Novel Psychoactive Substances Flashcards
What is the different variations of nomenclature for NPS?
o Designer drugs
o Legal highs
o Novel psychoactive substances
o New psychoactive substances
What are NPS?
According to EMCDDA a NPS is a drug that-
“in pure form or in preparation, that is not controlled by the UN drug conventions, but which may pose a public health treat comparable to that posed by substances listed in these conventions”
Do NPS generally have just one name?
Why is there a driver for change regarding NPS?
Due to a continual cycle of the development of a new variation of NPS as soon as the law is made against the existing NPS
What was the first legal high drug?
**BZP (benzylpiperazine): **where it all started (the first legal high drug)
* Ecstasy (MDMA) class A whereas BZP was, at the time, uncontrolled
Tell me about piperazines as NPS
Generally, must classify specific structures present in drugs rather than a whole class of drugs that is less common. Hence why drug manufacturers would create variations of piperazines to by-pass this
From 2005, there was a decline of the use of MDMA in ecstasy tablets, what was introduced and seen more of instead?
**Mephedrone (4-methylmethcathinone, MeOW, Mcat, 4-MMC, bubbles) **
- As MDMA became less used substances like mephedrone use got higher
- Acutely relatively safe but at the time, the long-term effects were not known
Tell me about mexedrone
- Structure fell outside the genetic cathinone ban
- Allegedly specifically tailored for the UK and manufactured within the EU
- When mephedrone was banned, mexedrone came in
- To ban a drug, have to prove that drug is harmful, this can be a long process
spice was introduced in 2008, what is this?
Spice (2008)- term used to **describe synthetic cannabinoids **
Contains cannabinoid receptor agonists
“Spice is an exotic incense blend of the highest quality herbs and herbal extracts”
* Usually a herbal mixture
o Damiana
o Wild lettuce
o Skullcap
o Motherwort
o Red clover
o Marshmallow
o Blue lotus
o Baybean
o Pink lotus
o Dwarf skullcap
o Indian warrior
o Lions tail
o Maconha brava
o White lotus
o Siberian motherwart
o Vanilla and honey
New psychoactive substances
What is the largest growing class of NPS nowadays?
Synthetic opioids
The **Cathinones **
Tell me about AMT (alpha-methyltryptamine)
- AMT is a psychedelic tryptamine prior to June 2016 not controlled in the UK
Now may be under the PS act 2016 - AMT was used as an antidepressant at a dose of 5-10mg
- At doses of 20-30mg it may cause euphoria, empathy and psychedelic effects that might last for 12 hours
- Doses of over 40mg effects may last for 24 hours or more
- The freebase from can be smoked
Psyclone (2013)
N-Cumyl 5F-AKB48
- N-Cumyl-1-(5-fluoropnetyl)indazole-3-carboxamide is similar to 5F-AKB-48 with the adamantly group replaced with cumyl
- Allegedly to make it more suitable for delivery with E cigarette vaporisers
Whats** Methiopropamine (MPA) **
- Thiophene analogue of methamphetamine
- Possession was not controlled in the UK for some time- then put under a TCDO and finally made class B
Whats are some Methylphenidate derivatives?
- Methylphenidate (Ritaline ®)
- Ethylphenidate
- 3,4-CTMP
- isoPropylphenidate
- HDMP-28 (methylnaphthidate)
Designed benzodiazepines
- Apparently not from any national pharmacopeia
- 2mg Xanax is the usual prescription amount so the fake ones can be more than 3x the amount
Where do all these new drugs come from?
- Developed and manufactured in China or Eastern Europe
- When the research on drug manufacturing was published online it allowed drugs to be developed from these researched drugs for therapeutic use in order to notice similarities to develop NPS
Where do people buy NPS?
- Head shops and other stores
- Open websites
- Dark websites
- Traditional dealers
NPS are usually sold on the internet in what two forms?
**1. As branded products **
a. Usually contained mixtures of drugs
**2. As research chemicals **
a. 90% of the time were what they were supposed to be and were pure
Is there money in selling NPS?
NPS are available, and profitable, but are they used? How do we determine this?
- Drugs seized from prisons
- Drugs seized from music festivals and clubs
- Wastewater analysis
- Pooled urine analysis
- Surveys
One indication is what we fine inside prisons. But how do drugs get into prisons?
- Over the wall
- Drones
- Smuggles
- Staff
- Visitors
- Post/mail
- Synthetic cannabinoids didn’t show on urine analysis tests so tended to be used
Novel ways of getting NPS into prisons
Letters (some prisons are now photocopying letters, not from lawyers, to reduce the level of drugs entering the prison)
Whats SEWPROF?
- A new paradigm is drug use and human health risk assessment: sewage profiling at the community level
- SEWPROF was a research project funded by the European commission, Marie Curie actions, seventh framework programmes, initial training network
- SEWPROF aimed to develop inter-disciplinary and cross-sectoral research capability for the next generation of scientists working in the newly emerging field of sewage epidemiology
- It provided an integrated approach towards public health monitoring at a community level based on innovative sewage epidemiology techniques
Drugs in wastewater (sewage)
- Results demonstrate significant potential of sewage epidemiology
- Complements questionnaire data
- Methadone used a heroin replacement therapy, has not peaks at weekends as drug addicts wouldn’t tend to only take at weekends
Establishing NPS metabolites
What are the pros and cons to the pooled urine analysis?
- Anonymous
- Non-attributable
- No ethical issues
- Informed consent not required
- One main sampling issue: no female samples, so a biased source of information
Assessing usage via surveys
- Global drug survey- annual
- EMCDDA “young people and drugs”- 2011, 2014
How do we detect NPS?
- Obtain samples- seizures (police, border patrol etc.), test purchases, hospital admissions, festival, prisons, nightclubs
- Analyse the samples
- Report results
- Disseminate information/data
How are NPS analysed?
- Analysis usually starts off with standard drug analysis techniques
o Fourier transform infrared spectrometry** (FTIR)**- moderately cheap, very fast, easy, no consumables, not solid dose
o Raman spectrometry- can be cheap, easy, no consumable, not solid dose
o Gas chromatography mass spectrometry (GC-MS)- more expensive, slower, accurate, any dose form - However, these do not work for new/unknown substances. So, for these, we move on to more complex techniques
o HP LC (TOF, Orbitrap)- expensive, slow, accurate, requires interpretation
o Nuclear magnetic resonance spectrometry (NMR)- very expensive, very slow, accurate, requires interpretation
o Synthesis- slow and complex
How are NPS reported?
Reporting NPS- EMCDDA
* Early warning system
* EMCDDA Reitox network
* UK doesn’t have a lot to do with this now due to BREXIT
What is the current approach for combatting legal highs?
- Before the PS Act 2016
o Misuse of Drugs act
o TCDOs and new processes - After the PS act 2016
What was the “old” UK legal process for combatting NPS?
- Identify a new substance
- Assess harm
- Implement legislature under the misuse of drugs acts 1971
- Slow, cumbersome, and not suited to circa 100 new substances a year
What is the new processess created to deal with NPS?
- Monitor the appearance of new compounds
- Report FEWS, ACMD, EMCDDA (EWS)
- Constitute a sufficient problem to warrant import ban (OGIL) or temporary class drug order (TCDO). Harm assessment not required
- TCDO (for 1 year)
o Perform rigorous risk assessment (by observation of effects on users)
o Assess pharmacology
Literature review
Mechanistic studies (in vitro)
Clinical vigilance
o Amend misuse of drugs act or remove TCDO
o Enforce legislation
- But the problem remained and the number of NPS continued to increase
What ban was put into place in December 2016?
December 2016 “generic synthetic cannabinoids ban” under the misuse of drugs Act
issues with policing new psychoactive substances
- Budgetary issue for police and labs
- Difficult to identify- isomers an lack of chemical standards requires expensive instruments
- Non-controlled substances were not a police issue
- CPS willingness to prosecute
The new UK legal process is the 2016 psychoactive substances act which came into place in June 2016. What is the general overview of this act?
Overview of the act
1. This act created a blanket ban on the production, distribution, sale and supply of psychoactive substances in the UK
- But not possession for personal use
- Meaning of “psychoactive substance”
o “Psychoactive substance” means any substance which-
(a) Can produce a psychoactive effect in a person who consumes it, and
(b) Is not an exempted substance - For the purposes of this act a substance produces a psychoactive effect in a person if, by stimulating or depressing the persons CNS, it affects the persons mental functioning or emotional state
What one drug that currently isnt controlled, but there is talk that it soon will be under certain circumstances due to misuse?
What does the PS Act hope to achieve?
- The end of NPS in the UK?
o Cocaine, MDMA, cannabis etc.
o Ireland - More realistically, the break the cycle of new compounds being used as drugs as outside of legislation and then the law catching up with the development of these new drugs
What has the PS Act achieved?
- High street head shops have closed or no longer sell NPS
- UK based web sites are closed or moved to other European countries
- But… web sites in other countries have picked up their business and prosper, these sites already existed and other may have now opened
- The availability of NPS on the dark web has probably increased
Other possible results of the PS Act
* Sales may have shifted to traditional drug dealers, especially at the start when stock may have been “dumped”
PS Act 2016- six years on
- NPs still available but more difficult to obtain
- Still seen but less quantity and less variety
- Still prevalent amongst vulnerable populations
- New ones still being reported (mostly outside UK)
- The act probably has reasonably achieved its objectives
NPS use in the UK post PSA: 2022
- Not much in the general UK drug taking population (but in 2021 and some 2022 festival increase in cathinones. It is not known if these were mis-sold drugs)
- Vulnerable populations
o Prisons
o Homeless - Synthetic cannabinoid receptor agonists
New psychoactive substances- many unknowns but there are two certainties. What is this?
- NPS are unlikely to go away anytime soon
- Dealing with them. Even with the PS act, will take significant funding. Funding that probably does not exist
