In late 2005 and early 2006, fentanyl abuse emerged as a public health problem in seven of the 20 Community Epidemiology Work Group (CEWG) areas. There were reports of confirmed or suspected deaths in these particular areas. Heroin abuse indicators increased in five CEWG areas and decreased in five areas. Other opiate abuse indicators increased in nine CEWG areas and remained stable or mixed in 11 CEWG areas. Cocaine/crack abuse indicators increased in only one CEWG, decreased in four that had previously reported high levels of abuse and remained stable or mixed in 12 areas. Methamphetamine abuse indicators did not decrease in any CEWG areas, decreased in 9 CEWG areas, remained stable or mixed in two and remained at low levels in nine areas. Lastly, marijuana abuse indicators remained at high levels for all 20 CEWG areas. The CEWG is a unique epidemiology network that has functioned as a drug abuse surveillance system to identify and assess current and emerging drug abuse patterns, trends and issues using multiple sources of information. The network is comprised of researches from 21 areas: Atlanta, Baltimore, Chicago, Denver, Detroit, Honolulu, Los Angeles, Miami/Ft. Lauderdale, Minneapolis/St. Paul, New Orleans, New York City, Newark, Philadelphia, Phoenix, St. Louis, San Diego, San Francisco, Seattle, Texas, and Washington, D.C. This report is a synopsis of findings reported by 20 CEWG representatives and issues discussed at the June 2006 CEWG meeting. Also presented are abstracts from 20 CEWG papers on drug abuse patterns and trends in CEWG areas. Appendixes A-D