An approach to the new psychoactive drugs phenomenon

Abstract

Background. The new psychoactive drugs (NPD) are those that represent a danger to public health and are not prohibited by conventions on international narcotics. The concept also includes new contexts and new routes of consumption as well as novel ways of distribution, notably Internet. The risks associated with NPD consumption are largely unknown to users and to health care providers. Objective. To integrate the existing evidence regarding the main NPD in terms of description, epidemiology, psychopharmacology, medical complications and psychoactive effects. Method. To review relevant and updated clinical information on NPD obtained from specialized books and indexed scientific journals (PubMed/Medline, Google Scholar, Scopus), as well as official documents edited by international organizations dedicated to the epidemiologic analysis of drug abuse and Internet websites and forums managed by psychoactive substance users. Results. Aspects of clinical and pharmacological interest are described comprehensively, together with epidemiological data and risks associated to the consumption of the most relevant NPD: synthetic cannabinoids, synthetic cathinones, NBOMe series, indoleamines, piperazines, hallucinogenic mushrooms (Psilocybe SP.), synthetic opioids, plant products (khat, kratom, Salvia divinorum, ayahuasca) and dissociative anesthetics. Discussion and conclusion. The emergence of the NPD is a phenomenon on the rise with important consequences for public health. Learning about new trends in drug consumption and its potential risks should be essential for the medical professional. New research is needed in order to understand the phenomenon of the NPD and its pharmacological, clinical and legal implications.

Para una ética de la estructuración farmacológica de las relaciones sociales

“…Los usos recreacionales o lúdicos pueden contemplar tanto sustancias aprobadas para uso terapéutico, como drogas, y principios activos no aprobados o ilegales (Dolengevich-Segal et al, 2017). Las regulaciones toman en cuenta el potencial de crear dependencia o la injusticia que puede significar disponer de algo no accesible a todo el mundo.…”

Pharmacotoxicology of Non-fentanyl Derived New Synthetic Opioids

“…AH-7921 recently entered the illicit drug market as new psychotropic substance in countries such as Japan, United States and Europe, resulting in several fatalities and intoxications ( Karinen et al, 2014 ; Kronstrand et al, 2014 ; Coppola and Mondola, 2015 ; Coopman et al, 2016 ; Armenian et al, 2017b ; Dolengevich-Segal et al, 2017 ; Domanski et al, 2017 ; Fels et al, 2017 ). In fatalities occurred in European countries, the reported blood concentrations ranged from 31 to 1,449 ng/mL ( Logan et al, 2017 ).…”

“…The substance is sold in the form of capsules, tablets or powder and administration routes described in the web forums include mainly the oral, but also inhaled (vaporized), intravenous, intranasal, sublingual and intrarectal routes with a high risk of overdose ( Coppola and Mondola, 2015 ; Katselou et al, 2015 ; Dolengevich-Segal et al, 2017 ). Light doses are from 5 to 10 mg, common doses from 10 to 25 and strong doses > 25 mg. Onset of action for oral administration is 15–45 min, duration 6–8 h and after effects 1–6 h ( Zawilska, 2017 ).…”

Synthetic Cannabinoids (SCs) in Metaphors: a Metaphorical Analysis of User Experiences of Synthetic Cannabinoids in Two Countries

“…New psychoactive substances (NPS) remain a global public health and clinical challenge (Gunderson et al 2012;Spaderna et al 2013;Corazza et al 2013;EMCDDA 2015;Van Hout and Hearne 2017;Kassai et al 2017a;Dolengevich-Segal et al 2017;Barnard et al 2017). The United Nations Office on Drugs and Crime (UNODC) defines NPS as 'substances of abuse, either in a pure form or a preparation, that are not controlled by the 1961 Single Convention on Narcotic Drugs or the 1971 Convention on Psychotropic Substances, but which may pose a public health threat' (UNODC 2013).…”

“…The United Nations Office on Drugs and Crime (UNODC) defines NPS as 'substances of abuse, either in a pure form or a preparation, that are not controlled by the 1961 Single Convention on Narcotic Drugs or the 1971 Convention on Psychotropic Substances, but which may pose a public health threat' (UNODC 2013). This broad NPS concept encompasses not only new compounds but also emerging trends in available substances, new contexts and routes of use and diffusion (Dolengevich-Segal et al 2017). The number and range of NPS continue to increase globally.…”