L17: Novel psychoactive substances

What are Novel Psychoactive Substances (NPS)?

Structural or functional analogues of controlled drugs designed to mimic effects while avoiding legal control or standard drug detection.

What were NPS originally marketed as?

“Legal highs.”

How were NPS often disguised for sale?

As plant food, bath salts, cat food, or similar products labelled “not for human consumption.”

When did NPS first become widely visible in the UK?

Around 2010.

What are the four main categories of NPS?

Synthetic cannabinoids, synthetic hallucinogens, synthetic depressants, and synthetic stimulants.

Why were NPS developed?

To mimic controlled drugs while avoiding classification as illegal.

Where were NPS commonly sold?

Online, in health shops, and later on the darknet.

What major drug shortage helped expand synthetic stimulant NPS in the 2000s?

A shortage of quality MDMA products.

What replaced poor-quality MDMA in the mid-2000s?

Piperazines, cathinones, and other synthetic stimulants.

What is MDMA?

3,4-methylenedioxymethamphetamine, a substituted amphetamine known as ecstasy.

When was MDMA first synthesised?

1912 by Merck in Germany.

What drug class does MDMA belong to?

Substituted amphetamines.

What neurotransmitters is MDMA structurally similar to?

Serotonin, norepinephrine, and dopamine.

What are the main effects of MDMA?

Euphoria, empathy, stimulation, increased heart rate, sweating, raised temperature, heightened senses, and insomnia.

Why is MDMA called an empathogen?

It can produce feelings of love, empathy, and peace with others.

What major risk is associated with MDMA?

Hyperthermia and neurotoxicity.

What is mephedrone?

A synthetic cathinone stimulant also called “meow meow.”

What natural plant stimulant is mephedrone related to?

Cathinone from khat.

What was mephedrone often sold as?

Plant food or bath salts.

What are major dangers of mephedrone?

Hyponatraemia, cerebral oedema, and sympathomimetic toxicity.

What is LSD?

Lysergic acid diethylamide, a synthetic hallucinogen.

Who synthesised LSD?

Albert Hofmann.

When was LSD synthesised?

1938 (with psychoactive effects recognised in 1943).

What natural source is LSD related to?

Ergot fungus (Claviceps purpurea).

What receptor is strongly associated with LSD effects?

5-HT2A serotonin receptors.

What are major risks of LSD?

Bad trips, paranoia, accidents, and flashbacks (hallucinogen persisting perception disorder).

Does LSD have strong dependence potential?

No, dependence potential is low.

What is ketamine?

A dissociative anaesthetic and NPS with hallucinogenic effects.

What receptor does ketamine block?

The NMDA subtype of glutamate receptor.

What are effects of ketamine?

Dissociation, altered vision and sound, sedation, and analgesia.

What major harms are linked to ketamine misuse?

Bladder damage, dissociation, breathing difficulty, and dependency.

What is esketamine?

The S-enantiomer of ketamine used as a nasal spray for treatment-resistant depression.

What is PCP?

Phencyclidine, a dissociative hallucinogen also called angel dust.

What receptor does PCP affect?

It blocks glutamate (NMDA) receptors.

What are major risks of PCP?

Psychosis, seizures, coma, respiratory depression, and cardiac arrest.

What are synthetic depressants?

Sedative or opioid-like NPS with inhibitory, relaxing, anti-anxiety effects.

What synthetic depressant group has recently increased?

Designer benzodiazepines (e.g. etizolam, pyrazolam, flubromazepam).

What is nitrous oxide?

A colourless gas (“laughing gas”) used medically and recreationally.

What are effects of nitrous oxide?

Euphoria, calmness, dizziness, memory impairment, and neuropathy.

What deficiency is linked to nitrous oxide neuropathy?

Vitamin B12 deficiency.

What are nitazenes?

Very potent synthetic opioids developed as morphine alternatives.

Why are nitazenes dangerous?

They cause severe respiratory depression and overdose at low doses.

Why are nitazenes especially risky in illicit drugs?

They are often used as hidden cutting agents in benzodiazepines, oxycodone, cocaine, and spice.

What was the major UK legal response to NPS in 2016?

The Psychoactive Substances Act 2016.

What did the Psychoactive Substances Act 2016 make illegal?

Producing, supplying, or importing psychoactive substances not already controlled.

What is not generally illegal under the Psychoactive Substances Act?

Simple possession (except in prison).

What substances are excluded from the Psychoactive Substances Act?

Food, caffeine, alcohol, tobacco, and medicinal products.

Where are many NPS manufactured?

China and India.

How are NPS commonly distributed internationally?

Mail and parcel delivery services.