[Emergent drugs (I): smart drugs]

Area of Science:

• Pharmacology
• Toxicology
• Public Health

Background:

• Emergence of novel psychoactive substances (NPS) termed 'smart drugs' or 'legal highs'.
• Widespread availability through online channels, particularly among younger populations for recreational use.
• Limited clinical research and detectability in standard hospital laboratories.

Purpose of the Study:

• To review the growing popularity and associated risks of specific novel drugs.
• To highlight the clinical profiles and adverse effects of BZP, mefedrone, and Spice.
• To address the perceived safety and emerging evidence of harm from these substances.

Main Methods:

• Review of existing literature and clinical observations on BZP, mefedrone, and Spice.
• Description of consumption patterns and user demographics.
• Analysis of reported adverse events and toxicological profiles.

Main Results:

• BZP and mefedrone, used as alternatives to ecstasy and cocaine, exhibit sympathomimetic effects, with documented cases of convulsions and fatalities.
• Spice, a blend containing synthetic cannabinoids (e.g., JWH-018), is linked to dependence and schizophrenia-like symptoms.
• Despite a perceived safety profile, significant adverse effects are increasingly reported.

Conclusions:

• Novel psychoactive substances pose significant public health challenges due to their increasing use and potential for severe harm.
• Clinical and toxicological data are crucial for understanding and managing the risks associated with these emergent drugs.
• Further research and improved detection methods are needed to address the growing threat of 'legal highs'.