Fatal Poisonings Associated with New Psychoactive Substances

Area of Science:

• Forensic Toxicology
• Pharmacology
• Public Health

Background:

• New psychoactive substances (NPS) present significant and often unknown health risks.
• Limited data exists on the long-term toxicity and specific risks associated with NPS consumption.
• Inconsistent product purity and composition of NPS increase user vulnerability to adverse events.

Purpose of the Study:

• To detail the circumstances and findings in fatal intoxications involving NPS since 2010.
• To summarize antemortem symptoms and adverse effects leading to NPS-related deaths.
• To tabulate concentrations and postmortem findings in cases of NPS ingestion.

Main Methods:

• Review of fatal intoxication cases involving NPS from 2010 onwards.
• Analysis of circumstances, clinical symptoms, and adverse effects documented in these cases.
• Tabulation of toxicological concentrations and postmortem findings.

Main Results:

• Synthetic opioids, particularly fentanyl analogues, are identified as a major cause of global accidental deaths.
• Synthetic cannabinoids exhibit unpredictable toxicity with cardiovascular effects.
• Cathinones and phenethylamines cause sympathomimetic and hallucinogenic toxidromes, including serotonin syndrome and cardiovascular risks.

Conclusions:

• NPS consumption is associated with severe adverse effects, often exceeding those of traditional drugs.
• The increasing trend in NPS-related deaths is linked to a shift towards more potent substances like fentanyl analogues.
• There is an urgent need for better understanding and regulation of NPS due to their high toxicity and associated fatalities.