What is avizafone? Avizafone is a prodrug of diazepam (Valium), a benzodiazepine. Avizafone was initially developed as an antidote for nerve agent gas poisoning. Avizafone is chemically distinct from diazepam and has a higher molecular weight, which may affect dosage calculations.
 
What was found? Within the past six months, avizafone has seen a 300% increase in Reddit posts. The highest peak in discussion within the past five years.
 
How is it being discussed? Online discussions about avizafone primarily revolve around its dosage and effects. People who use this drug are particularly interested in its potential as an alternative to diazepam for recreational or therapeutic purposes, and they report that the effects of avizafone last longer than those of diazepam. There is also a discussion warning that the potency of acquired avizafone can vary significantly.
 
Drug Terms: Avizafone
 
Methodological Note: Data was 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 into 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. 

Earlier this week, the University of Washington’s Addictions, Drug and Alcohol Institute published results from the 2023 Washington State Syringe Services Program Health Survey. Co-authored by NDEWS Sentinel Site Director Dr. Caleb Banta-Green, the survey was conducted in partnership with Public Health–Seattle & King County, the Washington Department of Health, and syringe services programs (SSPs) across the state. A total of 1,667 participants of Washington State SSPs completed the survey on their substance use, health behaviors, and health care and substance use treatment needs. Read the report here.

A study recently published in the Journal of Urban Health, co-authored by NDEWS Sentinel Site Director Dr. Phillip O. Coffin, examined the prevalence of racial and ethnic disparities in unintentional fentanyl use among people experiencing a medically attended opioid overdose. Data were reviewed from 448 suspected non-fatal overdose cases attended by a community paramedic overdose response team in San Francisco from June to September 2022. Intentional opioid use was reported by 57.3% of participants, 98.0% of whom intended to use fentanyl. No intentional opioid use was reported by 42.7% of participants, with most intending to use stimulants (72.6%). The findings suggest that a significant proportion of opioid overdoses in San Francisco may be attributed to unintentional fentanyl use among people without opioid tolerance. Read the study here.

A study published in Harm Reduction Journal, also co-authored by NDEWS Sentinel Site Director Dr. Phillip O. Coffin, characterized withdrawal symptoms in people with daily fentanyl use who underwent initiation using these strategies as outpatients. Results showed that among the 118 initiations with follow-up data, 31% of participants experienced any withdrawal symptoms, including 21% with mild symptoms, 8% with moderate, and 2% with severe. Precipitated withdrawal occurred in 10 cases or 8% of initiations with follow-up. The authors noted that clinicians should counsel patients who use fentanyl that mild withdrawal symptoms are likely during low-dose initiation, and there is still a low risk for precipitated withdrawal. Read the study here.

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.

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