By Janette L. Smith, Jared Brown, David Atefi, Thanjira Jiranantakan, Vanessa Shaw, Christopher Ewers, Lorraine du Toit-Prinsloo, Darren M. Roberts

Novel opioids, including non-medical and non-opium-based opioids such as fentanyl analogues and nitazenes, pose a significant risk of harm due to their high potency. There is little published data on novel opioid detections and harms in Australia, yet they are implicated in multiple deaths. This study describes the detections and harms of novel opioids in New South Wales.

Methods

A retrospective analysis was conducted using four statewide datasets: Coronial Toxicology, the Illicit Drug Analysis Unit, the Prescription, Recreational and Illicit Substance Evaluation Program (PRISE), and the NSW Poisons Information Centre. These datasets were interrogated for available data (cases or substances seized by police) on novel opioid detections between 1 January 2019 and 31 May 2024.

Results

Overall, there were 106 novel opioid detections in 103 cases. PRISE identified 91% of clinical cases, reflecting the program's reach. Fentanyl analogues predominated until 2021, whereas nitazenes predominated from 2022. Most detections were acetylfentanyl (n = 54), followed by isotonitazene detections (n = 13). Positive detections were more frequent in urine compared to blood, supporting testing on both samples. Overall numbers were low, but they were often associated with harm, including deaths.

Discussion and Conclusions

We anticipate that these data underestimate the harms from novel opioids; for example, these drugs are not being tested routinely in laboratory testing of biological samples, and not all police seizures are analysed. A change in the predominant novel opioid was observed during the study period. Enhancing systems for readiness to detect and respond to novel opioids is vital, including resourcing laboratories.

Drug Alcohol Rev. 2025;1–11

By European Union Drugs Agency (EUDA)

The European Drug Report 2025: Trends and Developments presents the EUDA’s latest analysis of the drug situation in Europe. Focusing on illicit drug use, related harms and drug supply, the report provides a comprehensive set of national data across these themes, as well as on specialist drug treatment and key harm reduction interventions

This report is based on information provided to the EUDA by the EU Member States, the candidate country Türkiye, and Norway, in an annual reporting process. The purpose of the current report is to provide an overview and summary of the European drug situation up to the end of 2024. All grouping, aggregates and labels therefore reflect the situation based on the available data in 2024 in respect to the composition of the European Union and the countries participating in the EUDA’s reporting exercises. However, not all data will cover the full period. Due to the time needed to compile and submit data, many of the annual national data sets included here are from the reference year January to December 2023. Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour such as drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Although considerable improvements can be noted, both nationally and in respect to what is possible to achieve in a European-level analysis, the methodological difficulties in this area must be acknowledged. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Caveats relating to the data are to be found in the online Statistical Bulletin 2025 , which contains detailed information on methodology, qualifications on analysis and comments on the limitations in the information set available. Information is also available there on the methods and data used for European-level estimates, where interpolation may be used :

PortugalEuropean Union Drugs Agency (EUDA); 2025 355p

By Godwin Omokhagbo Emmanuel, Folahanmi Tomiwa Akinsolu , Olunike Rebecca Abodunrin,

Oliver Chukwujekwu Ezechi

ntroduction

Substance use is a growing public health concern in West Africa, contributing to significant morbidity, mortality, and socioeconomic challenges. Despite the increasing prevalence, comprehensive data on the patterns and factors influencing substance use in the region remain limited. This systematic review and meta-analysis aim to synthesize existing research on the prevalence and patterns of substance use in West Africa, providing critical insights for developing targeted interventions and policies.

Methodology

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines. A systematic search was performed across four major databases [PubMed, Web of Science, CINAHL, and Scopus] from January 2000 to June 2024. A total of 22 studies involving 43,145 participants met the inclusion criteria. Multiple reviewers performed data extraction and quality assessment independently, and a random-effects meta-analysis was used to estimate the pooled prevalence of various substances. Sensitivity analysis was conducted using a leave-one-out approach to evaluate the influence of individual studies on the overall prevalence.

Results

The meta-analysis revealed the pooled prevalence rates of alcohol [44%], cannabis [6%], tramadol [30%], codeine [11%], and kolanut [39%]. The analysis identified high heterogeneity across studies [I2 = 98– 99%], reflecting diverse substance use patterns and influencing factors, including peer influence, availability of substances, socioeconomic conditions, and demographic characteristics. Sensitivity analysis indicated that no single study significantly impacted the overall prevalence estimates, confirming the robustness of the findings.

Conclusion

Substance use in West Africa is widespread and influenced by complex factors. The high prevalence of alcohol and tramadol use highlights the urgent need for targeted public health interventions, including stricter regulatory frameworks, community-based prevention programs, and comprehensive public education campaigns. This study provides a critical foundation for developing effective strategies to mitigate the escalating substance use crisis in the region.

PLOS Glob Public Health 4(12): e0004019. https://doi.org/10.1371/journal. pgph.0004019