This Week’s Focus: Overdose Awareness and Prevention

This week’s NDEWS Weekly Briefing centers on overdose awareness and prevention in recognition of the upcoming International Overdose Awareness Day on August 31st. We highlight original NDEWS content focused on our NDEWS Special Report and Web Monitoring Report on naloxone, along with responses to our quarterly Harm Reduction Organization Network report, and recent content that reflects the urgency and complexity of preventing overdose.

From innovative detection technologies to evolving clinical models, the resources shared below help inform communities, researchers, and public health professionals.

International Overdose Awareness Day, held annually on August 31st, is the world’s largest campaign focused on raising awareness about drug overdose, reducing the stigma surrounding substance use, and promoting evidence-based prevention and support strategies. View the US Center for Disease Control and Prevention's (CDC) International Overdose Awareness Day Toolkit here.

New CDC Data & Resources:
- Morbidity and Mortality Weekly Report (MMWR): Drug Overdose Deaths Involving Stimulants ― United States, 2018‒June 2024
- Updated 2024 overdose death data via SUDORS dashboard

Out of 444,343 instances of naloxone utilization in EMS encounters for nonfatal overdoses from January 1, 2024 to July 31, 2025, 109,840 (24.7%) occurred in Western states, 67,241 (15.1%) in Midwestern states, 188,312 (42.4%) in Southern states and 78,950 (17.8%) in Northeastern states. The data shows an initial statistically significant decrease in naloxone utilization in EMS encounters for nonfatal overdoses, followed by a statistically significant increase across Western, Midwestern, Northeastern and Southern states, and nationally overall.

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

Click here to learn more about NDEWS Hotspot Alerts

Why Are We Reporting On This? This week centers on overdose awareness and prevention in recognition of the upcoming International Overdose Awareness Day. This report is based on online community discussions about naloxone access, administration experiences, and overdose prevention.

What Was Found? Narcan/naloxone is most frequently discussed in the context of emergency overdose reversals and debates about access and availability. Posts indicate widespread awareness of naloxone, with numerous accounts of successful overdose reversal. The discussion varies from week to week without a clear overall increasing or decreasing trend.

Public Health Relevance: Multiple posts describe successful naloxone administrations that reversed potentially fatal overdoses, including detailed accounts of revival from fentanyl. Discussants often share practical guidance about recognizing overdose symptoms and proper naloxone administration techniques. The presence of contaminated drug supplies, particularly nitazenes in stimulants and fentanyl in various substances, is often cited as a reason for carrying naloxone.

How Is It Being Discussed? Reddit users frequently share overdose experiences, with multiple accounts describing the loss of consciousness and subsequent revival via naloxone. Several discussants report over 10 overdoses and naloxone revivals within a three month period. There is considerable discussion disseminating naloxone administration techniques and similar overdose mitigation techniques such as rescue breathing, and staggered use when consuming in a group. Access remains a central topic, with discussants sharing multiple free naloxone sources and expressing frustration about geographic disparities. The NEXT Distro program and the Never Use Alone hotline receives frequent mentions and recommendations in naloxone discussion. Technical discussions about naloxone's limitations appear frequently, with Reddit discussants clarifying it only reverses opioid overdoses and won't help with stimulant or other overdoses.

Click here to read more about NDEWS Online Monitoring.

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.

The NDEWS Harm Reduction Organization (HRO)-Network is made up of drug checking groups, overdose prevention centers, consumption sites, syringe exchanges, peer support services and others. While these organizations may be affiliated with government services such as the health departments, they are generally led by those with living or lived experience. Individuals who provide harm reduction services (either on a community level, part of a national organization and/or a network/collation/chapter), are an invaluable resource to their local communities and offer unique insight to identifying and monitoring novel psychoactive substances (NPS), co-use of substances, changes in the local drug supply or market, and adverse effects.

In this quarterly survey, we collected information on observed shifts in the local drug supply including adulterants, with a particular focus on sedatives, in addition to other local trends of note. Responses are anonymous and aggregated by reporting location. For the Spring 2025 report, we received a total of 20 responses from 18 states, of those 17 responses included extended responses across 16 states, see below. To read the full report, click here.

A recently published study in Neuropharmacology by Laffont et al. explores the effectiveness of a pair of intranasal medications – naloxone and nalmefene – in reversing overdoses caused by synthetic opioids. An expanded translational model simulated virtual subjects for each scenario. Simulations showed that a single dose of intranasal nalmefene (3 mg) was more effective at preventing cardiac arrest after a dangerous dose of fentanyl or carfentanil compared to a dose of intranasal naloxone (4 mg). Read the full study here.

A recently published commentary in Resuscitation Plus by Dernbach et al. discusses a novel “overdose chain of survival” that emphasizes the importance of linking acute care with long-term prevention. The six-link framework is a guide for clinical use, policy development, education, research, and for the improvement of outcomes after an overdose event. The conceptual model can adapt to evolving drug trends. The authors stated that the model highlights the need for integrated, patient-centered approaches to overdose response and prevention. Read the full study here.

A recently published study in Drug and Alcohol Dependence by Gullapalli et al. examines how machine learning may be able to detect opioid misuse to prevent opioid-related risks such as overdose and opioid use disorder. The study collected 9,238 data points from on-body sensors and cognitive tasks in a sample of 169 patients who were prescribed opioid analgesics to manage chronic pain. The machine learning model provided good predictive performance for identifying opioid misuse. Behavioral responses were stronger predictors of misuse compared to physiological signals. Read the full study here.

A recently published study in the Journal of Substance Use and Addiction Treatment by Goh et al. explores the perceptions of fentanyl, drug checking, and associated implementation suggestions among first responders and people who use drugs (PWUD) in King County, WA. The results found low support for drug checking for fentanyl and the distribution of fentanyl test strips by first responders. The study also suggested that drug checking may be most useful for PWUD trying to avoid fentanyl if structural barriers to access and use are addressed. Read the full study here.

A recently published short communication in Drug and Alcohol Dependence by Rosen et al. discusses the emerging technology of restroom motion sensors (RMS) to enhance detection and facilitate rapid response to overdoses in high-traffic public restrooms. A study was conducted from November 2022 to April 2024 across various businesses across eight townships in Rhode Island to assess the acceptability and perceived feasibility of using RMS. The results indicated low awareness (4%) of RMS by working staff, but high comfort with the sensors being installed (73%) and confidence (66%) in installing the system in the future. Read the full short communication here.

📅 Date: Wednesday, September 3, 2025

🕑 Time: 2:00 pm - 3:00 pm ET

📍 Location: Online 

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

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