National Drug & Alcohol Facts Week provides an opportunity to bring together scientists, students, educators, healthcare providers, and community partners to help advance the science and address youth drug and alcohol use in communities and nationwide. Learn more here.

This week, NDEWS highlights opioid and non-opioid nonfatal overdose alerts for 911 dispatches for Pennsylvania in 2023. Alerts indicate days in which the number of overdoses exceeded the expected number for that county, calculated through biospatial.Inc and accounts for population, seasonality, and other factors. In 2023, 15,218 opioid-involved nonfatal overdoses and 17,624 non-opioid-involved nonfatal overdoses were identified for the state of Pennsylvania. Counties with three or more alerts during the reporting period are labeled. Read more here.

NDEWS is excited to relaunch Reddit online mention alerts from our Web Monitoring Team. In April 2023, the previous Reddit data API was taken offline, but we were recently granted new API access from Reddit. Due to modifications to Reddit's Terms of Service and our data collection protocols  the current version of these alerts differs from previously published alerts. Please see the methodological note for more information.

What is kitty flipping? "Kitty flipping" is the practice of combining MDMA (ecstasy) and ketamine. This term is similar to "candy flipping" in which MDMA is combined with LSD. Historically, kitty flipping appears to refer more to using MDMA and ketamine within the same short time period, but a recent report by the media mentioned a drug seizure suggesting that MDMA and ketamine were pre-mixed.

What was found? The number of mentions of "kitty flipping" increased between mid-2022 and early 2023 and has been fairly consistent since then. This may indicate increased interest in the practice. It may also be caused by recent media mentions.

How is it being discussed? Discussion orients around the perception of kitty flipping as mixing the dissociative effects of ketamine with entactogenic effects of MDMA. People who use it also sometimes report use of this combination as a way to reduce the negative "comedown" effects of MDMA. Many people online caution against taking MDMA and ketamine simultaneously or pre-combined, and instead recommend specific timing combinations.

Drug Terms: Kitty flipping, kitty flip, kittyflip

Methodological Note: Data were collected and analyzed by the NDEWS Web Monitoring Team, led by Dr. Elan Barenholtz and NIDA T32 predoctoral fellow Daniel Van Zant of the Machine Perception and Cognitive Robotics (MPCR) Lab at Florida Atlantic University. Metrics are based on post counts derived from algorithmic monitoring of ~80 drug oriented Subreddits. No personally identifiable or post-specific information is incorporated in this monitoring process. Due to modifications in our data collection protocols, the NDEWS web monitoring team is currently unable to collect data for substances that generate high volumes of posts (e.g. xylazine or psilocybin). This temporary restriction, which is anticipated to persist until early June, reflects recent revisions to Reddit's Terms of Service on data gathering. For more methodological details, see our publication. 

People who have used drugs are invited to join Virtual HealthStreet to participate in periodic anonymous, special topic surveys specifically to get a better understanding of emerging drug trends across the US. Join here.

A study published this week by researchers in NDEWS Co-Investigator Dr. Bruce Goldberger’s lab developed and validated a method to quantitate the veterinary sedative xylazine as well as 4-ANPP, acetyl fentanyl, fentanyl, norfentanyl, and p-fluorofentanyl in blood using a single sample. The authors noted that this method provides an efficient approach for laboratories and has the potential to expand to other fentanyl analogs as they emerge. Read the study here.

A study published earlier this week found that approximately 11% of 12th-grade students across the US reported past-12-month use of delta-8-THC, according to data from the 2023 Monitoring the Future survey. The sample included 2,186 students, and among those who reported delta-8-THC use, 90.7% also reported marijuana use. Past-12-month delta-8-THC use was more common in the South and Midwest regions and in states without cannabis legalization or delta-8-THC regulations. Read the study here. Read the news release here.

The DEA Toxicology Testing Program (DEA TOX) recently published a Fourth Quarter 2023 Report presenting results of cases analyzed and completed between October 1, 2023, through December 31, 2023. During this period, 136 biological samples from 119 cases originating from 15 states were submitted to DEA TOX. A total of 838 drugs and metabolites were identified and confirmed. Read the full report here.

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