National Drug Early Warning System (NDEWS) Weekly Briefing

NDEWS ORIGINAL CONTENT

Alert from the NDEWS Web Monitoring Team: Online mentions of M30

Context: This past weekend, the NDEWS Rapid Street Reporting team visited Seattle, WA and identified several mentions of a substance referred to as "M30". Participants described "Blues" as fentanyl pills which can be torched and injected. Survey responses also highlighted the presence and danger of Blues in the Seattle community.

Coinciding Trends: Both Rapid Street Reporting participants and Reddit commenters describe M30 with slang terms that reference its blue color ("Blues", "Blue 30s", "Blue M30s"). Online and face-to-face mentions of M30 corroborate information about M30 pills. Both groups also describe M30 pills as originating from Mexico (and called "Mexis") and suspect the pills contain fentanyl.

What are M30s? M30 refers to blue, 30mg oxycodone pills pressed with the M30 imprint. Currently, the term predominantly refers to counterfeit pills containing fentanyl, as alerted by the DEA in 2021.

Web Monitoring Alert: A novel discussion trend for blue M30 pills on Reddit in 2022 coincides with the drug's prevalence in real-world signals. Since the NDEWS Web Monitoring Team issued an alert regarding the trend's peak in Weekly Briefing Issue 58 (October 2021), discussion of M30 has maintained a new baseline of activity, indicating a high level of sustained interest atypical of emerging substances on Reddit.

Drug Terms: Blues, M30, M-30, Blue 30, Mexis, Mexican Blues, M-Boxes.

Drug Enforcement Administration Toxicology Testing Program Quarter 1 2022 Report

The Drug Enforcement Administration's Toxicology Testing Program released their Quarter 1 2022 Report this week. This publication presents the results of cases analyzed and completed by the Clinical Toxicology and Environmental Biomonitoring Laboratory from January 1, 2022, through March 31, 2022. Read the full report here.

NOVEL PSYCHOACTIVE SUBSTANCES

NPS Discovery: Announcement of three newly identified novel psychoactive substances, ADB-5Br-INACA, MDMB-5Br-INACA, and BZO-4en-POXIZID in the US

NPS Discovery announced the identification of three newly identified novel psychoactive substances, ADB-5Br-INACA, MDMB-5Br-INACA, and BZO-4en-POXIZID, which are classified as synthetic cannabinoids. Read about their structure, appearance, and scheduling, among other details, here.

RECENTLY PUBLISHED

Trends in gabapentin detection and involvement in drug overdose deaths- 23 states and the District of Columbia, 2019-2020

Last week’s MMWR reported trends in gabapentin detection and involvement in drug overdose deaths. Data consisted of 58,362 overdose deaths with documented toxicology results that occurred between 2019 and 2020 in 23 states and the District of Columbia. A total of 5,687 (9.7%) deaths had gabapentin detected in postmortem toxicology. Read the full report here.

Use of laboratory data for illicit drug use surveillance and identification of socioeconomic risk factors

A study published in Drug and Alcohol Dependence used laboratory urine drug screen and complete metabolic panel data from patients presenting to an emergency department in St. Louis to measure long- and short-term temporal and geospatial changes in drug positivity at the zip-code level. The authors found an increase in fentanyl positive drug screens during the initial COVID-19 shutdown period in the spring of 2020. A decrease in cocaine positivity was seen in the fall and winter of 2020, with a return to baseline during the second major COVID-19 shutdown in the summer of 2021. Read the full report here.

Rapid changes in illegally manufactured fentanyl products and prices in the US

A study published in Addiction analyzed DEA data from 2013 to 2020 to assess variations in seizures and purity-adjusted price of illegally manufactured fentanyl (IMF) over time and geography. Results showed that the proportion of heroin seizures mentioning IMF and IMF seizures grew from near 0 to more than two-thirds. In California, most IMF seizures involved counterfeit tablets, while seizures in New York and Massachusetts largely involved powder formulations. The median price per pure gram of IMF powder sold at the >10-≤100g level fell by more than 50% from 2016 to 2021, with an average annual decline of 17%. Read the full report here.

Increased presence of para-Fluorofentanyl identified in lab data in Virginia and Maryland in 2021

Earlier this week, the Washington/Baltimore High Intensity Drug Trafficking Area (HIDTA) released a bulletin as a follow-up to the W/B HIDTA information bulletin #1536, "Increased Presence of Fluorofentanyl Identified in Forensic Casework" disseminated in June 2021. Virginia Department of Forensic Sciences lab data show the number of samples that tested positive for fluorofentanyl and para-fluorofentanyl grew exponentially between Quarter 1 2021 and Quarter 4 2021.

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