We understand that the landscape of drug overdose prevention is shifting rapidly. Many of you in government and frontline programs fear for your jobs, while others find themselves tasked with allocating opioid settlement funds. Drug overdose deaths are declining overall, but far too many people are still dying, with some communities facing greater burdens than ever. In some areas, harm reduction is flourishing; elsewhere, we witness the curtailing of lifesaving services. Younger activists are charting a new path forward, while established organizations rethink their strategies.
These are disorienting times. As a society, we can be—and always have been—many things at once. While it may feel like there is no cohesive path forward, we encourage you to recommit to meeting the needs of the people you serve. We are on the right path, and this is a time for fortitude. It is also a time for grace. There will be setbacks, and we can only suggest that resilience through rest will be an essential coping strategy. Hang in there; we got each other!
〽️Service Stats & Updates
As of Wednesday March 26, 2025...
11,578 samples analyzed
Serving 167 harm reduction programs
Reaching 244 counties in 40 states
404 unique substances identified
No changes to our Watchlist, but click below to see Live Reports on cafentanil, (dex)medetomidine, nitazenes, BTMPS and more.
NC Summit on Reducing Overdose
Top left/bottom right: Our UNC SDAL team; Top right/bottom left: Our team participating in a naloxone training and kit making making event held by Remedy Alliance's rockstars Maya and Eliza.
Our team attended the NC Summit on Reducing OD, in Raleigh, NC March 18-20, 2025. We engaged in insightful workshops, collaborative sessions, and inspiring keynotes (slides) that deepened our understanding and commitment to harm reduction strategies- one of those being our very own Dr. Nab😃 . The summit reinforced the power of community-driven solutions in reducing overdoses and supporting the health and well-being of people who use drugs. (Welcome to our new readers from the conference)
Department of Data
In exciting news, scientists in Sicily, Italy have independently determined the precise mechanism of interaction between xylazine and the kappa opioid receptor. They also point to strong binding to serotonin receptors, confirming computationally in silico what we observed experimentally.
An eye-opening component of their analysis was to create 500 new virtual molecules that had similar binding properties at kappa and serotonin receptors; they conclude: "The results of all the series [of virtual molecules] indicate that the chemical landscape for this class of compounds is still huge and that small modifications may further increase the activity of the parent molecule." This is the scientific first warning note that cracking down on xylazine now could readily lead to the synthesis and emergence of new knock-off xylazine-alike street drugs tomorrow.
See the open access paper by Floresta et al. for the [highly] technical details.
Giuseppe Floresta
Back on the street, after climbing steadily last summer and into the fall, we have started to see a slight dip in xylazine and (dex)medetomidine in fentanyl samples since the start of the calendar year. This may be because folks are used to expecting it, or may signal yet another shift in the drug supply. This is a bit puzzling since we expected these substances to proliferate, or perhaps there is enough consumer pushback to change the market? We know there is deep dissatisfaction with the synthetic opioid supply right now. If what we are seeing in our raw data is borne out by more complete analyses, it could be that these trends may already be changing before the expected passage of the HALT Fentanyl Act. But we encourage caution in drawing too many conclusions!
New Substances Detected
We saw an influx of new pharmaceuticals submitted to our service, which we think could be due to folks testing out the limits of our detection capabilities. What's more relevant is that we (and other drug checking programs) are seeing an uptick in interest and samples containing (unregulated) hormones purchased online. Our methods are good at detecting them, and I don't think many of us are surprised.
We'll get back to deeper analyses of new detections next month, but you can see the new detections here in the meantime.
🤔Thinking of getting a FTIR?
Read more about whether an FTIR machine would be a feasible option for your program!
Colin Wasson Miller
🤗 Opportunities for Impact
Job postings, conferences, proposals, and other events for you harm reduction baddies! If you have a job posting or event you'd like us to highlight, please be in touch.
- ACDC Summit
The 6th annual Alliance for Collaborative Drug Checking (ACDC) Virtual Summit will be held May 27-30th (12:30PM-6:30PM ET). The registration page is live! This is a great opportunity to hear from a wide variety of folks about all things drug checking. Last year’s topics included: Safe(ish) supply: Drug checking's role in DIY safe supply, Legislation and Advocacy for Drug Checking Programs, and Considerations in Advancing Drug Checking: Ethics, Research Relationships and the Limits of Data. Check out more here. - DHHS/Vital Strategies is hiring for a naloxone coordinator in NC. Click here to learn more.
- ICYMI the great panel discussion on recent changes in the drug supply at the Drug Policy Alliance virtual series is now up. Catch the rest on New Drugs and Markets: Meeting the Challenge of a Changing Drug Policy Landscape.
April 10, 2025 | 3:30pm – 5:00pm ET | Panel 2: Addressing Myths, Misinformation, and Real Harms
May 8, 2025 | 3:30pm – 5:00pm ET | Panel 3: Understanding Drug Markets
May 29, 2025 | 3:00pm – 5:00pm ET | Panel 4: Scaling Up Drug Checking, Envisioning Safe Supply, and Exploring New Horizons
- A study is being conducted for individuals impacted by the Felony SNAP ban due to a drug-related conviction. They are seeking participants who either have children or were affected as children when their parents were unable to access SNAP benefits. Participants will receive $50 per interview. Click here to find out more.
🎙️ Podcasts
Dr. Stefan Kertesz at the University of Alabama in Birmingham released this excellent podcast entitled “Caring for Patients or Policing Them? Prescription Drug Monitoring, Doctors and Opioids” with author Liz Chiarello.
🥼 Lab Visits
📖 Reading Room
A place for things that taught us something new and maybe you will learn something too!
JAMA Network Open: More on the Drug Bust Paradox. A new study out of San Francisco found a 74% increase in fatal opioid overdoses within 100 meters the day following drug seizure events. (news coverage) The risk persisted for a week. The study is consistent with another one from Indianapolis.
CDC’s Injury Center has launched the Mapping Injury, Overdose, and Violence Dashboard, providing localized, real-time data on overdose, suicide, and homicide deaths down to the census tract level. This tool can help federal, state, local, and tribal partners better understand and prevent injuries and violence in their communities. Explore the dashboard today to access timely, actionable data that can support public health strategies.
Bloomberg News did a nice story entitled "What We're Getting Right Fighting the Overdose Epidemic," including an important perspective from Indigenous communities. It's behind a paywall, but, ahem.
✈️ Out and About
We wrapped up our third and last site of a FDA-funded study on how people actually use naloxone. Through 75 in-depth interviews, we explored how many doses people use, how folks modify their risk for overdose, and other themes. Stay tuned for more on this important work. And thanks to taxpayers for funding science that saves lives.
👋 Meet Our Team Members
All team members play a part in making our newsletter come to life 😊
Paula
Paula joined our team last year to help out during a transition period and has stuck around (guess she likes us😜). She has a depth of experience in public health and research study methodology and operations (and furbabies).
🏆 Box of the Month
Sometimes our amazing partners write us a warm message, doodle or draw a picture on the return boxes we send out. This is in no way a requirement (♻️ we reuse the boxes), but we love receiving the random surprises!
Each month, we will showcase boxes we love.
