This Week’s Focus: Sentinel Site Report & insights from the Medicolegal Death Investigation-Network

Our Sentinel Site Directors provide timely, local signals of drug use trends and sometimes statewide patterns by responding each month to questions developed by the NDEWS team, suggested by directors, or submitted by readers. Informal networks supply on-the-ground context that augments Sentinel Site data. Continuous integration of these reports ensures NDEWS can issue timely public health alerts and adapt harm reduction strategies to evolving trends.

Recently NDEWS launched a new component consisting of quarterly surveys to informal networks sent on a rotating basis. They incorporate groups who offer a unique insight into local trends related to substance use, including new routes of administration, polysubstance use, drug-related mortality, and impacts of harm reduction and adverse drug events at the community level. Through these these informal networks of experts we aim to build a more comprehensive and robust overview of national and region-specific drug trends, by gaining more granular regional context and multidisciplinary perspectives to further enhance the existing NDEWS Early Warning Network. At this time, NDEWS has developed five informal networks of experts (so far), including:

     •Medicolegal Death Investigation (MDI)-Network (medical examiners,  coroners, toxicologists, forensic professionals, other medicolegal affiliates)
     •Death Care Professional (DCP)-Network (funeral directors and others who work in services related to death)
     •K-12 School Affiliate-Network (superintendents, parent teacher organizations/associations, principals, teachers, student support staff, guidance counselors, school nurses)
     • Harm Reduction Organization-Network (drug checking groups, overdose prevention centers, consumption sites, syringe exchanges, peer support services)
     •Press-Network (journalists, reporters, correspondents, writers, and other news related affiliates)

This week’s briefing highlights insight from the larger NDEWS Network including responses from Sentinel Site Directors, collected in April 2025, focused on emerging stimulant trends and harm reduction efforts, and responses from our Spring 2025 informal networks quarterly report collected from the Medicolegal Death Investigation (MDI)-Network experts.

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

Collected in April 2025, our Sentinel Site Directors reported on stimulant-related trends and harm reduction efforts, and included any other information NDEWS should know about related to substance use, overdoses (fatal or nonfatal), or other drug-related trends in their respective areas. Below we have highlighted their responses to stimulant-related trends, to read the full report covering all 3 questions and regional breakdowns for each click here.

Click here to read more about NDEWS Sentinel Site Reports

The NDEWS Medicolegal Death Investigation (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 Spring 2025 report, we received 20 responses from 12 states, see below. 

In this quarterly report, we asked the MDI-Network to provide information on trends these experts have observed related to shifts drug supply and naloxone administration prior to fatal overdose in recent decedents, post-mortem toxicology, and/or ME/C reports, along with any other information NDEWS should know about regarding other drug-related trends in their respective areas. To read the full report, click here.

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

📅 Date: Wednesday, July 2, 2025

🕑 Time: 2:00 pm - 3:00 pm  ET

📍Location: Online

Learn more here.

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.

Share your research, news, and events through our submission form.

Share your comments on our newsletter through our feedback form.

For more information on NDEWS' efforts, visit our website.

Follow NDEWS on Twitter/X: @NDEWSnews

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.