New psychoactive substances: a review and updates.

Area of Science:

• Pharmacology and Toxicology
• Public Health
• Forensic Science

Background:

• New psychoactive substances (NPS) represent a diverse and growing class of compounds with significant individual and societal health implications.
• NPS-related toxicity and dependence are recognized across various healthcare settings, including primary care, emergency departments, and psychiatric services.
• A pragmatic classification divides NPS into synthetic stimulants, synthetic cannabinoids, synthetic hallucinogens, and synthetic depressants (including opioids and benzodiazepines).

Purpose of the Study:

• To review the four main classes of NPS, covering their chemical properties, mechanisms of action, and usage patterns.
• To detail the physical and mental health harms associated with each NPS class.
• To explore the challenges in laboratory testing for NPS due to their rapid emergence and diverse formulations.

Main Methods:

• Literature review of existing research on NPS.
• Classification of NPS into four pragmatic groups: synthetic stimulants, cannabinoids, hallucinogens, and depressants.
• Analysis of chemical structures, mechanisms of action, and reported health harms.

Main Results:

• Each NPS class exhibits distinct chemical structures, modes of action, and associated toxicities.
• Synthetic stimulants, cannabinoids, hallucinogens, and depressants present unique patterns of physical and mental health harms.
• Laboratory detection of NPS is complicated by the continuous emergence of novel substances, varied formulations, and complex distribution networks.

Conclusions:

• Understanding the classification and harms of NPS is crucial for effective clinical and public health management.
• Addressing the challenges in NPS detection requires ongoing advancements in analytical techniques and forensic capabilities.
• Continued research and surveillance are essential to mitigate the evolving public health threat posed by NPS.