WASHINGTON D.C., United States – April 2018: As of 15 April 2018, the Illinois Department of Public Health (IDPH) has received reports of 126 cases of people suffering from severe bleeding, including three deaths after the use of synthetic cannabinoid products. Between 10 March and 5 April 2018, several persons in Indiana, Maryland, Missouri, and Wisconsin were also presented to emergency departments with unexplained serious bleeding after having used synthetic cannabinoids. A working hypothesis of the authorities concerned is that these synthetic cannabinoid products were contaminated with brodifacoum. Laboratory investigation confirms brodifacoum exposure in at least 18 patients and at least three synthetic cannabinoid product samples related to this outbreak have tested positive for brodifacoum. Health authorities have warned the public about recent increased risks from use of these products.

According to the Maryland Poison Center and the Maryland Department of Health, reported symptoms related to the use of these synthetic cannabinoid products include:

• Bruising
• Nosebleeds
• Bleeding of the gums
• Bleeding out of proportion to the level of injury
• Vomiting blood
• Blood in the urine or stool
• Excessively heavy menstrual bleeding
• Excessive back pain

For further information and updates on this ongoing development, please see:

Centers for Disease Control and Prevention – “Outbreak Alert: Potential Life-Threatening Vitamin K-Dependent Antagonist Coagulopathy Associated With Synthetic Cannabinoids Use”
https://content.govdelivery.com/accounts/USCDC/bulletins/1e6dac3

Illinois Department of Public Health – “Synthetic Cannabinoids”
http://dph.illinois.gov/topics-services/prevention-wellness/medical-cannabis/synthetic-cannabinoids

UNODC Report “Synthetic cannabinoids: Key facts about the largest and most dynamic group of NPS”
https://www.unodc.org/documents/scientific/Global_SMART_Update_13_web.pdf

OTTOWA, Canada – April 2018: According to the Canadian National Report on apparent opioid-related deaths, the opioid crisis has affected every part of the country. In 2016, there were 2,946 apparent opioid-related deaths in Canada and another 2,923 were reported from January to September 2017, corresponding to an estimated annual death rate of 10.6 per 100,000 population in 2017. The majority of the opioid-related deaths in 2016 and in 2017 involved fentanyl or fentanyl analogues and 76 per cent of accidental (unintentional) apparent opioid-related deaths occurred among males. It is expected that these figures will change as additional data become available.

Figure 1. Number (January to September) and estimated annual rate (per 100,000 population) of apparent opioid-related deaths in Canada by province or territory, 2017

For further information please see:

Public Health Agency of Canada – “National report: Apparent opioid-related deaths in Canada”
https://www.canada.ca/en/public-health/services/publications/healthy-living/national-report-apparent-opioid-related-deaths-released-march-2018.html

Drug Analysis Service (DAS) – “Drug Analysis Service: Summary report of samples analysed”
https://www.canada.ca/en/health-canada/services/health-concerns/controlled-substances-precursor-chemicals/drug-analysis-service/drug-analysis-service-summary-report-samples-analysed.html

UNODC Report “Fentanyl and its analogues - 50 years on”
https://www.unodc.org/documents/scientific/Global_SMART_Update_17_web.pdf

WASHINGTON D.C., United States – April 2018: The Center for Forensic Science Research and Education (CFSRE), in collaboration with NMS Labs and the Organized Crime Drug Enforcement Task Force (OCDETF) in the Department of Justice, has documented several NPS, which have been identified in the United States for the very first time. The NPS identified in seized material include four synthetic cannabinoids, four fentanyl analogues as well as another synthetic opioid, U-48800.

Figure 1. NPS identified for the first time in seized material in the United States

For further information, please see:

The Center for Forensic Science Research and Education (CFSRE) – “NPS discovery”
https://www.forensicscienceeducation.org/resources/nps-discovery/

For more information on the global emergence of NPS, see:

Global SMART Update Volume 19 “Understanding the synthetic drug market: the NPS factor”
https://www.unodc.org/documents/scientific/Global_Smart_Update_2018_Vol.19.pdf

CANBERRA, Australia – March 2018: In a “Global review of drug checking services operating in 2017” the Australian Drug Policy Modelling Program (DPMP) analysed the features of 31 drug checking services operating in 20 countries across Europe, the Americas and Australasia. This report shows that there has been a strong increase in the number of organisations conducting drug checking and that they are employing a breadth of analytic techniques to identify and quantify the contents of drug samples. All drug checking services communicate their forensic results directly to individual service users and more than half also alert the public, health/welfare/outreach, researchers and promoters/event managers of the test results. Alongside the feedback about the drug sample’s content, almost every service provides a brief intervention and most provide harm reduction information. When particularly dangerous drug samples are identified, drug checking services can play a role in issuing early warning alerts and informing specific harm reduction interventions.

Figure: Number of drug checking services operating in 2017 worldwide

For more information, please see:

Drug Policy Modelling Program (DPMP) Bulletin – “Global review of drug checking services operating in 2017”
https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Global%20review%20of%20drug%20checking%20services%20operating%20in%202017.pdf

Profiles of drug checking services in 2017
https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Profiles%20of%20drug%20checking%20services%20in%202017.pdf

VIENNA, Austria – March 2018: From 20 to 22 March 2018, the UNODC Laboratory and Scientific Section (LSS), in collaboration with the UNODC Regional Office for Central America and the Caribbean in Panama (UNODC ROPAN), conducted the first capacity building workshop on “Drug identification with handheld electronic field testing devices” for law enforcement and laboratory officers in Central America and the Caribbean. This workshop was held in Panama City and attended by officers from the Bahamas, the Dominica Republic, Jamaica, Panama, and Trinidad and Tobago. Training enhanced the capacity of law enforcement and laboratory personnel to identify a wide range of controlled substances as well as new synthetic substances. This workshop was the first training to introduce the use of hand-held electronic field testing devices, a Raman spectrometer, for which UNODC guidelines and a training course had been recently developed. The meeting was closed with a handing over ceremony of two handheld electronic field testing devices for Panama to the Minister for Public Security, His Excellency Alexis Bethancourt. Following the workshop, each attending country will receive 2 Raman spectrometers.

For more information, please see:

UNODC Guidelines on Raman Handheld Field Identification Devices for Seized Material
https://www.unodc.org/documents/scientific/Guidelines_Raman_Handheld_Field_dentification_Devices.pdf

Tweet – “UNODC conducts its first training on using handheld electronic field testing devices for drug and precursor identification in Central America and the Caribbean”
https://twitter.com/raithelhuber/status/977150037477249024

Tweet – “UNODC conducts its first training on using handheld electronic field testing devices for drug and precursor identification in Central America and the Caribbean” (Spanish)
https://twitter.com/UNODC_ROPAN/status/976591101355266048

WELLINGTON, New Zealand – March 2018: On 14th March 2018, the New Zealand Police issued a warning about N-ethylpentylone after Christchurch Hospital Emergency Department reported the admission of 13 people at the end of February, who had unintentionally used N-ethylpentylone which had been sold to them as “ecstasy”.

N-ethylpentylone, which is also known as ethylone, has been reported to the UNODC Early Warning Advisory by 28 countries from East Asia, Europe and North America. The majority of these countries identified the substance for the first time in 2016. The substance was first reported to UNODC in 2011.

For further information please see:

New Zealand Police – “Police issue warning about N-Ethylpentylone”
http://www.police.govt.nz/news/release/police-issue-warning-about-n-ethylpentylone

VIENNA, Austria – March 2018: At its 61st regular session from 12 to 16 March 2018, the Commission on Narcotic Drugs decided to place twelve susbtances under international control. Following recommendations by the WHO Expert Committee on Drug Dependence, twelve substances were added to the relevant schedules of the Single Convention on Narcotic Drugs of 1961 as amended by the 1972 Protocol and the Convention on Psychotropic Substances of 1971.

Added to the Single Convention on Narcotic Drugs of 1961, as amended by the 1972 Protocol

1. Ocfentanil - Schedule I
2. Furanylfentanyl (Fu-F) - Schedule I
3. Acryloylfentanyl (Acrylfentanyl) - Schedule I
4. 4-fluoroisobutyrfentanyl (para-Fluoroisobutyrfentanyl, 4-FIBF, pFIBF) - Schedule I
5. Tetrahydrofuranylfentanyl (THF-F) - Schedule I
6. Carfentanil - Schedule I and Schedule IV

Added to the Convention on Psychotropic Substances of 1971

7. 4-fluoramphetamine (4-FA) - Schedule II
8. AB-PINACA - Schedule II
9. AB-CHMINACA - Schedule II
10. 5F-PB-22 - Schedule II
11. UR-144 - Schedule II
12. 5F-MDMB-PINACA (5F-ADB) - Schedule II