The lowdown on new psychoactive substances
Today’s digital era presents an abundance of novel and exciting thrills, but for people who use drugs, new technologies in the form of illicit substances are fraught with inherent risk.
New and emerging drugs are known as novel or new psychoactive substances (NPS). These are synthetic drugs designed to mimic illicit substances like cannabis, cocaine, heroin, ecstasy or LSD.
Professor Rachel Sutherland from the National Drug and Alcohol Research Centre (NDARC) says there are over 600 identified novel psychoactive substances, and the continual emergence of new substances makes it difficult to understand the effects and concerns of each drug.
“The main concern is there are so many NPS, and we really know very little about them,” Rachel says.
“For most NPS we don’t have much information about the short and long-term effects, the toxicity, and all those kinds of long-term health concerns. For the most part, there is a lack of evidence regarding their harms.”
NPS are commonly known as designer drugs, research chemicals, synthetic drugs, analogues or legal highs. However they are often wrongly perceived as “legal” by some people who use them.
Manufacturers of these drugs often develop new chemicals to replace those that are banned. This means that the chemical structures of the drugs are constantly changing to try to stay ahead of the law. Most states in Australia have now introduced blanket bans on all NPS.
In Queensland, New South Wales and South Australia there is now a total ban on possessing or selling any substance that has a psychoactive effect other than alcohol, tobacco or food. In other states and territories specific NPS are banned and emerging ones are regularly added to the list.
Research in the 2016 National Drug Strategy Household Survey reports that synthetic cannabinoids are the most widely used NPS.
Edith Cowan University Researcher Dr Stephen Bright says many people who use drugs are unknowingly consuming NPS, which are commonly mixed with traditional illicit substances like heroin, amphetamines and ecstasy.
“The biggest category of people using NPS is people who are unintentionally using them. They have no idea they’re using a fentanyl analogue, or some kind of other novel opioid. They think they’re using heroin. They think they’re taking MDMA when they’re actually taking MDPV or some other weird drug,” says Stephen.
Stephen says NPS sold as traditional illicit substances posed particular risks for people who inject drugs. Some NPS are of much higher potency than their traditional counterparts and it is often difficult to identify a particular NPS without prior substance testing.
While research conducted in 2017 by the European Monitoring Centre for Drugs and Drug Addiction shows a decrease in the number of reported novel psychoactive substances, it found an increase in the number of novel opioids, like fentanyl analogues, which have also been identified in Australia.
Stephen reports that some novel opioids are of much higher potency than heroin. Overseas Needle and Syringe Programs have responded by introducing greater access to naloxone. He suggests similar measures would also be effective in Australia and that introducing drug testing in supervised injecting facilities could decrease the risk of overdose from NPS.
“What we’re seeing overseas, in terms of what Needle and Syringe Programs can do, is ensuring people have access to decent quantities of naloxone.
“If you’ve overdosed on fentanyl, you’re going to need a hell of a lot more naloxone than you would for heroin,” comments Stephen.
“Some of the more innovative places in Canada and Europe have introduced drug testing facilities within the NSPs. They allow people to come in and get their drugs tested before they use them so they know what they’re using.”
While rates of NPS use are low among the general population, Rachel says the rates are elevated among people who use other illicit substances. What’s more, while there is a lack of Australian research there is international evidence to suggest NPS are frequently used by those in prisons and other people subject to regular drug testing.
“There have been some suggestions that NPS will be used among people who are trying to avoid workplace drug testing, or in the prison setting for example. It does largely appear to be confined to other illicit substances users. There is other international evidence of elevated rates of use of NPS among other populations like prisoners and homeless people,” Rachel says.
Rachel says it was possible to detect NPS in urine, hair, or blood samples, but that identification is complicated by the number and continual evolution of NPS.
“Because there are so many substances – there are six or seven hundred substances that fall within the NPS category – it’s difficult to talk about NPS as a single entity because there is such a range of different substances. Certainly, biological sampling can pick up certain NPS.”
While NPS have typically been associated with the ‘dark web’, Rachel says most NPS are acquired through the same methods as traditional drugs.
“People are still obtaining from in person sources, so friends or dealers. There are some who obtain NPS from online sources, but NPS are predominantly obtained from friends and dealers as with all kind of other illicit substances,” she says.
NDARC research shows most NPS have a scientific name and a street name and are more commonly referred to among the general population by their street name. Some examples of NPS include those known as meow meow, DMT, kronic and BZP.
Most NPS are scientifically categorised by their effects. Popular categories include cannabinoids, and cathinones and phenethylamines which have both psychoactive and stimulant effects. Other substances are structurally diverse and not confined to one particular category.
Synthetic cannabinoids often appear as dried plant matter sprayed with a dissolved substance. Other NPS can appear as pills, small pellet-like tablets, injectable liquids, white powder, crystals, or on a blotter tab.
Notes for Needle and Syringe Program workers:
- NPS can be more potent than traditional substances and therefore carry greater risk of overdose.
- NPS are often sold as or mixed with traditional illicit substances.
- Greater access to naloxone can decrease the risk of overdose from opioid NPS.
- NPS are continually emerging and evolving and little is understood about the long-term health risks and other concerns.
- The individual effects of particular NPS are difficult to identify.
– Tom de Souza