An Update on the Implications of New Psychoactive Substances in Public Health

Abstract

The emergence of new psychoactive substances has earned a great deal of attention, and several reports of acute poisoning and deaths have been issued involving, for instance, synthetic opiates. In recent years, there have been profound alterations in the legislation concerning consumption, marketing, and synthesis of these compounds; rapid alert systems have also been subject to changes, and new substances and new markets, mainly through the internet, have appeared. Their effects and how they originate in consumers are still mostly unknown, primarily in what concerns chronic toxicity. This review intends to provide a detailed description of these substances from the point of view of consumption, toxicokinetics, and health consequences, including case reports on intoxications in order to help researchers and public health agents working daily in this area.

Acute Kidney Injury (AKI) in Young Synthetic Cannabinoids Abusers

“…The results relating to the socio-demographic aspects of the consumption of synthetic cannabinoids are in line with the evidence relating to the consumption of cannabinoids, with a prevalence of consumption in males under the age of 30 years [ 48 , 49 , 50 ].…”

The Novel Psychoactive Substances Epidemic: a Scientometric Perspective

“…The cited reference with the highest burst strengths in this cluster focuses on fentanyl and other novel synthetic opioids [34, 146, 147], supporting this notion. Many citing articles were concerned with opioid-related deaths [39, 148, 149, 150] and a significant number of articles pointed towards the rapidly surging numbers globally and its implications on public health [151, 152, 153].…”

New Psychoactive Substances: Major Groups, Laboratory Testing Challenges, Public Health Concerns, and Community-Based Solutions

“…Opioids [8,43], peptides [44,45], gammahydroxybutyric acid (GHB) analogues [46,47], methaqualone analogues [48,49], androgenic anabolic steroids [3,4,50], selective androgen receptor modulators (SARMs), piperazines [53,54], amphetamines [14,55], and cathinones ("Bath Salts") [8,56] are also shown in Table 1. Additionally, pyrrolidinophenones and pyrrolidines [57][58][59][60], thiophenes [61][62][63], oxazolidines [64,65], phenylmorpholines (Substituted phenylmorpholines)/phenmetrazines [66], nootropics [67][68][69], and tropanes, as well as piperidines [70] are collated in Table 1.…”

“…Crack contains similar chemical structure as cocaine but in a distinct form and often used in place of cocaine. Synthetic stimulants have actions on the two neurotransmitter systems at diferent degrees, which accounts for the difering desirable and undesirable efects [58,59], which include muchdesired experiences, e.g., euphoria, energy boost and alertness, increased feelings of compassion/empathy, libido, sociability, improved self-confdence, and sense of relaxation and inner peace [145,146]. Synthetic stimulants also have adverse efects, including high potential for addiction, severe intoxications associated with neuropsychiatric, neurological, cardiac, and metabolic complications, with increased fatality risks [147,148].…”

“…DMC is usually metabolized by N-deethylation, hydroxylation, or Nacetylation. In general, cocaine analogues are often artifcial constructs of a novel chemical compound derived from the molecular structure of cocaine, with the resulting products having strong similarity to cocaine, which may have altered chemical functions [14,59]. Within the analogues derived from the cocaine structure, we maintain 3βbenzoyloxy or similar functionality on a skeleton of tropane, in comparison to other related stimulants.…”