This week’s NDEWS Weekly Briefing focuses on overdose awareness and prevention in advance of International Overdose Awareness Day on August 31. Featured content includes original NDEWS heatmaps of suspected EMS encounters for nonfatal and fatal overdoses across the US by time of day and day of the week. The Web Monitoring Report focuses on discussions by Reddit commentors who mention NARCAN® or naloxone.

As always, we welcome your input.

Image source: OverdoseDay.com

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.

More information provided by OverdoseDay.com a Pennington Institute Initiative:
- Overdose Basics
- Overdose Prevention
- Global Facts & Stats

Click here for a PDF version of the report.

Click here to learn more about NDEWS Special Reports.

Why are we reporting on this? This week centers on overdose awareness and prevention in recognition of the upcoming International Overdose Awareness Day on August 31st. This report is based on online community discussions about naloxone access, administration experiences, and overdose prevention. Reddit discussions reveal essential risk mitigation dialogue alongside notable public health concerns, including misconceptions regarding naloxone utility for non-opioids, adverse symptoms associated with acute reversal, and barriers related to retail pricing and acquisition.

What is Naloxone/NARCAN®? Naloxone is an opioid receptor antagonist available in intranasal spray, injectable, and combination pharmaceutical formulations. It is designed to rapidly reverse opioid-induced central nervous system and respiratory depression by competitively displacing opioid agonists from receptor sites.

Previous Web Monitoring Reports:
- 08/29/2025 - Naloxone

Public Health Impacts: Reddit discussants report physical and psychological distress following naloxone administration, including gastrointestinal symptoms, restlessness, shivering, and anxiety associated with precipitated withdrawal. Some commenters also describe physical soreness and emotional distress following resuscitation events. Discussants additionally report barriers to obtaining over-the-counter naloxone due to its retail cost, particularly for individuals seeking emergency supplies outside of public health programs.

How is it being discussed? Reddit commenters widely advocate carrying naloxone as a core risk mitigation measure, consistently recommending it for events, nightlife settings, and situations involving potential exposure to adulterants. Discussants frequently exchange guidance on locating free supplies through community clinics, syringe service programs, and distribution initiatives. Conversations also highlight misconceptions regarding drug interactions, with commenters inquiring whether naloxone can reverse intoxications involving benzodiazepines, stimulants, dissociatives, or cannabis. Furthermore, discussants actively look at pharmaceutical combinations of naloxone with agonists such as buprenorphine, oxycodone, and tilidine, debating bioavailability across routes of administration, abuse-deterrent properties, and the mechanics of avoiding precipitated withdrawal during medical induction.

Click here to learn more about NDEWS Web Monitoring.

Image source: Substance Use: Research & Treatment

A recent publication in Substance Use: Research and Treatment by Ramos et al. examined barriers and facilitators related to naloxone access and use among adolescents in the United States. The review found that barriers to naloxone access are multifactorial, including cost-related constraints, inconsistent implementation of over-the-counter dispensing practices, limited awareness of dispensing policies, and stigma toward people who use drugs. Facilitators included policy changes enabling non-prescription dispensing, pharmacy standing orders, and laws that permit independent minor consent for substance use treatment. The authors conclude that additional efforts are warranted to improve naloxone availability and use among adolescents.

Read the full study here.

Image source:

A recent publication in Frontiers in Public Health by Samora et al. examined opioid overdose response preparedness among college students in the southwestern United States using the Ready, Willing, Able framework. Survey findings characterized low levels of readiness and ability and moderate levels of willingness, with fewer than one-quarter of students reporting knowledge of where to access naloxone on campus or how to use it. Focus group participants identified facilitating factors such as accessing campus-based naloxone distribution and training, as well as barriers including lack of advertisement of university resources, stigma toward overdose response preparedness, and ineffective training. Students identified solutions including expanding access to and awareness of university-based resources, empathy-based messaging, and hands-on, step-by-step overdose response training.

Read the full study here.

Image source: Fig. 1 Comparison of baseline and post NARRC-B survey responses

A recent publication by Hooten et al. evaluated changes in Community Health Worker knowledge and attitudes toward opioid use before and after a standardized Opioid Overdose Prevention and Response training. The training improved knowledge and self-confidence in responding to an opioid overdose, with 74.6% of participants endorsing that they would be able to respond effectively to an overdose following training. However, some knowledge gaps persisted, including inaccuracies and misunderstandings in key areas of factual knowledge despite being explicitly covered in the training. The authors note that individual feedback and booster training sessions may further help promote consistency of Community Health worker knowledge and preparedness.

Read the full study here.

Image source: Journal of Adolescent Health

A recent publication in Journal of Adolescent Health by Sindelar et al. assessed youth knowledge and perceptions related to fentanyl among youth aged 14–24 years in the United States. Most youth reported having knowledge of fentanyl, and many believed fentanyl is dangerous due to its high potency and risk of overdose. Youth believed that fentanyl exposure occurs primarily through illicit means, medical care, or adulterated substances. Respondents reported that more education, greater availability of public health resources such as fentanyl test strips and naloxone, and open conversations about fentanyl could help protect youth from the dangers of fentanyl.

Read the full study here.

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!

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- Interdisciplinary training at the intersection of addiction science, epidemiology, and surveillance
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- 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 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.

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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 Special Reports 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.