In this week’s report, NDEWS highlights observations from biospatial.io detailing the EMS encounters for nonfatal methamphetamine-related overdoses in the US from 2023 to 2025. The data shows that counties with the highest rates of EMS encounters for nonfatal methamphetamine-related overdose encounters over 27 months were heavily concentrated in the southeastern US. Among US states with at least 75% coverage, there were 735,651 EMS encounters in response to nonfatal methamphetamine-related overdose encounters.

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

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A recently published study in JAMA Psychiatry by Han et al., co-authored by NIDA Director Dr. Nora Volkow, examined prescription stimulant use, misuse, and prescription stimulant use disorder (PSUD) among U.S. adults aged 18–64. Using data from IQVIA and the 2021–2022 National Survey on Drug Use and Health (NSDUH), the authors estimated that 25.3% of adults who used prescription stimulants misused, and 9.0% met DSM-5 criteria for PSUD. Notably, 72.9% of those with PSUD reported only using their own prescribed stimulants, and 87.1% used amphetamines. PSUD rates were more than twice as high among amphetamine users compared to those using methylphenidate (11.2% vs. 5.1%). Misuse and PSUD were also strongly associated with other substance use disorders and mental health conditions.

Read more here.

A recently published Addiction Outlook piece in Psychology Today by NDEWS SAG member Dr. Mark Gold examines the escalating crisis of ADHD medication misuse among U.S. adults, particularly in high-performance environments like Wall Street and Silicon Valley. Citing recent data, the publication reports a dramatic 250% increase in stimulant prescriptions from 2006 to 2016, despite only minimal increases in ADHD. Nearly 7% of U.S. adults used prescription stimulants in 2020—many without a diagnosis—primarily for cognitive enhancement or productivity. The piece also highlights the role of telehealth platforms in driving new prescriptions and the consequences of stimulant misuse, including addiction, psychosis, and cardiovascular risks. Notably, it emphasizes racial disparities in diagnosis, with Black youth more likely to be misdiagnosed or untreated for ADHD.

Read more here.

A recently published opinion in Frontiers in Psychiatry by Dr. Norman Miller warns of a U.S. amphetamine "epidemic", fueled by overdiagnosis, pharmaceutical marketing, and weak telemedicine oversight. Though the U.S. makes up less than 5% of the global population, it consumes over 80% of ADHD medications. Dr. Miller highlights rising risks of addiction, diversion, psychosis, and misdiagnosis due to symptom overlap with other disorders. He calls for stricter diagnostic standards and more long-term studies on amphetamine safety and efficacy. 

Read more here.

A recently published study in Brain Sciences by Holborn et al. used a mixed methods design to examine self-medication of ADHD with novel psychoactive substances (NPS). Among 225 survey respondents and nine interviewees, the most commonly used stimulants were 4F-MPH and 2-FMA. Individuals rated NPS self-medication as more effective than conventional treatment across multiple outcomes (p < 0.001). Interviews revealed four key themes: NPS used as stopgaps or supplements to prescriptions, poor access to care, difficulty finding supportive psychiatrists, and distrust in healthcare systems. Despite high psychiatric comorbidity and polydrug use, participants preferred prescription treatment, citing NPS use as a last resort driven by systemic barriers. 

Read more here.

A recently published review in Current Opinion in Neurobiology by Young et al. highlights the lack of FDA-approved treatments for stimulant-use disorder (StUD), despite rising overdose deaths and relapse rates. Novel therapies in development include psilocybin, monoclonal antibodies, conjugate vaccines (e.g., IXT-v100), GABA modulators, and nonmuscle myosin II inhibitors. A Phase 3 trial of naltrexone-bupropion has shown promise, and the FDA has issued guidance supporting harm reduction outcomes over full abstinence.

Read more here.

A recently published viewpoint in JAMA Psychiatry by Drs. Joshua Rising and Robert Califf outlines FDA efforts to address rising stimulant prescribing for adults, nonmedical use, and persistent medication shortages. The authors cite a 58% increase in stimulant dispensing from 2012 to 2022—driven largely by adults aged 31–40—and warn that relaxed telemedicine regulations may contribute to inappropriate prescribing.

Read more here - JAMA Psychiatry

A recent article from Alcoholism & Drug Abuse Weekly summarized the viewpoint, drawing parallels to the opioid crisis and emphasizing the need for more research on adult ADHD diagnosis, treatment trajectories, and the broader public health impact of prescription stimulant use.

Read more here - Alcohol & Drug Abuse Weekly

Submit any information concerning new trends in methamphetamine use in your area, here.

Is there any other information NDEWS should know about related to substance use, overdoses (fatal or nonfatal) or other drug-related trends in your area, including trends associated with polysubstance or co-use? 

A recently published forensic analysis by the Center for Forensic Science Research and Education (CFSRE), co-authored by NDEWS Scientific Advisory Group (SAG) members Dr. Barry Logan and Dr. Alex Krotulski, highlights the emergence of smoke shop products marketed as “7-hydroxy mitragynine.” These products—legally purchased and tested—were found to contain high levels of 7-hydroxy mitragynine and its potent metabolite, mitragynine pseudoindoxyl, along with other kratom alkaloids. Notably, these compounds are up to 10–100 times more potent than mitragynine, yet remain unregulated in the U.S. The report raises public health concerns about product potency, unclear manufacturing processes, and limited toxicological data.

Read more here.

📅 Date: Wednesday, April 30, 2025

🕑 Time: 2:00 pm ET

📍 Location: Online

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📅 Date: Tuesday, April 8, 2025

🕑 Time: 4:00 pm ET

📍 Location: Online

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📅 Date: Wednesday, April 9, 2025

🕑 Time: 3:00 pm ET

📍 Location: Online

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📅 Date: Thursday, April 10, 2025

🕑 Time: 11:00 am to 12:30 pm ET

📍 Location: Online

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📅 Date: Thursday, April 10, 2025

🕑 Time: 3:30 pm to 5:00 pm ET

📍 Location: Online

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📅 Dates: May 29 - May 30, 2025

📍Location: UF Academic and Research Center at Lake Nona, Orlando, FL

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📅 Dates: June 2 - 4, 2025

📍 Location: University of Puget Sound, Tacoma, WA

Learn more here.

📅 Date: Friday, June 20, 2025

📍 Location: New Orleans

Learn more here.

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