate Director of NIDA’s HEALing Communities Study (HCS) Jennifer Villani and published in JAMA Network Open, provides results of the Communities That HEAL intervention clinical trial, evaluating its effectiveness in preventing fatal overdoses.

This randomized parallel study — the largest addiction prevention and treatment implementation study ever conducted, according to the NIH — took place in 67 communities across four U.S. states between 2020 and 2023 and included more than 8 million participants. The study found that intervention communities saw 37% fewer deaths among those using an opioid and psychostimulant other than cocaine, though the overdose death rate in these communities only decreased by 8% overall.

Read the study here.

The U.S. Drug Enforcement Administration issued a final ruling permanently scheduling new psychoactive substances butonitazene, flunitazene, and metodesnitazene as Schedule I controlled substances, according to the Federal Register. The ruling went into effect on October 25, 2024.

These novel synthetic opioids had been temporarily placed in Schedule 1 along with four other nitazenes in April 2022.

Read the article here.

Image courtesy of the DEA

Washington University and Northwestern University researchers and engineers have produced an implantable device that administers naloxone upon sensing dropping oxygen levels in surrounding tissues, according to a recently published study in Science Advances.

The device, which is called a Naloximeter, sends a mobile app notification when oxygen levels fall below a certain point, requiring the owner to abort within 30 seconds to prevent release of naloxone contained in the device. Upon releasing the life-saving medication, the device also alerts first responders.

Read the study here.

Photo credit: Joanna Ciatti and Jihun Park/Washington University

Date: November 6 – 7, 2024, noon – 5 p.m. ET

Location: Bethesda, Maryland, USA, and virtual via videocast.nih.gov

Learn more here. 

This conference highlights a range of research from the NIH Institutes and Centers and will features a fireside chat with Drs. Jane M. Simoni, Director of the Office of Behavioral and Social Sciences Research, and Nora M. Volkow, Director of the National Institute on Drug Abuse.

Date: November 6, 2024, 1 – 4 p.m. ET

Location: Virtual

Learn more here.

Presentations and discussion will center around the lived experience of patients with chronic pain. The Helping to End Addiction Long-term (HEAL) Initiative seeks to speed scientific solutions to the overdose epidemic, including opioid and stimulant use disorders, and the crisis of chronic pain. 

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 here. 

Date: November 19, 2024, 4:30 – 6 p.m. EST

Location: Virtual

Learn more here. 

Organized by AIDS United, Black Harm Reduction Network, Drug Policy Alliance, Human Impact Partners, and the National Alliance of State & Territorial AIDS Directors (NASTAD), this webinar will feature experts who will share recent racial and ethnic trends in overdose mortality, including drug type, age, and gender variations.

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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 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.