International Drug Scheduling; Convention on Psychotropic Substances; Single Convention on Narcotic Drugs; ADB-BUTINACA; Adinazolam; Bromazolam; Protonitazene (Propoxynitazene); Etazene (Etodesnitazene); Etonitazepyne (N-Pyrrolidino etonitazene); 2-Methyl-AP-237; Alpha-PiHP; 3-Methylmethcathinone (3-MMC); Zopiclone; Request for Comments, 47428-47431 [2022-16572]
Download as PDF
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interests. There may also be an alternate
industry representative.
The Commissioner or designee shall
have the authority to select members of
other scientific and technical FDA
advisory committees (normally not to
exceed 10 members) to serve
temporarily as voting members and to
designate consultants to serve
temporarily as voting members when:
(1) expertise is required that is not
available among current voting standing
members of the Committee (when
additional voting members are added to
the Committee to provide needed
expertise, a quorum will be based on the
combined total of regular and added
members); or (2) to comprise a quorum
when, because of unforeseen
circumstances, a quorum is or will be
lacking. Because of the size of the
Committee and the variety in the types
of issues that it will consider, FDA may,
in connection with a particular
committee meeting, specify a quorum
that is less than most of the current
voting members. The Agency’s
regulations (21 CFR 14.22(d)) authorize
a committee charter to specify quorum
requirements.
If functioning as a medical device
panel, an additional non-voting
representative member of consumer
interests and an additional non-voting
representative member of industry
interests will be included in addition to
the voting members.
Further information regarding the
most recent charter and other
information can be found at https://
www.fda.gov/advisory-committees/
blood-vaccines-and-other-biologics/
blood-products-advisory-committee or
by contacting the Designated Federal
Officer (see FOR FURTHER INFORMATION
CONTACT). In light of the fact that no
change has been made to the committee
name or description of duties, no
amendment will be made to 21 CFR
14.100.
This notice is issued under the
Federal Advisory Committee Act (5
U.S.C. App.). For general information
related to FDA advisory committees,
please visit us at https://www.fda.gov/
AdvisoryCommittees/default.htm.
Dated: July 28, 2022.
Lauren K. Roth,
Associate Commissioner for Policy.
[FR Doc. 2022–16577 Filed 8–2–22; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2022–N–1625]
International Drug Scheduling;
Convention on Psychotropic
Substances; Single Convention on
Narcotic Drugs; ADB-BUTINACA;
Adinazolam; Bromazolam;
Protonitazene (Propoxynitazene);
Etazene (Etodesnitazene);
Etonitazepyne (N-Pyrrolidino
etonitazene); 2-Methyl-AP-237; AlphaPiHP; 3-Methylmethcathinone (3-MMC);
Zopiclone; Request for Comments
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice; request for comments.
The Food and Drug
Administration (FDA or Agency) is
inviting interested persons to submit
comments concerning abuse potential,
actual abuse, medical usefulness,
trafficking, and impact of scheduling
changes on availability for medical use
of 10 drug substances. These comments
will be considered in preparing a
response from the United States to the
World Health Organization (WHO)
regarding the abuse liability and
diversion of these drugs. WHO will use
this information to consider whether to
recommend that certain international
restrictions be placed on these drug
substances. This notice requesting
comments is required by the Controlled
Substances Act (CSA).
DATES: Either electronic or written
comments must be submitted by August
24, 2022.
ADDRESSES: You may submit comments
as follows. Please note that late,
untimely filed comments will not be
considered. The https://
www.regulations.gov electronic filing
system will accept comments until
11:59 p.m. Eastern Time at the end of
August 24, 2022. Comments received by
mail/hand delivery/courier (for written/
paper submissions) will be considered
timely if they are received on or before
that date.
SUMMARY:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal:
https://www.regulations.gov. Follow the
instructions for submitting comments.
Comments submitted electronically,
including attachments, to https://
www.regulations.gov will be posted to
the docket unchanged. Because your
comment will be made public, you are
solely responsible for ensuring that your
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comment does not include any
confidential information that you or a
third party may not wish to be posted,
such as medical information, your or
anyone else’s Social Security number, or
confidential business information, such
as a manufacturing process. Please note
that if you include your name, contact
information, or other information that
identifies you in the body of your
comments, that information will be
posted on https://www.regulations.gov.
• If you want to submit a comment
with confidential information that you
do not wish to be made available to the
public, submit the comment as a
written/paper submission and in the
manner detailed (see ‘‘Written/Paper
Submissions’’ and ‘‘Instructions’’).
Written/Paper Submissions
Submit written/paper submissions as
follows:
• Mail/Hand Delivery/Courier (for
written/paper submissions): Dockets
Management Staff (HFA–305), Food and
Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Dockets Management
Staff, FDA will post your comment, as
well as any attachments, except for
information submitted, marked and
identified, as confidential, if submitted
as detailed in ‘‘Instructions.’’
Instructions: All submissions received
must include the Docket No. FDA–
2022–N–1625 for ‘‘International Drug
Scheduling; Convention on
Psychotropic Substances; Single
Convention on Narcotic Drugs; ADBBUTINACA; Adinazolam; Bromazolam;
Protonitazene (propoxynitazene);
Etazene (etodesnitazene); Etonitazepyne
(N-pyrrolidino etonitazene); 2-MethylAP-237; alpha-PiHP; 3Methylmethcathinone (3-MMC);
Zopiclone; Request for Comments’’
Received comments, those filed in a
timely manner (see ADDRESSES), will be
placed in the docket and, except for
those submitted as ‘‘Confidential
Submissions,’’ publicly viewable at
https://www.regulations.gov or at the
Dockets Management Staff between 9
a.m. and 4 p.m., Monday through
Friday, 240–402–7500.
• Confidential Submissions—To
submit a comment with confidential
information that you do not wish to be
made publicly available, submit your
comments only as a written/paper
submission. You should submit two
copies total. One copy will include the
information you claim to be confidential
with a heading or cover note that states
‘‘THIS DOCUMENT CONTAINS
CONFIDENTIAL INFORMATION.’’ The
Agency will review this copy, including
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Federal Register / Vol. 87, No. 148 / Wednesday, August 3, 2022 / Notices
the claimed confidential information, in
its consideration of comments. The
second copy, which will have the
claimed confidential information
redacted/blacked out, will be available
for public viewing and posted on
https://www.regulations.gov. Submit
both copies to the Dockets Management
Staff. If you do not wish your name and
contact information to be made publicly
available, you can provide this
information on the cover sheet and not
in the body of your comments and you
must identify this information as
‘‘confidential.’’ Any information marked
as ‘‘confidential’’ will not be disclosed
except in accordance with 21 CFR 10.20
and other applicable disclosure law. For
more information about FDA’s posting
of comments to public dockets, see 80
FR 56469, September 18, 2015, or access
the information at: https://
www.govinfo.gov/content/pkg/FR-201509-18/pdf/2015-23389.pdf.
Docket: For access to the docket to
read background documents or the
electronic and written/paper comments
received, go to https://
www.regulations.gov and insert the
docket number, found in brackets in the
heading of this document, into the
‘‘Search’’ box and follow the prompts
and/or go to the Dockets Management
Staff, 5630 Fishers Lane, Rm. 1061,
Rockville, MD 20852, 240–402–7500.
FOR FURTHER INFORMATION CONTACT:
Edward (Greg) Hawkins, Center for Drug
Evaluation and Research, Controlled
Substance Staff, Food and Drug
Administration, 10903 New Hampshire
Ave., Bldg. 51, Rm. 5150, Silver Spring,
MD 20993–0002, 301–796–0727,
edward.hawkins@fda.hhs.gov.
SUPPLEMENTARY INFORMATION:
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I. Background
The United States is a party to the
1971 Convention on Psychotropic
Substances (Psychotropic Convention).
Article 2 of the Psychotropic
Convention provides that if a party to
the convention or WHO has information
about a substance, which in its opinion
may require international control or
change in such control, it shall so notify
the Secretary-General of the United
Nations (U.N. Secretary-General) and
provide the U.N. Secretary-General with
information in support of its opinion.
Section 201(d)(2)(A) of the CSA (21
U.S.C. 811(d)(2)(A)) (Title II of the
Comprehensive Drug Abuse Prevention
and Control Act of 1970) provides that
when WHO notifies the United States
under Article 2 of the Psychotropic
Convention that it has information that
may justify adding a drug or other
substances to one of the schedules of the
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Psychotropic Convention, transferring a
drug or substance from one schedule to
another, or deleting it from the
schedules, the Secretary of State must
transmit the notice to the Secretary of
Health and Human Services (Secretary
of HHS). The Secretary of HHS must
then publish the notice in the Federal
Register and provide opportunity for
interested persons to submit comments
that will be considered by HHS in its
preparation of the scientific and medical
evaluations of the drug or substance.
II. WHO Notification
The Secretary of HHS received the
following notice from WHO
(nonrelevant text removed):
Ref.: C.L.27.2022
The World Health Organization (WHO)
presents its compliments to Member States
and Associate Members and has the pleasure
of announcing that the 45th Expert
Committee on Drug Dependence (ECDD) will
meet from 10 to 14 October 2022, in Geneva,
Switzerland. Given that WHO Expert
Committee meetings are of a closed nature,
this letter serves to notify Member States of
the substances under review at the 45th
ECDD, which are in the Annex I, attached for
reference.
WHO is mandated by the 1961 and 1971
International Drug Control Conventions to
make recommendations to the UN SecretaryGeneral on the need for and level of
international control of psychoactive
substances based on the advice of its
independent scientific advisory body, the
ECDD. To assess whether or not a
psychoactive substance should be placed
under international control, the ECDD
convenes annually to review the potential of
this substance to cause dependence, abuse
and harm to health, as well as any
therapeutic applications. In order to perform
this review and make evidence-based
decisions, the ECDD conducts medical,
scientific, and public health evaluations of
the selected psychoactive substances using
the best available information.
Although the meetings are of a closed
nature, Member States are invited to
contribute to the ECDD review process by
joining the 45th ECDD Open Session on 10
October 2022. The Information Session will
be held virtually and allow interested parties
to learn about present and future activities of
the ECDD Secretariat, and to present
information concerning substances under
review to the Expert Committee for
consideration in its deliberations.
Registration information will be made
available on the ECDD website in due course:
https://www.who.int/medicines/access/
controlled-substances/en/.
As in the past and in line with the
publication ‘‘Guidance on the WHO review of
psychoactive substances for international
control’’ (EB126/2010/REC1, Annex 6) 1,
Member States can also contribute to the
ECDD review process by providing accurate
information concerning the substances under
review in advance of the meeting. For this
purpose, a questionnaire will be sent to
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47429
Member States to gather country information
on the legitimate use, harmful use, status of
national control and potential impact of
international control for each substance
under evaluation.
In addition to the questionnaire, Member
States are also encouraged to provide any
additional relevant information (unpublished
or published) on substances to be reviewed
by the 45th ECDD.
The World Health Organization takes this
opportunity to renew to Member States and
Associate Members the assurance of its
highest consideration.
GENEVA, 10 June 2021
1 https://apps.who.int/gb/ebwha/pdf_files/
EB126-REC1/B126_REC1-en.pdf#page=58.
Annex I
45th Expert Committee on Drug Dependence
(ECDD) Substances For Review 10–14
October 2022
Critical reviews: The substances listed
below have never been formally reviewed by
WHO and are not currently under
international control. Information was
brought to WHO’s attention that these
substances are clandestinely manufactured,
of especially serious risk to public health and
society, and of no recognized therapeutic use
by any Party. The Expert Committee will
consider whether information presented
during a critical review may justify the
scheduling or a change in the scheduling of
the substance in the 1961 or 1971
Conventions.
Synthetic cannabinoid receptor agonists
1. ADB–BUTINACA
Benzodiazepines
2. Adinazolam
3. Bromazolam
Novel synthetic opioids
4. Protonitazene (propoxynitazene)
5. Etazene (etodesnitazene)
6. Etonitazepyne (N-pyrrolidino
etonitazene)
7. 2-Methyl-AP–237
Cathinones/stimulants
8. alpha-PiHP
9. 3-Methylmethcathinone (3–MMC)
Pre-reviews: The substances listed below
have been proposed for a pre-review. The
purpose of a pre-review is to determine
whether current information justifies an
Expert Committee critical review. A prereview is a preliminary analysis and findings
at this stage should not determine whether
the control status of a substance should be
changed.
Medicines
1. Zopiclone
FDA has verified the website addresses
contained in the WHO notice, as of the date
this document publishes in the Federal
Register, but websites are subject to change
over time. Access to view the WHO
questionnaire can be found at https://
www.who.int/publications/m/item/45thecdd-questionnaire.
III. Substances Under WHO Review
ADB–BUTINACA is a synthetic
cannabinoid that has been sold online
and is used to mimic the biological
effects of tetrahydrocannabinol, the
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main psychoactive constituent in
marijuana. Research and clinical reports
have demonstrated that synthetic
cannabinoids are applied onto plant
material so that the material may be
smoked as users attempt to obtain a
euphoric and psychoactive ‘‘high.’’
Synthetic cannabinoids have been
marketed under the guise of ‘‘herbal
incense,’’ and promoted by drug
traffickers as legal alternatives to
marijuana. According to the National
Forensic Laboratory Information System
(NFLIS-Drug) database,1 ADB–
BUTINACA was first reported in 2020,
and there were 4,358 reports in 2021.
There are toxicology reports identifying
ADB–BUTINACA in at least six deaths
and eight non-fatal emergency room
visits. There are no commercial or
approved medical uses for ADB–
BUTINACA. As a positional isomer of
AB–PINACA, ADB–BUTINACA is
controlled in schedule I of the CSA.
Adinazolam is a designer
benzodiazepine (i.e., a structural or
functional analog of other drugs in the
benzodiazepine class) and is expected to
have central nervous system (CNS)
depressant-like effects similar to that of
other known benzodiazepines.
Adinazolam was first reported to NFLISDrug in 2019, and there were 87 reports
in 2021. Adinazolam has appeared in
toxicology reports in the United States.
Adinazolam is not currently controlled
in the United States.
Bromazolam is a designer
benzodiazepine and is expected to have
CNS depressant-like effects similar to
that of other known benzodiazepines.
Bromazolam was first reported to
NFLIS-Drug in 2016, and there were 743
reports in 2021. Bromazolam has
appeared in at least two overdose death
reports in the United States and adverse
effects associated with the use of
bromazolam have been reported.
Bromazolam is not currently controlled
in the United States.
Protonitazene (propoxynitazene),
etazene (etodesnitazene), and
etonitazepyne (N-pyrrolidino
etonitazene) are novel synthetic opioid
receptor agonists of the benzimidazole
structural class. Law enforcement data
indicates that these substances have
appeared on the U.S. illicit markets as
evidenced by their identification in
forensic drug seizures and biological
samples. Etazene was first reported to
NFLIS-Drug in 2020, and there were 41
reports in 2021. Protonitazene and
1 NFLIS-Drug is a national forensic laboratory
reporting system that systematically collects drug
identification results from drug cases submitted to
and analyzed by Federal, State and local forensic
laboratories in the United States. NFLIS-Drug data
were queried on June 29, 2022.
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etonitazepyne were both first reported
to NFLIS-Drug in 2021 with 20 and 129
reports in that year, respectively. The
abuse of these benzimidazole opioids
are similar to other synthetic opioids.
Protonitazene, etazene, and
etonitazepyne have been identified in
toxicology and several post-mortem
cases. The public health risks attendant
to the abuse of mu-opioid receptor
agonists are well established. These
risks included large numbers of drug
treatment admissions, emergency
department visits, and fatal overdoses.
On April 12, 2022, the U.S. Drug
Enforcement Administration issued a
temporary order to control these
substances as schedule I substances
under the CSA.
2-Methyl-AP-237 is a novel synthetic
mu-opioid receptor agonist. It was first
reported to NFLIS-Drug in 2019, and
there were 45 reports in 2021. Abuse of
2-methyl-AP-237 is similar to other
synthetic opioids, and has been
associated with adverse health effects,
including death. In the United States,
there are at least 10 confirmed reports
of fatal poisonings and several reports of
emergency room visits, and non-fatal
poisonings associated with 2-methylAP-237. 2-Methyl-AP-237 is not
currently controlled in the United
States. There are no commercial or
approved medical uses of 2-methyl-AP237.
Alpha-PiHP is a synthetic stimulant
designer drug structurally similar to
other schedule I synthetic cathinones.
Alpha-PiHP is a monoamine transporter
(dopamine transporter and
norepinephrine transporter) uptake
inhibitor. Adverse effects associated
with synthetic cathinones abuse include
agitation, hypertension, tachycardia,
and death. Alpha-PiHP was first
reported to NFLIS-Drug in 2017, and
there were 332 reports in 2021. AlphaPiHP has been confirmed to have played
a role in fatal and non-fatal overdose
events in the United States. Alpha-PiHP
has no approved medical uses in the
United States. As a positional isomer of
alpha-PHP, alpha-PiHP is controlled in
schedule I of the CSA.
3-Methylmethcathinone (3-MMC) is a
designer drug of the phenethylamine
class, which is structurally and
pharmacologically similar to
amphetamine, 3,4methylenedioxymethamphetamine,
cathinone and other related substances.
3-MMC is a monoamine transporter
(dopamine transporter, serotonin
transporter, and norepinephrine
transporter) uptake inhibitor. Like other
schedule I synthetic cathinones, 3-MMC
is abused for its psychoactive effects.
Adverse effects associated with
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synthetic cathinones abuse include
agitation, hypertension, tachycardia,
and death. 3-MMC was first reported to
NFLIS-Drug in 2012, and there were
three reports in 2021. 3-MMC has no
approved medical uses in the United
States. As a positional isomer of
mephedrone, 3-MMC is controlled in
schedule I of the CSA.
Zopiclone is a nervous system
depressant drug used in the treatment of
insomnia. Its mechanism of action is
based on modulating benzodiazepine
receptors. Zopiclone is approved for
medical use in the United States as (S)zopiclone (or eszopiclone), the active (S)
isomer of zopiclone. Zopiclone has
abuse potential and may be misused due
to its ability to produce euphoric effects
at high doses. Amnesia and
hallucinations have been reported with
higher doses. Zopiclone is controlled in
schedule IV of the CSA.
IV. Opportunity To Submit Domestic
Information
As required by section 201(d)(2)(A) of
the CSA, FDA, on behalf of HHS, invites
interested persons to submit comments
regarding the 10 drug substances. Any
comments received will be considered
by HHS when it prepares a scientific
and medical evaluation for drug
substances that is responsive to the
WHO Questionnaire for these drug
substances. HHS will forward such
evaluation of these drug substances to
WHO, for WHO’s consideration in
deciding whether to recommend
international control/decontrol of any of
these drug substances. Such control
could limit, among other things, the
manufacture and distribution (import/
export) of these drug substances and
could impose certain recordkeeping
requirements on them.
Although FDA is, through this notice,
requesting comments from interested
persons, which will be considered by
HHS when it prepares an evaluation of
these drug substances, HHS will not
now make any recommendations to
WHO regarding whether any of these
drugs should be subjected to
international controls. Instead, HHS will
defer such consideration until WHO has
made official recommendations to the
Commission on Narcotic Drugs, which
are expected to be made in late 2022.
Any HHS position regarding
international control of these drug
substances will be preceded by another
Federal Register notice soliciting public
comments, as required by section
201(d)(2)(B) of the CSA.
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Dated: July 28, 2022.
Lauren K. Roth,
Associate Commissioner for Policy.
comments, that information will be
posted on https://www.regulations.gov.
• If you want to submit a comment
with confidential information that you
do not wish to be made available to the
public, submit the comment as a
written/paper submission and in the
manner detailed (see ‘‘Written/Paper
Submissions’’ and ‘‘Instructions’’).
[FR Doc. 2022–16572 Filed 8–2–22; 8:45 am]
BILLING CODE 4164–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2022–D–1173]
Electronic Submission of Expedited
Safety Reports From Investigational
New Drug-Exempt Bioavailability/
Bioequivalence Studies; Draft
Guidance for Industry; Availability
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice of availability.
The Food and Drug
Administration (FDA or Agency) is
announcing the availability of a draft
guidance for industry entitled
‘‘Electronic Submission of Expedited
Safety Reports From IND-Exempt BA/BE
Studies.’’ This guidance provides
instructions for the electronic
submission of expedited individual case
safety reports (ICSRs) from
investigational new drug (IND)-exempt
bioavailability (BA)/bioequivalence (BE)
studies through the FDA Adverse Event
Reporting System (FAERS) database.
DATES: Submit either electronic or
written comments on the draft guidance
by October 3, 2022 to ensure that the
Agency considers your comment on this
draft guidance before it begins work on
the final version of the guidance.
ADDRESSES: You may submit comments
on any guidance at any time as follows:
SUMMARY:
lotter on DSK11XQN23PROD with NOTICES1
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal:
https://www.regulations.gov. Follow the
instructions for submitting comments.
Comments submitted electronically,
including attachments, to https://
www.regulations.gov will be posted to
the docket unchanged. Because your
comment will be made public, you are
solely responsible for ensuring that your
comment does not include any
confidential information that you or a
third party may not wish to be posted,
such as medical information, your or
anyone else’s Social Security number, or
confidential business information, such
as a manufacturing process. Please note
that if you include your name, contact
information, or other information that
identifies you in the body of your
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Written/Paper Submissions
Submit written/paper submissions as
follows:
• Mail/Hand Delivery/Courier (for
written/paper submissions): Dockets
Management Staff (HFA–305), Food and
Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Dockets Management
Staff, FDA will post your comment, as
well as any attachments, except for
information submitted, marked and
identified, as confidential, if submitted
as detailed in ‘‘Instructions.’’
Instructions: All submissions received
must include the Docket No. FDA–
2022–D–1173 for ‘‘Electronic
Submission of Expedited Safety Reports
from IND-Exempt BA/BE Studies.’’
Received comments will be placed in
the docket and, except for those
submitted as ‘‘Confidential
Submissions,’’ publicly viewable at
https://www.regulations.gov or at the
Dockets Management Staff between 9
a.m. and 4 p.m., Monday through
Friday, 240–402–7500.
• Confidential Submissions—To
submit a comment with confidential
information that you do not wish to be
made publicly available, submit your
comments only as a written/paper
submission. You should submit two
copies total. One copy will include the
information you claim to be confidential
with a heading or cover note that states
‘‘THIS DOCUMENT CONTAINS
CONFIDENTIAL INFORMATION.’’ The
Agency will review this copy, including
the claimed confidential information, in
its consideration of comments. The
second copy, which will have the
claimed confidential information
redacted/blacked out, will be available
for public viewing and posted on
https://www.regulations.gov. Submit
both copies to the Dockets Management
Staff. If you do not wish your name and
contact information to be made publicly
available, you can provide this
information on the cover sheet and not
in the body of your comments and you
must identify this information as
‘‘confidential.’’ Any information marked
as ‘‘confidential’’ will not be disclosed
except in accordance with 21 CFR 10.20
and other applicable disclosure law. For
more information about FDA’s posting
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47431
of comments to public dockets, see 80
FR 56469, September 18, 2015, or access
the information at: https://
www.govinfo.gov/content/pkg/FR-201509-18/pdf/2015-23389.pdf.
Docket: For access to the docket to
read background documents or the
electronic and written/paper comments
received, go to https://
www.regulations.gov and insert the
docket number, found in brackets in the
heading of this document, into the
‘‘Search’’ box and follow the prompts
and/or go to the Dockets Management
Staff, 5630 Fishers Lane, Rm. 1061,
Rockville, MD 20852, 240–402–7500.
You may submit comments on any
guidance at any time (see 21 CFR
10.115(g)(5)).
Submit written requests for single
copies of the draft guidance to the
Division of Drug Information, Center for
Drug Evaluation and Research, Food
and Drug Administration, 10001 New
Hampshire Ave., Hillandale Building,
4th Floor, Silver Spring, MD 20993–
0002. Send one self-addressed adhesive
label to assist that office in processing
your requests. See the SUPPLEMENTARY
INFORMATION section for electronic
access to the draft guidance document.
FOR FURTHER INFORMATION CONTACT:
Susan Levine, Center for Drug
Evaluation and Research, Food and
Drug Administration, 10903 New
Hampshire Ave., Bldg. 75, Rm. 1674,
Silver Spring, MD 20993–0002, 240–
402–7936, Susan.Levine@fda.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
FDA is announcing the availability of
a draft guidance for industry entitled
‘‘Electronic Submission of Expedited
Safety Reports from IND-Exempt BA/BE
Studies.’’ This guidance provides
instructions for the electronic
submission of expedited ICSRs from
IND-exempt BA/BE studies through the
FAERS database. An ICSR captures
information necessary to support the
reporting of an adverse event related to
an individual subject that is associated
with the use of an FDA-regulated
product.1 The electronic submission of
the ICSRs from IND-exempt BA/BE
studies is a voluntary option.
In the Federal Register of September
29, 2010 (75 FR 59935), FDA published
a final rule that revised the IND safety
reporting requirements for human drug
and biological products under 21 CFR
312 and added safety reporting
requirements for persons conducting
1 See additional information on Individual Case
Safety Reports available at https://www.fda.gov/
industry/fda-resources-data-standards/individualcase-safety-reports.
E:\FR\FM\03AUN1.SGM
03AUN1
Agencies
[Federal Register Volume 87, Number 148 (Wednesday, August 3, 2022)]
[Notices]
[Pages 47428-47431]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-16572]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2022-N-1625]
International Drug Scheduling; Convention on Psychotropic
Substances; Single Convention on Narcotic Drugs; ADB-BUTINACA;
Adinazolam; Bromazolam; Protonitazene (Propoxynitazene); Etazene
(Etodesnitazene); Etonitazepyne (N-Pyrrolidino etonitazene); 2-Methyl-
AP-237; Alpha-PiHP; 3-Methylmethcathinone (3-MMC); Zopiclone; Request
for Comments
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice; request for comments.
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SUMMARY: The Food and Drug Administration (FDA or Agency) is inviting
interested persons to submit comments concerning abuse potential,
actual abuse, medical usefulness, trafficking, and impact of scheduling
changes on availability for medical use of 10 drug substances. These
comments will be considered in preparing a response from the United
States to the World Health Organization (WHO) regarding the abuse
liability and diversion of these drugs. WHO will use this information
to consider whether to recommend that certain international
restrictions be placed on these drug substances. This notice requesting
comments is required by the Controlled Substances Act (CSA).
DATES: Either electronic or written comments must be submitted by
August 24, 2022.
ADDRESSES: You may submit comments as follows. Please note that late,
untimely filed comments will not be considered. The https://www.regulations.gov electronic filing system will accept comments until
11:59 p.m. Eastern Time at the end of August 24, 2022. Comments
received by mail/hand delivery/courier (for written/paper submissions)
will be considered timely if they are received on or before that date.
Electronic Submissions
Submit electronic comments in the following way:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments. Comments submitted
electronically, including attachments, to https://www.regulations.gov
will be posted to the docket unchanged. Because your comment will be
made public, you are solely responsible for ensuring that your comment
does not include any confidential information that you or a third party
may not wish to be posted, such as medical information, your or anyone
else's Social Security number, or confidential business information,
such as a manufacturing process. Please note that if you include your
name, contact information, or other information that identifies you in
the body of your comments, that information will be posted on https://www.regulations.gov.
If you want to submit a comment with confidential
information that you do not wish to be made available to the public,
submit the comment as a written/paper submission and in the manner
detailed (see ``Written/Paper Submissions'' and ``Instructions'').
Written/Paper Submissions
Submit written/paper submissions as follows:
Mail/Hand Delivery/Courier (for written/paper
submissions): Dockets Management Staff (HFA-305), Food and Drug
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
For written/paper comments submitted to the Dockets
Management Staff, FDA will post your comment, as well as any
attachments, except for information submitted, marked and identified,
as confidential, if submitted as detailed in ``Instructions.''
Instructions: All submissions received must include the Docket No.
FDA-2022-N-1625 for ``International Drug Scheduling; Convention on
Psychotropic Substances; Single Convention on Narcotic Drugs; ADB-
BUTINACA; Adinazolam; Bromazolam; Protonitazene (propoxynitazene);
Etazene (etodesnitazene); Etonitazepyne (N-pyrrolidino etonitazene); 2-
Methyl-AP-237; alpha-PiHP; 3-Methylmethcathinone (3-MMC); Zopiclone;
Request for Comments'' Received comments, those filed in a timely
manner (see ADDRESSES), will be placed in the docket and, except for
those submitted as ``Confidential Submissions,'' publicly viewable at
https://www.regulations.gov or at the Dockets Management Staff between
9 a.m. and 4 p.m., Monday through Friday, 240-402-7500.
Confidential Submissions--To submit a comment with
confidential information that you do not wish to be made publicly
available, submit your comments only as a written/paper submission. You
should submit two copies total. One copy will include the information
you claim to be confidential with a heading or cover note that states
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will
review this copy, including
[[Page 47429]]
the claimed confidential information, in its consideration of comments.
The second copy, which will have the claimed confidential information
redacted/blacked out, will be available for public viewing and posted
on https://www.regulations.gov. Submit both copies to the Dockets
Management Staff. If you do not wish your name and contact information
to be made publicly available, you can provide this information on the
cover sheet and not in the body of your comments and you must identify
this information as ``confidential.'' Any information marked as
``confidential'' will not be disclosed except in accordance with 21 CFR
10.20 and other applicable disclosure law. For more information about
FDA's posting of comments to public dockets, see 80 FR 56469, September
18, 2015, or access the information at: https://www.govinfo.gov/content/pkg/FR-2015-09-18/pdf/2015-23389.pdf.
Docket: For access to the docket to read background documents or
the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in
the heading of this document, into the ``Search'' box and follow the
prompts and/or go to the Dockets Management Staff, 5630 Fishers Lane,
Rm. 1061, Rockville, MD 20852, 240-402-7500.
FOR FURTHER INFORMATION CONTACT: Edward (Greg) Hawkins, Center for Drug
Evaluation and Research, Controlled Substance Staff, Food and Drug
Administration, 10903 New Hampshire Ave., Bldg. 51, Rm. 5150, Silver
Spring, MD 20993-0002, 301-796-0727, [email protected].
SUPPLEMENTARY INFORMATION:
I. Background
The United States is a party to the 1971 Convention on Psychotropic
Substances (Psychotropic Convention). Article 2 of the Psychotropic
Convention provides that if a party to the convention or WHO has
information about a substance, which in its opinion may require
international control or change in such control, it shall so notify the
Secretary-General of the United Nations (U.N. Secretary-General) and
provide the U.N. Secretary-General with information in support of its
opinion.
Section 201(d)(2)(A) of the CSA (21 U.S.C. 811(d)(2)(A)) (Title II
of the Comprehensive Drug Abuse Prevention and Control Act of 1970)
provides that when WHO notifies the United States under Article 2 of
the Psychotropic Convention that it has information that may justify
adding a drug or other substances to one of the schedules of the
Psychotropic Convention, transferring a drug or substance from one
schedule to another, or deleting it from the schedules, the Secretary
of State must transmit the notice to the Secretary of Health and Human
Services (Secretary of HHS). The Secretary of HHS must then publish the
notice in the Federal Register and provide opportunity for interested
persons to submit comments that will be considered by HHS in its
preparation of the scientific and medical evaluations of the drug or
substance.
II. WHO Notification
The Secretary of HHS received the following notice from WHO
(nonrelevant text removed):
Ref.: C.L.27.2022
The World Health Organization (WHO) presents its compliments to
Member States and Associate Members and has the pleasure of
announcing that the 45th Expert Committee on Drug Dependence (ECDD)
will meet from 10 to 14 October 2022, in Geneva, Switzerland. Given
that WHO Expert Committee meetings are of a closed nature, this
letter serves to notify Member States of the substances under review
at the 45th ECDD, which are in the Annex I, attached for reference.
WHO is mandated by the 1961 and 1971 International Drug Control
Conventions to make recommendations to the UN Secretary-General on
the need for and level of international control of psychoactive
substances based on the advice of its independent scientific
advisory body, the ECDD. To assess whether or not a psychoactive
substance should be placed under international control, the ECDD
convenes annually to review the potential of this substance to cause
dependence, abuse and harm to health, as well as any therapeutic
applications. In order to perform this review and make evidence-
based decisions, the ECDD conducts medical, scientific, and public
health evaluations of the selected psychoactive substances using the
best available information.
Although the meetings are of a closed nature, Member States are
invited to contribute to the ECDD review process by joining the 45th
ECDD Open Session on 10 October 2022. The Information Session will
be held virtually and allow interested parties to learn about
present and future activities of the ECDD Secretariat, and to
present information concerning substances under review to the Expert
Committee for consideration in its deliberations. Registration
information will be made available on the ECDD website in due
course: https://www.who.int/medicines/access/controlled-substances/en/.
As in the past and in line with the publication ``Guidance on
the WHO review of psychoactive substances for international
control'' (EB126/2010/REC1, Annex 6) \1\, Member States can also
contribute to the ECDD review process by providing accurate
information concerning the substances under review in advance of the
meeting. For this purpose, a questionnaire will be sent to Member
States to gather country information on the legitimate use, harmful
use, status of national control and potential impact of
international control for each substance under evaluation.
In addition to the questionnaire, Member States are also
encouraged to provide any additional relevant information
(unpublished or published) on substances to be reviewed by the 45th
ECDD.
The World Health Organization takes this opportunity to renew to
Member States and Associate Members the assurance of its highest
consideration.
GENEVA, 10 June 2021
\1\ https://apps.who.int/gb/ebwha/pdf_files/EB126-REC1/B126_REC1-en.pdf#page=58.
Annex I
45th Expert Committee on Drug Dependence (ECDD) Substances For Review
10-14 October 2022
Critical reviews: The substances listed below have never been
formally reviewed by WHO and are not currently under international
control. Information was brought to WHO's attention that these
substances are clandestinely manufactured, of especially serious
risk to public health and society, and of no recognized therapeutic
use by any Party. The Expert Committee will consider whether
information presented during a critical review may justify the
scheduling or a change in the scheduling of the substance in the
1961 or 1971 Conventions.
Synthetic cannabinoid receptor agonists
1. ADB-BUTINACA
Benzodiazepines
2. Adinazolam
3. Bromazolam
Novel synthetic opioids
4. Protonitazene (propoxynitazene)
5. Etazene (etodesnitazene)
6. Etonitazepyne (N-pyrrolidino etonitazene)
7. 2-Methyl-AP-237
Cathinones/stimulants
8. alpha-PiHP
9. 3-Methylmethcathinone (3-MMC)
Pre-reviews: The substances listed below have been proposed for
a pre-review. The purpose of a pre-review is to determine whether
current information justifies an Expert Committee critical review. A
pre-review is a preliminary analysis and findings at this stage
should not determine whether the control status of a substance
should be changed.
Medicines
1. Zopiclone
FDA has verified the website addresses contained in the WHO
notice, as of the date this document publishes in the Federal
Register, but websites are subject to change over time. Access to
view the WHO questionnaire can be found at https://www.who.int/publications/m/item/45th-ecdd-questionnaire.
III. Substances Under WHO Review
ADB-BUTINACA is a synthetic cannabinoid that has been sold online
and is used to mimic the biological effects of tetrahydrocannabinol,
the
[[Page 47430]]
main psychoactive constituent in marijuana. Research and clinical
reports have demonstrated that synthetic cannabinoids are applied onto
plant material so that the material may be smoked as users attempt to
obtain a euphoric and psychoactive ``high.'' Synthetic cannabinoids
have been marketed under the guise of ``herbal incense,'' and promoted
by drug traffickers as legal alternatives to marijuana. According to
the National Forensic Laboratory Information System (NFLIS-Drug)
database,\1\ ADB-BUTINACA was first reported in 2020, and there were
4,358 reports in 2021. There are toxicology reports identifying ADB-
BUTINACA in at least six deaths and eight non-fatal emergency room
visits. There are no commercial or approved medical uses for ADB-
BUTINACA. As a positional isomer of AB-PINACA, ADB-BUTINACA is
controlled in schedule I of the CSA.
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\1\ NFLIS-Drug is a national forensic laboratory reporting
system that systematically collects drug identification results from
drug cases submitted to and analyzed by Federal, State and local
forensic laboratories in the United States. NFLIS-Drug data were
queried on June 29, 2022.
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Adinazolam is a designer benzodiazepine (i.e., a structural or
functional analog of other drugs in the benzodiazepine class) and is
expected to have central nervous system (CNS) depressant-like effects
similar to that of other known benzodiazepines. Adinazolam was first
reported to NFLIS-Drug in 2019, and there were 87 reports in 2021.
Adinazolam has appeared in toxicology reports in the United States.
Adinazolam is not currently controlled in the United States.
Bromazolam is a designer benzodiazepine and is expected to have CNS
depressant-like effects similar to that of other known benzodiazepines.
Bromazolam was first reported to NFLIS-Drug in 2016, and there were 743
reports in 2021. Bromazolam has appeared in at least two overdose death
reports in the United States and adverse effects associated with the
use of bromazolam have been reported. Bromazolam is not currently
controlled in the United States.
Protonitazene (propoxynitazene), etazene (etodesnitazene), and
etonitazepyne (N-pyrrolidino etonitazene) are novel synthetic opioid
receptor agonists of the benzimidazole structural class. Law
enforcement data indicates that these substances have appeared on the
U.S. illicit markets as evidenced by their identification in forensic
drug seizures and biological samples. Etazene was first reported to
NFLIS-Drug in 2020, and there were 41 reports in 2021. Protonitazene
and etonitazepyne were both first reported to NFLIS-Drug in 2021 with
20 and 129 reports in that year, respectively. The abuse of these
benzimidazole opioids are similar to other synthetic opioids.
Protonitazene, etazene, and etonitazepyne have been identified in
toxicology and several post-mortem cases. The public health risks
attendant to the abuse of mu-opioid receptor agonists are well
established. These risks included large numbers of drug treatment
admissions, emergency department visits, and fatal overdoses. On April
12, 2022, the U.S. Drug Enforcement Administration issued a temporary
order to control these substances as schedule I substances under the
CSA.
2-Methyl-AP-237 is a novel synthetic mu-opioid receptor agonist. It
was first reported to NFLIS-Drug in 2019, and there were 45 reports in
2021. Abuse of 2-methyl-AP-237 is similar to other synthetic opioids,
and has been associated with adverse health effects, including death.
In the United States, there are at least 10 confirmed reports of fatal
poisonings and several reports of emergency room visits, and non-fatal
poisonings associated with 2-methyl-AP-237. 2-Methyl-AP-237 is not
currently controlled in the United States. There are no commercial or
approved medical uses of 2-methyl-AP-237.
Alpha-PiHP is a synthetic stimulant designer drug structurally
similar to other schedule I synthetic cathinones. Alpha-PiHP is a
monoamine transporter (dopamine transporter and norepinephrine
transporter) uptake inhibitor. Adverse effects associated with
synthetic cathinones abuse include agitation, hypertension,
tachycardia, and death. Alpha-PiHP was first reported to NFLIS-Drug in
2017, and there were 332 reports in 2021. Alpha-PiHP has been confirmed
to have played a role in fatal and non-fatal overdose events in the
United States. Alpha-PiHP has no approved medical uses in the United
States. As a positional isomer of alpha-PHP, alpha-PiHP is controlled
in schedule I of the CSA.
3-Methylmethcathinone (3-MMC) is a designer drug of the
phenethylamine class, which is structurally and pharmacologically
similar to amphetamine, 3,4-methylenedioxymethamphetamine, cathinone
and other related substances. 3-MMC is a monoamine transporter
(dopamine transporter, serotonin transporter, and norepinephrine
transporter) uptake inhibitor. Like other schedule I synthetic
cathinones, 3-MMC is abused for its psychoactive effects. Adverse
effects associated with synthetic cathinones abuse include agitation,
hypertension, tachycardia, and death. 3-MMC was first reported to
NFLIS-Drug in 2012, and there were three reports in 2021. 3-MMC has no
approved medical uses in the United States. As a positional isomer of
mephedrone, 3-MMC is controlled in schedule I of the CSA.
Zopiclone is a nervous system depressant drug used in the treatment
of insomnia. Its mechanism of action is based on modulating
benzodiazepine receptors. Zopiclone is approved for medical use in the
United States as (S)-zopiclone (or eszopiclone), the active (S) isomer
of zopiclone. Zopiclone has abuse potential and may be misused due to
its ability to produce euphoric effects at high doses. Amnesia and
hallucinations have been reported with higher doses. Zopiclone is
controlled in schedule IV of the CSA.
IV. Opportunity To Submit Domestic Information
As required by section 201(d)(2)(A) of the CSA, FDA, on behalf of
HHS, invites interested persons to submit comments regarding the 10
drug substances. Any comments received will be considered by HHS when
it prepares a scientific and medical evaluation for drug substances
that is responsive to the WHO Questionnaire for these drug substances.
HHS will forward such evaluation of these drug substances to WHO, for
WHO's consideration in deciding whether to recommend international
control/decontrol of any of these drug substances. Such control could
limit, among other things, the manufacture and distribution (import/
export) of these drug substances and could impose certain recordkeeping
requirements on them.
Although FDA is, through this notice, requesting comments from
interested persons, which will be considered by HHS when it prepares an
evaluation of these drug substances, HHS will not now make any
recommendations to WHO regarding whether any of these drugs should be
subjected to international controls. Instead, HHS will defer such
consideration until WHO has made official recommendations to the
Commission on Narcotic Drugs, which are expected to be made in late
2022. Any HHS position regarding international control of these drug
substances will be preceded by another Federal Register notice
soliciting public comments, as required by section 201(d)(2)(B) of the
CSA.
[[Page 47431]]
Dated: July 28, 2022.
Lauren K. Roth,
Associate Commissioner for Policy.
[FR Doc. 2022-16572 Filed 8-2-22; 8:45 am]
BILLING CODE 4164-01-P