The 86th CPDD Annual Meeting is now over; held in Montreal this past week, the meeting had the highest attendance ever! On Saturday, we held our annual NDEWS Summit. In attendance were nearly 65 individuals in person and on Zoom.

Our agenda included a welcome from NIDA, updates from the NDEWS Coordinating Center and Sentinel Sites, the sharing of our latest publications, and a review of the presentations scheduled for the week. Much of our time together was spent listening to attendees discuss new partnership ideas, research questions to be addressed, and new approaches for integrating data. We look forward to implementing many of these ideas.

In addition, many colleagues praised the quality of our posters, highlighting the excellent work done by our trainees. Tam Millay's talk on psychedelics received rave reviews for its compelling content and superb delivery. Additionally, our symposium on emerging trends from NDEWS, including insights from wastewater analysis and contributions from our colleagues in Canada an Mexico, garnered positive feedback.

Overall, we gained 50 new Weekly Briefing subscribers so far!

If you have any data or information regarding the use of pentobarbital, also known as Nembutal(R), use in your area, please share it using this form.

What is 7-OH? 7-hydroxymitragynine or 7-OH is an opioid-receptor binding alkaloid that occurs naturally in trace amounts in kratom leaves
 
What was found? Dr. Christopher McCurdy, an internationally recognized kratom expert, alerted the NDEWS team to the presence of synthetically created 7-OH pharmaceuticals being marketed as kratom products. In response, the NDEWS team analyzed Reddit to find mentions of 7-OH. Analysis of online discussions indicates a recent increase in interest and discussion. Discussion remained relatively stable until November 2023 when an upward trend started to emerge. Since March 2024, there has been a strong upward trend with an over 300% increase in discussion. This sudden surge in interest raises concerns about the potential for increased misuse of this potent compound.

Expert Insight: "These new products are not kratom and are synthetically produced to generate high levels of 7-hydroxymitragynine. 7-Hydroxymitragynine is a highly selective opioid that does not behave like the naturally occurring alkaloids in the plant. It is essentially an unregulated synthetic opioid that is untested in humans and creates a significant risk to public health." -Dr. Christopher McCurdy
 
How is it being discussed? Reddit users report that 7-OH provides subjective effects similar to prescription opioids. Some Reddit users report developing a dependence within just two weeks of use, as well as severe and long-lasting withdrawal symptoms. Users report that single doses can be highly potent. There are also concerns about the safety and purity of 7-OH tablets, as they may be cut with other substances. Many discussants report that they purchased 7-OH for chronic pain management.
 
Drug Terms: 7-hydroxymitragynine, 7-OH, 7HMZ, 7(omega)MZ
 
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 all subreddits on Reddit. 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. 

Last week, the Centers for Disease Control and Prevention issued a Health Alert Network (HAN) Health Advisory to update the public on the investigation of a series of acute illnesses and other adverse effects following the consumption of Diamond Shruumz-brand microdosing chocolate bars, cones, and gummies. Illnesses were reported to multiple poison control centers across the US. As of June 10th, 2024, 12 cases among eight states have occurred between March 30th and June 9th. Affected individuals presented with a variety of symptoms including seizures, central nervous system depression, agitation, abnormal heart rates, hyper/hypotension, nausea, and vomiting. Of the 12 cases, ten have been hospitalized. Read the alert here.

Next week, The Reagan-Udall Foundation for the FDA, in collaboration with the FDA, is hosting a hybrid public meeting on “Understanding Current Use of Ketamine for Emerging Areas of Therapeutic Interest.” NDEWS Deputy Director Dr. Joseph Palamar will be in attendance presenting on Thursday, June 27, during the third panel session on “Recreational Ketamine Use, Misuse of Prescribed Ketamine, and Associated Adverse Effects” using NDEWS data. Register here for in-person and virtual attendance.

Last week, the Center for Forensic Science Research and Education (CFSRE) in conjunction with the Colombo Plan, published a Sentinel Snapshot with results related to qualitative and quantitative testing of samples seized from the US Southwest border. Samples seized from the Southwest border ports of entry by Customs and Border Protection (CBP) were submitted to the CFSRE for testing. A total of 1,219 tablets monogrammed “M30” with the appearance of pharmaceutical oxycodone from 81 seizures were analyzed. Most of the tablets analyzed (84%) were a combination of fentanyl, acetaminophen, and metamizole. However, 8.3% of tablets contained a mixture of para-fluorofentanyl and fentanyl. Pentobarbital and methamphetamine were identified in 1% and 2% of samples. Xylazine, caffeine, levamisole, and lidocaine were the non-controlled adulterants present in the tablets. Of these, xylazine was the most prevalent in 5.9% of samples. Read the report here.

A study recently published in Archives of Toxicology, co-authored by NDEWS colleagues Dr. Barry Logan and Dr. Alex Krotulski, assessed in vitro structure–activity relationships of 9 previously uncharacterized nitazenes alongside known structural analogs. The study specifically focused on μ-opioid receptor (MOR) activation. Forensic data from North America and the UK was included. The results showed that 'ring' substitutions (N-pyrrolidino and N-piperidinyl) generally increase MOR activity, while the removal of the 5-nitro group decreases potency. N-desethyl modifications show slightly lower potency, except N-desethyl isotonitazene, which is more potent. Read the study here.

🔸 Axios
New animal tranquilizer seen in illegal drugs

This presentation will explore attempts to alter analytical and interpretive aspects of postmortem toxicology for expediency purposes.

Date: June 26th, 2024

Time: 2:00 p.m. ET

Register here.

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