The NDEWS Early Warning Network comprises 17 Sentinel Sites spanning urban, suburban, and rural areas in the US. They regularly collect community-level indicators of drug use, morbidity, and mortality.

In July 2024, we surveyed our Sentinel Site Directors and asked them to report on substance use, overdoses (fatal or nonfatal), or other drug-related trends in their respective areas. View their full responses here.

Click here to read more about NDEWS Sentinel Site Reports

This week's NDEWS Hotspot Alerts report shows counties with higher-than-expected counts of nonfatal heroin-involved overdoses between January 1 and September 30, 2024. During this time span, there were 18 alerts across seven states and 13 counties. In comparison, there were 53 alerts across 10 states and 33 counties in the same time span in 2023, showing a meaningful reduction in alerts. Click here to read the full report.

Click here to read more about NDEWS Hotspot Alerts.

The NDEWS Rapid Street Reporting team surveyed 183 people during an August 16-17, 2024, visit to Tampa, Florida, revealing the widespread use by participants of alcohol, marijuana — both recreational and medical, including semi-synthetic marijuana — and other drugs. Alcohol (65%) and marijuana (33.3%) were the most used substances over the previous 12 months, followed by Delta-8-THC (13.7%), psilocybin (8.7%), Delta-10-THC (8.2%) and Kratom (6.6%). Click here to read the full report.

Click here to read more about NDEWS Rapid Street Reporting.

What is Avizafone? Avizafone is a prodrug of diazepam (Valium), belonging to the benzodiazepine class of drugs. Initially developed as an antidote for nerve agent gas poisoning, it has since found its way into recreational use. Avizafone is chemically distinct from diazepam and has a higher molecular weight, which may affect dosage calculations.

What was found? We last reported on Avizafone on April 26, 2024. Since then, activity has continued to increase and is currently at an all-time peak.

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. Since our last report, there is an increase in mentions of Avizofone’s expensiveness, mentions of its status in being in a legal grey area.

Drug Terms: Avizafone

Help us reach our goal of 6,000 subscribers by the end of 2024!
You can share the NDEWS Weekly Briefing with friends, colleagues, and others who would benefit from information on recent and relevant news, articles, and data related to novel drug trends in the U.S. and globally by clicking here.

A new study, published in Science Direct by Tse Yang Lim and colleagues, analyzed nearly 12 million drug samples from the National Forensic Laboratory Information System (NFLIS) and highlights the increased presence of fentanyl in non-fentanyl drugs from 2013 to 2023.

The study found fentanyl co-occurrence in 50% of heroin samples by 2023, with notable increases in methamphetamine and cocaine samples, particularly in northeastern states where fentanyl adulteration surpassed 10% in some regions between 2017 and 2023.

While fentanyl co-occurrence with methamphetamine and cocaine remains below 4% nationally, this rise signals growing overdose risks for users who may be unaware of fentanyl in their supply. The findings call for targeted harm reduction efforts, such as drug-checking programs and expanded naloxone access, alongside enhanced public health surveillance to track these trends. Read the study here. 

Millenium Health laboratory recently published a report regarding the presence of the fentanyl analogue carfentanil in urine drug testing. These detections, which were found among 21 states, grew substantially from 2023 to 2024 and are associated with drug mixing.

The report noted that while there was a high prevalence of carfentanil being detected nationally in 2019-2020, the presence of the substance all but disappeared from the laboratory’s database until mid-2023. From July 2023 to June 2024, however, the substance, which is reportedly 100 times more potent than fentanyl, was detected 134 times. Read the report here.

Above: Carfentanil Detection by State, July 2023 – June 2024.
Below: Detection rate for additional drugs in fentanyl-positive specimens with and without carfentanil over the same time span. Courtesy of Millennium Health.

Director of the National Institute on Drug Abuse (NIDA) Dr. Nora D. Volkow recently posted on her blog about how commercial interests serve as a major determinant of addictive behaviors and disorders.

Pointing to three of the four major industrial contributors to global morbidity and mortality — alcohol, tobacco and ultra-processed foods — Volkow indicates that their commonality lies in the fact that “they activate the brain’s reward system in ways that are highly reinforcing,” triggering compulsive consumption resulting in addiction.

Volkow directs attention to existing industries distributing novel products — nicotine vaping, cannabis, online gambling, and even social media — that similarly activate the brain’s reward system and suggests that more research is needed to determine how commercial interests affect public and individual health. Read the post here. 

Graphic credit: PeopleImages/Getty Images

The Centers for Disease Control and Prevention (CDC) issued a release on Thursday warning those who order prescription medications through online pharmacies about the dangers and risks associated with illegal online pharmacies. They urged people to avoid using medications obtained from anyone other than a licensed clinician or pharmacy.

The U.S. Food and Drug Administration (FDA) has warned that online pharmacies claiming to sell prescription drugs at discounted prices, often without needing a prescription, pose a risk to those who order medications. Such illegal online pharmacies often sell unapproved, counterfeit, or otherwise unsafe medicines.

According to the U.S. Department of Justice, individuals who operate such illegal online pharmacies promote, sell, produce, and ship millions of counterfeit prescription pills to tens of thousands of people throughout the country, and those who have ordered medications from such online pharmacies could be at increased risk for overdose, particularly because counterfeit pills often contain fentanyl.

Read more here.

Date: Tuesday, October 8, 2024, 1 p.m. EST

Location: Virtual

Learn more here.

Date: Monday, November 11 – Wednesday, November 13, 2024

Location: Philadelphia, Pennsylvania, USA

Learn more here. 

Share your research, news, and events through our submission form.

Share your comments on our newsletter through our feedback form.

For more information on NDEWS' efforts, visit our website.

Follow NDEWS on Twitter/X: @NDEWSnews