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Summary

The use of novel psychoactive substances (NPS) is rising, with many synthetic compounds not detected by standard drug tests. Clinicians must be aware of these substances for accurate diagnoses.

Keywords:
Designer drugsDrugs of abuseKratomNovel psychoactive substancesPhenibutTianeptine

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Area of Science:

  • Pharmacology
  • Toxicology
  • Clinical Chemistry

Background:

  • The prevalence of novel psychoactive substances (NPS) has significantly increased over the past decade.
  • NPS encompass a diverse range of compounds, including plant-derived and increasingly synthetic substances like synthetic cannabinoids, cathinones, kratom, phenibut, designer opioids, and benzodiazepines.
  • These substances exhibit varied potencies and effects due to differential binding affinities to targeted receptors.

Purpose of the Study:

  • To highlight the growing issue of novel psychoactive substances (NPS) and their implications in clinical settings.
  • To emphasize the limitations of routine drug screening methods in detecting NPS.
  • To underscore the importance of clinician awareness for accurate diagnosis and patient management.

Main Methods:

  • Literature review on the emergence and characteristics of NPS.
  • Analysis of the chemical diversity and pharmacological actions of common NPS.
  • Evaluation of the detection capabilities of standard immunoassay urine drug screens for NPS.

Main Results:

  • Standard immunoassay urine drug screens frequently fail to detect a wide array of NPS.
  • The varied pharmacological profiles of NPS present diagnostic challenges.
  • Increased clinician awareness is crucial for identifying patients using NPS.

Conclusions:

  • Novel psychoactive substances (NPS) pose a significant challenge to routine clinical toxicology.
  • Enhanced awareness and potentially specialized testing are necessary for the detection and management of NPS.
  • Clinicians need to be informed about NPS to ensure accurate patient assessment and care.