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New and Emerging Illicit Psychoactive Substances
Ryan Graddy1, Megan E Buresh1, Darius A Rastegar1
1Division of Chemical Dependence, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite D5W, Baltimore, MD 21224, USA.
The Medical Clinics of North America
|June 24, 2018
Summary
Novel psychoactive substances, including synthetic cathinones and cannabinoids, pose significant health risks such as psychosis and death. Current treatments focus on supportive care and benzodiazepines for agitation, with no rapid identification tests available.
Area of Science:
- Forensic toxicology
- Emergency medicine
- Public health
Background:
- Emergence of novel psychoactive substances (NPS) presents challenges.
- Young men are primary users, often polydrug users.
- Key NPS categories include cathinones, synthetic cannabinoids, synthetic opioids, and designer benzodiazepines.
Purpose of the Study:
- To review the landscape of emerging novel psychoactive substances.
- To highlight the associated health risks and current management strategies.
Main Methods:
- Literature review of recent NPS trends.
- Analysis of clinical effects and toxicological profiles.
- Summary of treatment approaches.
Main Results:
- Cathinones ('bath salts') and synthetic cannabinoids ('spice') are prevalent, causing agitation, psychosis, and potentially death.
- Synthetic opioids, often fentanyl analogues, carry a high overdose risk.
- Designer benzodiazepines are also increasingly identified.
Conclusions:
- NPS pose severe and diverse health threats.
- Lack of rapid diagnostic tests complicates clinical management.
- Supportive care and benzodiazepines are current mainstays for managing acute toxicity.
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