"As shown above, the data supports that these stronger, longer-acting agents may be unnecessary, with other research suggesting their existence may also cause undue harm.

"While the addition of stronger, longer-acting opioid overdose reversal agents expands the options available to combat the fatal opioid overdose crisis, their inception is perhaps without clinical grounds. Data supports continued practice without these stronger, longer acting nalmefene agents, and it is unclear whether any benefits nalmefene offers outweigh the apparent risks of its use. Nalmefene may yet find a clinical niche, but at this time, appears to be a solution designed to resolve hypothetical complications without fully understanding the unintended consequences of use.

"As physicians, pharmacists, scientists, and specialists in poison information, we are experts in pharmacology, toxicology, and the management of opioid overdose and addiction. We applaud the effort to seek out new therapeutic strategies for the management of these patients.

New regulations governing methadone treatment for opioid use disorder go into effect in the US on October 2, 2024. As reported by the Associated Press on Sept. 20, 2024 ("US will let more people take methadone at home"):

"● In 2022, 107,941 drug overdose deaths occurred, resulting in an age-adjusted rate of 32.6 deaths per 100,000 standard population (Figure 1).

"● Overall, the age-adjusted rate of drug overdose deaths nearly quadrupled from 8.2 in 2002 to 32.6 in 2022; however, the rate did not significantly change between 2021 (32.4) and 2022 (32.6).

"● Between 2021 and 2022, the age-adjusted rate of drug overdose deaths for males increased 1.1% from 45.1 to 45.6, while the rate for females decreased 1.0% from 19.6 to 19.4, although this decrease was not significant. 
 

"This study presents an independent, laboratory-based assessment of the potential of the first commercially available NTS for drug checking applications. The NTS displayed limited lot-to-lot variability, with an experimental limit of detection for isotonitazene of 2000 or 3000 ng/mL. Twenty-four of the 33 evaluated nitazene analogues cross-reacted with the NTS at concentrations at or below 9000 ng/mL. The test strips consistently detected the presence of a nitazene analogue in 6 authentic drug samples.

"• The global burden of disease and injuries caused by alcohol consumption can be quantified for 31 health conditions on the basis of the available scientific evidence for the role of alcohol use in their development, occurrence and outcomes.

"• Worldwide, 2.6 million deaths were attributable to alcohol consumption in 2019, representing 4.7% of all deaths in that year.

"• The alcohol-attributable disease burden is heaviest among males: 2 million alcohol-attributable deaths and 6.9% of all DALYs among males and 0.6 million deaths and 2.0% of all DALYs among females in 2019.

"Use of hallucinogens in the past 12 months was similar for college and noncollege young adults (7.5% vs. 10.8%) in 2023. There were also no significant differences for past 12 month use of LSD (1.8% vs. 2.3%), hallucinogens other than LSD (7.4% vs. 10.4%), MDMA (ecstasy, Molly; 0.3% vs. 1.2%), and ketamine (1.8% vs. 0.9%; Table/Figure 96)."

"Among people aged 12 or older in 2023, 0.3 percent (or 828,000 people) misused fentanyl in the past year, including 0.2 percent of adolescents aged 12 to 17, 0.3 percent of young adults aged 18 to 25, and 0.3 percent of adults aged 26 or older (Table A.12B). Corresponding estimated numbers of people who misused fentanyl in the past year were 50,000 adolescents aged 12 to 17, 110,000 young adults aged 18 to 25, and 668,000 adults aged 26 or older.