Public Alerts

Levamisole was initially developed in the mid-1960s as a veterinary and human anti-worming drug. In 1990, it was approved by the United States Food and Drug Administration (FDA) as a therapy for the treatment of colorectal cancer, however, by 2000 it had been withdrawn from the market due to severe adverse effects described below. Since the early 2000’s, levamisole has been in widespread use as an adulterating agent for illicit street drugs, especially cocaine, heroin, and fentanyl. Although its prevalence varies over time and geographically, LEVAMISOLE HAS AT TIMES BEEN DETECTED IN UP TO 79% OF THE COCAINE STREET SUPPLY AT VARYING PERCENTAGES, UP TO 74% BY WEIGHT.
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Brorphine is a potent synthetic opioid with structural resemblance to fentanyl and its analogues. However, brorphine is not controlled in the U.S. under core-structure scheduling of fentanyl related substances. Recent detections in drug related deaths leads us to believe this new synthetic opioid has the potential to cause widespread harm and is of public health concern. As of mid-July 2020, brorphine was confirmed in seven blood specimens associated with fatalities in the U.S.; brorphine has also been reported in Europe (Belgium).
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Between 2017 and 2019, the substituted cathinone N-ethyl pentylone (ephylone) was the most commonly encountered emergent synthetic stimulant to appear in forensic casework. Due to its prevalence and contributions to mortality, N-ethyl pentylone was federally scheduled by the United States Drug Enforcement Administration (DEA) in August 2019. This statute created a shift in the NPS drug market, noted by proliferation of two new synthetic stimulants: Eutylone and Benzylone.
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Flualprazolam has been confirmed in at least 44 biological specimens associated with postmortem (PM) death investigations and driving under the influence of drugs (DUID) investigations in the United States since June 2019. The objective of this public announcement is to notify public health and public safety officials, law enforcement, clinicians, medical examiners and coroners, laboratory personnel, and all other related communities about information surrounding the emergent benzodiazepine flualprazolam — a novel psychoactive substance (NPS).

NPS benzodiazepines, sometimes referred to as designer benzodiazepines, are synthetically manufactured drugs, often associated with unknown biological effects and health risks, a dangerous combination for any recreational drug user. NPS benzodiazepines resemble traditional benzodiazepines, such as diazepam and alprazolam, but differ with the addition of new elements or functional groups. NPS benzodiazepines are often prepared in powder or tablet form and can be mixed with street level drugs, including traditional benzodiazepines and opioids. NPS benzodiazepines are of public health and safety concern due to high potency at low doses producing strong sedation and amnesia. Additional adverse effects include loss of coordination, drowsiness, dizziness, blurred vision, slurred speech, and, in some cases, death.
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Isotonitazene has been identified in eight blood specimens associated with postmortem death investigations in the United States since August 2019. Isotonitazene was first reported in August 2019 based on the results from seized drug and toxicology casework in Europe (Belgium) and Canada (Alberta); the Canadian toxicology case was collected in March 2019.
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The objective of this public announcement is to notify public health and public safety, law enforcement, clinicians, medical examiners and coroner, laboratory personnel, and all other related communities about new information surrounding the emergent synthetic cannabinoid 4F-MDMB-BINACA.
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The Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation received notification over the weekend from July 20 to 22, 2018, that hospitals in the Greater Philadelphia Area were seeing increased numbers of admitted patients for suspected opioid overdose.
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