Presentation Title: Addressing the Latest Emerging Substance Use Trends: Xylazine, Nitazenes, Tianeptine, Hallucinogens and Others
 

Session Description:
The substance use landscape is ever changing due to shifts in the demand and supply of substances, the increasing or decreasing importance of various risk and protective factors, and the improvement or deterioration of the social determinants of health. It is vital for prevention professionals to be able to identify and understand these changes and know how to appropriately react to them. Relative changes in substance use patterns, or the causes behind use, can lead to a re-prioritization of key prevention activities in a community or state. This presentation will provide an overview of emerging drug trends nationwide, explain what is known about the causes behind these trends, and discuss potential implications for the prevention field. It will also discuss how prevention professionals can find more information about the emerging trends in their communities or states. Lastly, it will summarize how prevention professionals can use emerging trend data to support their strategic planning efforts, leading to improved goals or objectives. By identifying and addressing emerging trends before they fully develop into larger issues, prevention professionals can better serve the populations most in need of services in their area and improve health equity and outcomes.

This presentation will present data on four primary emerging substance use trends: xylazine, nitazenes, tianeptine, and hallucinogens:

• Xylazine is a non-opioid sedative only approved for veterinary use in the United States. Human consumption of xylazine—often alongside opioid use—has been reported in Puerto Rico for over 20 years. Recently, xylazine use has spread across much of the mainland United States, with epicenters in areas of heavy opioid use.
• Nitazenes are synthetic opioids with an extremely high potency— similar to fentanyl. Much like fentanyl, it is frequently mixed into other substances and unknowingly consumed by people— significantly increasing the risk of an overdose. One common nitazene, isonitazene, was first identified in the Midwest in 2019 and has since been identified in other regions.
• Tianeptine is an antidepressant and dietary supplement not approved for either use by the FDA. It has been approved as an antidepressant in some other countries, although that approval has been rescinded by some in recent years. The effects of tianeptine can mimic opioids and recently an increasing number of people have used it as an opioid substitute. Tianeptine poisoning can be fatal and there has been an increase in tianeptine-related calls to poison control centers.
• Hallucinogens are a class of psychoactive substances that can alter perceptions, moods, and states of consciousness. Hallucinogens are one of the oldest known classes of substances and well-known examples include MDMA and LSD. However, in recent years hallucinogen use has been steadily increasing— reaching an all-time high among young adults in 2021, the most recent year with complete data.