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EMCDDA. New psychoactive substances: 25 years of early warning and response in Europe — an update from the EU Early Warning System

This update from the EU Early Warning System overviews the NPS situation in Europe in 2020-2021 and highlights emerging threats to support early warning, preparedness planning and response measures. In addition, it reflects on the changes and the lessons learned from 25 years of monitoring NPS in Europe. (EMCDDA, Lissabon, Juni 2022)

https://www.emcdda.europa.eu/publications/rapid-communication/update-eu-early-warning-system-2022_en

New Psychoactive Substances Consumption in Opioid-Use Disorder Patients. 

Alías-Ferri M, Pellegrini M, Marchei E, Pacifici R, Rotolo MC, Pichini S, Pérez-Mañá C, Papaseit E, Muga R, Fonseca F, Torrens M, Farré M. 

Biology (Basel). 2022 Apr 22;11(5):645. doi: 10.3390/biology11050645. PMID: 35625373; PMCID: PMC9138226.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9138226/

Novel Psychoactive Substances: The Razor's Edge between Therapeutical Potential and Psychoactive Recreational Misuse. 

Correia B, Fernandes J, Botica MJ, Ferreira C, Quintas A. 

Medicines (Basel). 2022 Mar 1;9(3):19. doi: 10.3390/medicines9030019. PMID: 35323718; PMCID: PMC8950629.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8950629/

Novel psychoactive substance. 

Pucci M, Bradberry S, Ford L. 

Clin Med (Lond). 2021 Jul;21(4):e430-e431. doi: 10.7861/clinmed.Let.21.4.9. PMID: 35192500; PMCID: PMC8313199.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313199/

A deep generative model enables automated structure elucidation of novel psychoactive substances. 

Skinnider, M.A., Wang, F., Pasin, D. et al.

Nat Mach Intell 3, 973–984 (2021). doi.org/10.1038/s42256-021-00407-x

https://www.nature.com/articles/s42256-021-00407-x

UNODC. Current NPS Threats - Volume IV - November 2021

Over 1100 NPS from 133 countries and territories have been reported to the UNODC Early Warning Advisory on New Psychoactive Substances

Benzodiazepine-type substances are a primary NPS threat, identified in 68% of toxicology cases

Poly-drug use continues to be a major feature of toxicology reports, particularly in cases concerning fatalities and driving under the influence of drugs. (UNODC, Wien, November 2021)

https://www.unodc.org/documents/scientific/NPS_threats_IV_web.pdf

 

UNODC. Synthetic Drugs and New Psychoactive Substances in Latin America and the Caribbean - 2021

The report provides a regional analysis of the key trends and emerging developments of the synthetic drugs and NPS market as well as options for response in Latin America and the Caribbean. Over the past years, the synthetics drug market has experienced a massive expansion and diversification in the region and seen a rapid emergence of a wide range of NPS. The latest developments include an expanding methamphetamine market, growing concerns around the non-medical use of ketamine, the emergence of fentanyl and MDMA manufacture, as well as new “ecstasy” trends such as higher dosed MDMA tablets and new forms of presentation such as crystalline MDMA. Moreover, the report sheds light on the comparatively high prevalence of use of hallucinogens in the region and the high prevalence of use of tranquilizers among women. (UNODC, Wien, September 2021)

https://www.unodc.org/unodc/en/scientists/2021-synthetic-drugs-and-new-psychoactive-substances-in-latin-america-and-the-caribbean.html

USA. NPS Discovery: Welcome to our premier open-access drug early warning system! 

Our evidence-based approach leads the development of high impact reports for real-time action.

ABOUT US: The Center for Forensic Science Research and Education (CFSRE) is working in collaboration with law enforcement, public health, and public safety agencies to rapidly identify emerging drugs, also known as Novel Psychoactive Substances (NPS), associated with intoxications and adverse events. The information, reports, and resources consolidated here by the CFSRE allow for the rapid dissemination of information to stakeholders and affected communities. (NPS Discovery, USA, 2021)

https://www.npsdiscovery.org/

USA. Recommended Scope for NPS Testing in the United States

Purpose: The objective of this report is to provide updated guidance in developing an appropriate analytical scope of testing for novel psychoactive substances (NPS) in the United States based on current trends and intelligence. This report is based on information available in Q3 2021 and is subject to change along with the drug market. (NPS Discovery, USA, Oktober 2021)

https://www.npsdiscovery.org/wp-content/uploads/2021/11/Q3-2021-NPS-Scope-Recommendations_NPS-Discovery_110221.pdf

Eurasien. NPS use in Eastern Europe and Central Asia

Throughout the Eastern Europe and Central Asia (EECA) region, the use and variety of NPS are relevant issues, although the nature and extent differ among the EECA countries and subregions, with better awareness of their presence among health professionals and people who use drugs. Synthetic cannabinoids and synthetic cathinones are predominant groups of NPS and widely available, whereas synthetic opioids seem to be more present in Estonia and Lithuania. Among people who use NPS, there are two key populations: those who have more experience with use of drugs, who have shifted to the use of NPS for a variety of reasons, and young people with no previous history of drug use. (Eurasian Harm Reduction Association (EHRA), 2021)

https://harmreductioneurasia.org/harm-reduction/new-psychoactive-substances/nps-ee-and-ca/

Pharmacotherapy of Patients Taking New Psychoactive Substances: A Systematic Review and Analysis of Case Reports. 

Ordak M, Zmysłowska A, Bielski M, Rybak D, Tomaszewska M, Wyszomierska K, Kmiec A, Garlicka N, Zalewska M, Zalewski M, Nasierowski T, Muszynska E, Bujalska-Zadrozny M. 

Front Psychiatry. 2021 Apr 23;12:669921. doi: 10.3389/fpsyt.2021.669921. PMID: 33967865; PMCID: PMC8102790.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102790/

Acute neurological consequences of novel psychoactive substance use: a retrospective review in a large UK hospital. 

Tanti M, Cosgrove J, Kelleher C, Jones R, Maguire M. 

Clin Med (Lond). 2021 May;21(3):189-194. doi: 10.7861/clinmed.2020-0706. Epub 2021 May 4. PMID: 33947659; PMCID: PMC8140705.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140705/

Patterns of new psychoactive substance use among opioid-dependent patients attending for opioid substitution treatment

McCarron P., Smyth B., Carroll G., Glynn M., Barry J., Whiston L., Keenan E., Darker C., and Truszkowska E.

Heroin Addiction and Related Clinical Problems, Published Ahead of Print, May 3, 2021

https://www.heroinaddictionrelatedclinicalproblems.org/harcp-archives-doi-articles.php

International Perspective on New Psychoactive Substances (NPS) – Virtual seminar 18 June 08.00-09.15 (Berlin time)

This seminar is offered within the context of SOLID project funded by DAAD (German Academic Exchange Service Exceed program) and implemented at the Frankfurt University of Applied Sciences and across five Universities in Central Asia (Kazakhstan, Kyrgyzstan, Uzbekistan) and China (Shanghai). Our partners informed us about a significant structural change in the drug use consumption patterns in their countries. The experts are reporting a continuous decrease of the trafficking and consumption of opioids, such as opium and heroin, whereas the trafficking and consumption of New Psychoactive Substances (NPS) (Central Asia) and methamphetamines (China) especially via internet/darknet is increasing. They are also reporting that the services to reduce the drug related harms and treatment centres have not enough knowledge and tools to deal with patients suffering from overdoses and health problems due to the consumption of NPS/Methamphetamines.

https://solid-exceed.org/programme

Hot” and “Cold” Cognition in Users of Club Drugs/Novel Psychoactive Substances  

Savulich George, Bowden-Jones Owen, Stephenson Robert, Brühl Annette B., Ersche Karen D., Robbins Trevor W., Sahakian Barbara J.

Frontiers in Psychiatry, VOLUME 12, 2021, p333, DOI=10.3389/fpsyt.2021.660575

https://www.frontiersin.org/articles/10.3389/fpsyt.2021.660575/full

"Overview of the major classes of new psychoactive substances, psychoactive effects, analytical determination and conformational analysis of selected illegal drugs" 

Lukić, Vera, Micić, Ružica, Arsić, Biljana, Nedović, Bojan and Radosavljević, Živana. 

Open Chemistry, vol. 19, no. 1, 2021, pp. 60-106. doi.org/10.1515/chem-2021-0196

https://www.degruyter.com/document/doi/10.1515/chem-2021-0196/html

New psychoactive substances: a review and updates. 

Shafi A, Berry AJ, Sumnall H, Wood DM, Tracy DK. 

Ther Adv Psychopharmacol. 2020 Dec 17;10:2045125320967197. doi: 10.1177/2045125320967197. PMID: 33414905; PMCID: PMC7750892.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750892/

January 2021 – UNODC-SMART: Almost 1,050 NPS reported to UNODC from 126 countries and territories

VIENNA, Austria – January 2021: New psychoactive substances (NPS) remain a global phenomenon with 126 countries and territories from all regions of the world having reported one or more NPS to the UNODC Early Warning Advisory (EWA) on NPS. Governments, forensic laboratories and partner organisations worldwide have identified and reported a total of 1,047 substances up to December 2020 to the UNODC EWA on NPS. (UNODC Laboratory and Scientific Section, Januar 2021)

https://www.unodc.org/LSS/Announcement/Details/c64c59d6-6279-4934-a25d-b3dc2a35247d

UNODC. Current NPS Threats

As a new feature of the UNODC Early Warning Advisory (EWA) on new psychoactive substances (NPS), the EWA Tox-Portal is an innovative tool to collect, analyse and share data on toxicology and harm related to the use of NPS at a global level. In collaboration with The International Association of Forensic Toxicologists (TIAFT) and other partners, the Tox-Portal is designed to generate timely information on the harms and adverse health consequences associated with the use of NPS, based on case reports of intoxications, including fatalities. Information from the Tox-Portal will contribute to identifying the most harmful NPS as an important step towards prioritizing NPS for international review in the framework of the International Drug Control Conventions.  Current NPS Threats reports are published biannually and combine data from drug seizures as well as drug detections in biological fluid casework allowing an overview of the NPS landscape. (UNODC, Wien, October 2020)

https://www.unodc.org/unodc/en/scientists/current-nps-threats.html

Sex and Gender Differences in the Effects of Novel Psychoactive Substances. 

Fattore L, Marti M, Mostallino R, Castelli MP. 

Brain Sci. 2020 Sep 3;10(9):E606. doi: 10.3390/brainsci10090606. PMID: 32899299.

https://www.mdpi.com/2076-3425/10/9/606/htm

Prevalence of Novel Psychoactive Substance (NPS) Use in Patients Admitted to Drug Detoxification Treatment. 

Specka M, Kuhlmann T, Sawazki J, et al. 

Front Psychiatry. 2020;11:569. Published 2020 Jul 7. doi:10.3389/fpsyt.2020.00569

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358402/

The Role of Dopamine in the Stimulant Characteristics of Novel Psychoactive Substances (NPS) - Neurobiological and Computational Assessment Using the Case of Desoxypipradrol (2-DPMP). 

Loi B, Sahai MA, De Luca MA, Shiref H, Opacka-Juffry J. 

Front Pharmacol. 2020;11:806. Published 2020 Jun 5. doi:10.3389/fphar.2020.00806

The Role of Dopamine in the Stimulant Characteristics of Novel Psychoactive Substances (NPS) - Neurobiological and Computational Assessment Using the Case of Desoxypipradrol (2-DPMP). 

Heroin Adulterated with the Novel Synthetic Cannabinoid, 5F-MDMB-PINACA: A Case Series. 

Ershad M, Dela Cruz M, Mostafa A, Khalid MM, Arnold R, Hamilton R. 

Clin Pract Cases Emerg Med. 2020;4(2):121‐125. Published 2020 Apr 23. doi:10.5811/cpcem.2020.2.45060

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220005/

EMCDDA technical report on the new psychoactive substance N,Ndiethyl- 2-[[4-(1-methylethoxy)phenyl]methyl]-5-nitro-1Hbenzimidazole- 1-ethanamine (isotonitazene)

Summary

The purpose of this technical report is to provide an analysis of the available information on N,N-diethyl-2-[[4-(1-methylethoxy)phenyl]methyl]-5-nitro-1H-benzimidazole-1-ethanamine (commonly known as isotonitazene), an opioid analgesic that has recently emerged on the drug market in Europe, to support a risk assessment of the substance that has been requested by the European Commission in accordance with Article 5c of Regulation (EC) No 1920/2006 (as amended). (EMCDDA, Lissabon, Juni 2020)

https://www.emcdda.europa.eu/publications/technical-reports/technical-report-isotonitazene_en

EMCDDA initial report on the new psychoactive substance N,N-diethyl-2-[[4-(1-methylethoxy)phenyl]methyl]-5-nitro-1H-benzimidazole-1-ethanamine (isotonitazene)

Summary

Isotonitazene is a synthetic opioid analgesic monitored by the EMCDDA as a new psychoactive substance through the European Union Early Warning System since 2019. Based on potential public health risks, an initial report has been prepared and submitted to the Commission and the Member States, in accordance with Article 5b of Regulation (EC) No 1920/2006 (as amended). Its purpose is to provide scientific evidence to the Commission to allow it to make an informed decision regarding whether or not there is a need to request a risk assessment on a new psychoactive substance. (EMCDDA, Lissabon, April 2020)

http://www.emcdda.europa.eu/publications/initial-reports/isotonitazene

Psychedelic Medicine - Hacking Psychiatry?! (Video)

Psychedelic Therapy as a fundamentally new approach to mental health issues Psychedelic research constitutes a challenge to the current paradigm of mental healthcare. But what makes it so different? And will it be able to meet the high expectations it is facing? This talk will provide a concise answer. Psychedelic Therapy is evolving to be a game changer in mental healthcare. Where classical antidepressants and therapies e.g. for Posttraumatic Stress Disorder often have failed to provide relief, substance assisted psychotherapies with Psilocybin, LSD and MDMA show promising results in the ongoing clinical trials worldwide. A challenge to the current paradigm: Unlike the conventional approach of medicating patients with antidepressants and other psychotropic drugs on a daily basis for months and years at a time, Psychedelic Therapy offers single applications of psychedelics or emotionally opening substances such as Psilocybin, LSD and MDMA within the course of a limited number of therapeutic sessions. The clinical trials conducted in this kind of setting are currently designed around depression, substance abuse, anxiety and depression due to life threatening illnesses, PTSD, anorexia and social anxiety in Autism. Though the results look promising, it is important not to take these therapies for a “magic bullet cure” for all and very patient will mental issues. This talk will outline the principles of psychedelic therapy and research and provide a concise overview of what psychedelic therapy can and cannot offer in the future. Andrea Jungaberle

(36C3 – Jahreskongress des CCC - Chaos Computer Club, 28.12.2019, Video, 36:42)

https://www.youtube.com/watch?v=ejggK9VMVzg&feature=youtu.be

UNODC. Current NPS Threats – Volume II (January 2020)

UNODC Early Warning Advisory Toxicology Highlights

Poly-drug use continues to feature highly in cases of fatalities associated

with NPS.

Benzodiazepine-type NPS are increasingly reported in cases of driving

under the influence of drugs in some countries.

Incidents of kratom identification in poly-drug use cases are increasingly

reported in a number of countries

https://www.unodc.org/documents/scientific/Current_NPS_Threats_Volume_II_final.pdf

New psychoactive substances (NPS) in the Netherlands: occurrence in forensic drug samples, consumer drug samples and poisons center exposures between 2013 and 2017.

Hondebrink, L., Nugteren‐van Lonkhuyzen, J. J., Hunault, C. C., van den Berg, J., van der Gouwe, D., and van Riel, A. J. H. P. ( 2020) 

Addiction,doi.org/10.1111/add.14868.

https://onlinelibrary.wiley.com/doi/full/10.1111/add.14868?campaign=wolearlyview

USA. Johns Hopkins Scientists Give Psychedelics the Serious Treatment

The first research center of its kind in the country is bringing renewed rigor to the investigation of the drugs’ therapeutic uses. (Scientific American, USA, 16.01.2020)

https://www.scientificamerican.com/article/johns-hopkins-scientists-give-psychedelics-the-serious-treatment/

New psychoactive substances: concerted efforts and common legislative answers for stemming a growing health hazard.

Zaami S.

Eur Rev Med Pharmacol Sci. 2019 Nov;23(22):9681-9690. doi: 10.26355/eurrev_201911_19529.

https://www.europeanreview.org/article/19529