This week's NDEWS Hotspot Alerts report includes 18 counties with higher-than-expected drug-related 911 dispatch counts over the previous 7-day period. Read more here. Click here to read more about NDEWS Hotspot Alerts.

What is MD-PiHP? MD-PiHP is a synthetic cathinone. It is a pyrrolidine derivative structurally similar to α-PiHP, MD-PHP, and 3f-PiHP.

What was found? Analysis of online discussions indicated that MD-PiHP has had sparse mentions since at least 2018. It first started being mentioned consistently in December 2023. Since then, it has maintained a steady level of activity and discussion.

How is it being discussed? Reddit users report obtaining MD-PiHP in crystal form and using various routes of administration, including vaping, snorting, and injection. Discussions mention sedating effects, strong dopamine activity, and anticholinergic properties. However, there are significant gaps in knowledge being discussed. Users are unsure about critical information like dosages, duration of effects, how frequently it can be redosed, and whether it has any activity on the serotonin system.

Drug Terms: MD-PiHP, MDPiHP

Earlier this week, the 2023 National Survey on Drug Use and Health report was published by the Substance Abuse and Mental Health Services Administration (SAMHSA). The report provides a comprehensive overview of substance use and mental health trends within the US. Key topics of the report include the use of tobacco, alcohol, illicit drugs, and substance use disorders, along with treatment statistics. Read the report here.

Earlier this week, National Institute on Drug Abuse Deputy Director Dr. Nora Volkow published a blog discussing the need for greater access to methadone to address the fentanyl crisis. According to a naturalistic follow-up study, 53% of patients admitted to methadone treatment who tested positive for fentanyl at intake were still in treatment a year later, compared to 47% of patients who tested negative — almost all of those retained in treatment achieved remission. The blog covers methadone preferences for patients leaving opioid use disorder treatment, recent efforts to expand medication for opioid use disorder (MOUD), the positive effects of expanded access to MOUD during the COVID pandemic, and recent examples of how methadone dispensing in pharmacies and doctors' offices can produce better outcomes than standard care in an opioid treatment program. Read the blog here.

A study published earlier this week examined whether illicitly manufactured fentanyl use predicts human immunodeficiency virus (HIV) and hepatitis C virus (HCV) incidence among a longitudinal cohort of people who inject drugs (PWID) in the US – Mexico border region of Tijuana, Mexico, and San Diego, California. Data was collected by trained bilingual interviewers using a mobile outreach vehicle targeting areas with concentrated drug use. Study participants completed semi-annual interviewer-administered surveys and rapid tests for HIV and HCV. The results showed that among the 398 PWID, 42% reported receptive needle sharing, and 25% reported using illicitly manufactured fentanyl. HCV incidence was 14.26 per 100 person-years, and HIV incidence was 1.29. Read the study here.

An article recently published by the Los Angeles Times reported that deaths from drug overdoses and poisoning reached a plateau last year in Los Angeles County. Across L.A. County, 3,092 lives were lost to drug overdoses or poisonings in 2023, a slight decline from 3,220 deaths the year before, according to a newly updated report. L.A. County officials also reported that the rate of deadly overdoses had stopped surging among unhoused people in 2022, with health officials crediting a dramatic increase in community distribution of naloxone. Read the article here.

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