National Drug Early Warning System (NDEWS) Weekly Briefing


NDEWS Alert: Above-threshold rates of substance-related 911 calls for Sentinel Site counties, 9/10/21–9/16/21

Counties in several NDEWS Sentinel Sites saw above-threshold rates of 911 calls involving opioid overdoses, alcohol-related incidents, and methamphetamine-related incidents over the last week, based on real-time 911 dispatch data from biospatial. States with counties that had observed 911 calls with unexpected increases for the week included Georgia for opioid overdose-related calls, Florida and Arizona for alcohol-related calls, and Florida for methamphetamine-related calls.

NDEWS Alerts involve a dynamic notification system that calculates a score to quantify the degree to which observed counts of 911 calls deviate from the expected range of values. These alerts are provided by the anomalous alert system from biospatial. More information and past alerts can be found here.


CDC issues health advisory regarding increases in availability of cannabis products containing delta-8 THC and reported cases of adverse events

The CDC issued a Health Alert Network Health Advisory this week to alert stakeholders and the public about increased availability of cannabis products containing delta-8 tetrahydrocannabinol (THC). A wide variety of delta-8 THC products are increasingly appearing in both marijuana and hemp marketplaces as well as online, and variations in product content, manufacturing practices, and labeling may lead to unexpected effects among consumers. The American Association of Poison Control Centers (AAPCC) began monitoring delta-8 THC adverse effects in 2021 and found that from January 1 to July 31, 2021, there were 660 reported delta-8 THC poisonings ("exposures"), 18% of which required hospitalization. Read the full alert here.


Disparities in opioid overdose death trends by race/ethnicity, from the HEALing Communities Study

New research conducted as part of the HEALing Communities Study and recently published in the American Journal of Public Health examined trends in overdose deaths by race/ethnicity from 2018 to 2019 in New York, Massachusetts, Kentucky, and Ohio. Opioid overdose death rates were calculated per 100k residents focusing on 67 communities in these four states using state death certificate records. The authors found that overall opioid death rates did not significantly change between 2018 and 2019, but there was a 40% increase in opioid overdose death rate for non-Hispanic Black individuals compared to non-Hispanic White individuals. Read the full study here and the NIH press release here.

CDC Notes from the Field: Xylazine detection and involvement in drug overdose deaths

The CDC published two articles in this week's Morbidity and Mortality Weekly Report (MMWR) regarding the detection and involvement of xylazine in drug overdose deaths. In the first article, researchers examined drug overdose deaths involving xylazine in Connecticut, where xylazine has been included in toxicology panels since 2013. They found that 5.8% of overdose deaths in 2019 and 11.4% of overdose deaths from January to July 2020 were positive for xylazine. Read the full article here.

In the second article, researchers used data from the State Unintentional Drug Overdose Reporting System (SUDORS) in 38 states and the District of Columbia to examine xylazine-positive and xylazine-involved overdose deaths that occurred during 2019. They found that among the 45,676 overdose deaths reported to SUDORS during 2019, 1.8% of deaths were identified as xylazine-positive and 1.2% of deaths were identified as xylazine-involved. Among all xylazine-involved deaths, one or more drugs were also listed as a cause of death. Read the full article here.

EMCDDA technical report: Synthetic cannabinoids in Europe––a review

In a new report, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) provides a technical review of the current body of knowledge regarding synthetic cannabinoids that are currently monitored by the EU Early Warning System. The report outlines the history and development of synthetic cannabinoids and international control measures, a review of synthetic cannabinoids in Europe, health and social risks, and the extent and patterns of use, availability, and potential for diffusion. Read the full report here.

Targeting community-based naloxone distribution using opioid overdose death rates: A descriptive analysis of naloxone rescue kits and opioid overdose deaths in Massachusetts and Rhode Island

A study recently published in the International Journal of Drug Policy compared naloxone distribution and opioid overdose death rates in Massachusetts and Rhode Island to identify target communities for expanded community-based opioid education and naloxone distribution programs. Spatial patterns of opioid overdose fatalities and naloxone distribution were compared in both states during 2016 to 2019 using data from public health departments. Researchers identified variations in spatial patterns of opioid overdose fatalities and naloxone availability, which can be used to identify priority communities for naloxone distribution strategies. Read the full article here.


Respiratory failure in confirmed synthetic cannabinoid overdose

A short communication published in Clinical Toxicology examined the incidence of acute respiratory failure within an observational cohort of emergency department patients with suspected synthetic cannabinoid overdose. The study found an incidence of 31% for acute respiratory failure in the cohort. Sedatives were also detected among 40% of patients in the cohort, and 27% demonstrated opioid exposure. Overall, compared to non-synthetic cannabinoid overdose, synthetic cannabinoid overdose was found to be significantly associated with acute respiratory failure. Read the full article here.


The impact of the national stay-at-home order on emergency department visits for suspected opioid overdose during the first wave of the COVID-19 pandemic

A recent study used syndromic surveillance data from four states participating in the HEALing Communities Study (Kentucky, Massachusetts, New York, and Ohio) to examine the declaration of the national stay-at-home order's impact on emergency department (ED) visits for suspected opioid overdose. Massachusetts, New York, and Ohio saw a statistically significant decline in ED visits for suspected opioid overdose immediately after the nationwide stay-at-home declaration. After this date, the four states had varying ED encounter trends, showing that the national stay-at-home order had a differential impact on opioid overdose ED visits. Read the full study here. 

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