Novel psychoactive substances (NPS) are compounds specifically manufactured to simulate the effects of recreational drugs. These new drugs are often alternatively referred to as a “legal high.” Any given NPS classifies as cannabinoids, depressants, hallucinogens and stimulants. The most common categories encountered are stimulants and cannabinoids. Various countries around the world have disparate legislative approaches to these drugs. In essence, these synthetic opioids are designer drugs, and they’re expected to have an impact like that of fentanyl pretty soon.
A study published in the British Medical Journal by three London researchers concluded that NPS shouldn’t be considered any safer than the recreational drugs they mimic. NPS also include drugs made in esoteric or criminal laboratories without consistent methods or ingredients. Not all NPS are legal despite the commonly used term, “legal high,” in reference to NPS. Whether legal or illegal, use of these drugs can lead to addiction, overdose and death.
How Popular Is NPS?
A key part of modern, clinical toxicology is monitoring adverse events that correlate with NPS use. Drug enforcement authorities and public health officials have dedicated increasing amounts of time to tracking NPS. The difficulty in doing so stems from the fact that these drugs are constantly proliferating all over the world. A study published in American Chemical Society in December 2021 may represent a unique solution.
The study involved testing wastewater from around the world. Samples gathered just before New Year’s Day led scientists to conclude that certain NPS are increasing in popularity worldwide. A standout among them was 3-methylmethcathinone (3-MMC). The team boasts of the efficacy of wastewater epidemiology on the basis that everyone goes to the restroom. That would suggest samplings are exceptionally thorough with this methodology.
The team used liquid chromatography-mass spectrometry to scan for 27 unmetabolized NPS. They found 11 of those substances present in wastewater from 25 treatment plants in ten countries. Most were synthetic cathinones, predominantly methcathinone, eutylone and 3-MMC. They noted that methcathinone, however, could’ve been present due to the degradation of ephedrine or pseudoephedrine, which are legal. They maintain regardless that the data collected still reflects an uptick in the global use of NPS.
Youth Encounter the New Drugs
Almost a third of teens and young adults in the U.S. who have been prescribed a psychoactive drug were found to misuse those drugs according to yet another BMJ study. This comes from an analysis of national survey responses. The prevalence of NPS and the frequency of misuse presents a recipe for disaster. The study found stimulants and tranquilizers most likely to be misused among teens and young adults. Moreover, one in three teens and young adults in the U.S. gets prescribed one of these each year.
The National Survey of Drug Use and Health Sampling saw 110,556 respondents between the ages of 12 and 25. This was conducted from 2015 to 2018 and published in February 2021. About 35% of respondents admitted to taking a prescribed NPS, and 31% admitted to misusing those prescriptions. Synthetic opioids were the most commonly prescribed drugs among them, but misuse was highest for stimulants and tranquilizers at almost 45%.
Implications of Trend for New Drugs
Illegal drug makers are driven to continually tweak the chemical structures of NPS by laws prohibiting these substances. Tweaking to stay just inside the lines keeps moving NPS engineers in the direction of cannabinoid receptor agonists. These have complicated molecular structures that can easily be tweaked in many simple ways to keep these substances on the legal side of the line.
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