In this week’s report, NDEWS highlights observations from biospatial detailing the overlap between suicide ideation and nonfatal opioid-involved overdoses. Between August 1st, 2023, and July 31st, 2024, there were a total of 4,648 opioid-involved nonfatal overdoses that also included indications of suicide ideation. Among all states, the ten counties with the highest rate per 10,000 population are shown below. The table below lists the top ten counties by rate and count. The figures on the second page describe the demographics. View the report here.

A study recently published in Drug and Alcohol Dependence, co-authored by NDEWS researchers Dr. Joseph Palamar, Dr. Nicole Fitzgerald, Dr. Linda Cottler, and NDEWS affiliate Dr. Tom Carr, examined overall and drug-specific associations between county-level fentanyl burden––based on seizures of fentanyl in pills and powder, pills-only, or powder only––and county-level fatal drug overdoses in the US from 2013 to 2020. The results showed that counties with a high burden of pill or powder fentanyl seizures, or both, exhibited higher total overdose mortality than non-high-burden counties. A similar pattern of associations with fentanyl seizure/burden was noted for overdose deaths involving synthetic opioids. Read the study here.

Last week’s MMWR co-authored by NDEWS colleagues Dr. Alex Krotulski and Dr. Barry Logan, described the detection of medetomidine from illicit agents among patients evaluated in an emergency department after suspected opioid overdoses, none of whom had received medetomidine as part of clinical care. From August 2022 to July 2023, medetomidine was found in five patients, along with xylazine, fentanyl, and illicit opioids. All patients received naloxone. Read the report here.

A recently published study co-authored by NDEWS colleagues Dr. Alex Krotulski and Dr. Barry Logan presented a case series of three fatalities that occurred in a Cook County jail between January and April 2023, related to synthetic cannabinoid MDMB-4en-PINACA. Upon surveillance review, incarcerated individuals were seen sharing paper strips and shortly after being found unconscious. Scene investigation revealed burnt paper strips near the decedents. Toxicology panels did not detect any illegal drugs however, analysis specifically targeting synthetic cannabinoids revealed the presence of MDMB-4en-PINACA. The authors note that synthetic cannabinoids are usually sprayed on paper surfaces, and incarcerated individuals are suspected of consuming synthetic cannabinoids by smoking, licking, chewing, and swallowing drug-laden strips of paper.
Read the study here.

A study recently published in Nature, co-authored by researchers at the University of Florida, reported the identification of a novel compound that can enhance naloxone’s effect — and reduce withdrawal symptoms. The companion drug, which researchers are calling compound 368, when paired with low doses of naloxone, can reverse respiratory depression without inducing withdrawal symptoms. Compound 368 and naloxone were found to bind at different sites of the opioid receptor. This dual binding keeps naloxone attached to the receptor longer, providing extended protection against respiratory depression without inducing withdrawal symptoms. Read the article here. Read the UF College of Pharmacy news release here.

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