New psychoactive substances: challenges for drug surveillance, control, and public health responses

Peacock, Amy; Bruno, Raimondo; Gisev, Natasa; Degenhardt, Louisa; Hall, Wayne; Sedefov, Roumen; White, Jason M.; Thomas, Kevin V.; Farrell, Michael; Griffiths, Paul

doi:10.1016/s0140-6736(19)32231-7

Cited by 246 publications

(195 citation statements)

References 84 publications

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“…NPS represent a serious public health challenge due to the lack of awareness of their actual composition, as well as their potency, effects and risk profile. NPS stimulants and novel synthetic opioids–most of which are much stronger than morphine–have already been linked to a spike in intoxications and fatalities in the USA and Europe [ 17 – 22 ]. Although the available epidemiological evidence on the use of NPS has increased in recent years, knowledge of lifetime prevalence rates is limited due to the scarcity of relevant population-based surveys with adequate sampling design [ 23 – 39 ].…”

Section: Introductionmentioning

confidence: 99%

Lifetime prevalence of novel psychoactive substances use among adults in the USA: Sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007–2014

et al. 2020

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Introduction As Novel psychoactive substances (NPS) are conceived to mimic the effects of common illicit drugs, they represent a serious public health challenge due to the spike in intoxications and fatalities that have been linked to their use. This study aims to provide epidemiological data on NPS use in the USA, determining lifetime prevalence of use and defining demographic, socioeconomic, drug use patterns and mental health correlates. Methods This study uses secondary data from the US National Survey on Drug Use and Health (NSDUH), which is a large cross-sectional population-based survey carried out annually in the USA. We analysed data from 2007–14 (N = 307,935) using bivariate descriptive analysis and binary logistic regression to calculate prevalence and determine factors underlying NPS consumption. Adjusted odds ratios (OR) with 95% CI’s were calculated for a set of selected independent variables. Results and discussion Our analysis NSDUH from 2007–14 highlights an increase in NPS use among adults, especially among white young men aged 18 to 25. Although the level of education of NPS users was relatively higher as compared to non-users, NPS users seemed to have a less wealthy situation. However, socioeconomic vulnerability appeared to be less important than mental health issues as a correlate to NPS use. NPS users seem to have followed a pattern of polysubstance use throughout their life, which involves both traditional illicit drugs and classic synthetic drugs. As NPS use seemed to be more prevalent among people having mental health issues, the rise in their use may have a negative impact on population mental health outcomes. Conclusion Further comparative research on trends in NPS use and potential public health responses would be instrumental for developing appropriate health interventions, including drug checking, education for users and training for healthcare professionals working both within emergency wards and in/outpatient addiction and mental health services.

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Section: Introductionmentioning

confidence: 99%

Lifetime prevalence of novel psychoactive substances use among adults in the USA: Sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007–2014

et al. 2020

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“…Considering the plethora of negative health consequences associated with SCRA consumption, growing public concern has prompted the legislative control of a wide number of these new psychoactive substances (NPS) to varying degrees around the world. However, such efforts to curb the manufacture, distribution, and recreational use of SCRAs have been met with considerable difficulty . For example, the control of a given SCRA typically results in the emergence of another structurally related SCRA which circumvents legislative control.…”

Section: Introductionmentioning

confidence: 99%

“…However, such efforts to curb the manufacture, distribution, and recreational use of SCRAs have been met with considerable difficulty. 68 For example, the control of a given SCRA typically results in the emergence of another structurally related SCRA which circumvents legislative control. SCRA classes began to appear in blood and/or urine samples taken from individuals admitted to hospital after NPS use.…”

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confidence: 99%

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Alam

Keating

2020

Drug Testing and Analysis

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Synthetic cannabinoid receptor agonists (SCRAs) first appeared on the international recreational drug market in the early 2000s in the form of SCRA‐containing herbal blends. Due to the cannabimimetic effects associated with the consumption of SCRAs, they have acquired an ill‐informed reputation for being cheap, safe, and legal alternatives to illicit cannabis. Possessing high potency and affinity for the human cannabinoid receptor subtype‐1 (CB1) and ‐2 (CB2), it is now understood that the recreational use of SCRAs can have severe adverse health consequences. The major public health problem arising from SCRA use has pressed legislators around the world to employ various control strategies to curb their recreational use. To circumvent legislative control measures, SCRA manufacturers have created a wide range of SCRA analogs that contain, more recently, previously unencountered azaindole, γ‐carbolinone, or carbazole heterocyclic scaffolds. At present, little information is available regarding the chemical syntheses of these newly emerging classes of SCRA, from a clandestine perspective. When compared with previous generations of indole‐ and indazole‐type SCRAs, current research suggests that many of these heterocyclic SCRA analogs maintain high affinity and efficacy at both CB1 and CB2 but largely evade legislative control. This review highlights the importance of continued research in the field of SCRA chemistry and pharmacology, as recreational SCRA use remains a global public health issue and represents a serious control challenge for law enforcement agencies.

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“…[90][91][92][93] SCs are made in clandestine labs, sold under names like Spice and K2, and labeled "not for human consumption" to avoid being classified as a controlled substance under federal laws. 94,95 SCs are used as powders sprayed on inert plant material and then smoked or vaped.…”

Section: Synthetic Cannabinoidsmentioning

confidence: 99%

Cannabis and work: Need for more research

Howard

Osborne

2020

American J Industrial Med

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Cannabis sativa is one of the oldest and most widely used plants in the world with a variety of industrial, medical, and nonmedical applications. Despite its long history, cannabis-derived products remain a source of controversy across the fields of medicine, law, and occupational safety and health. More favorable public attitudes about cannabis in the US have resulted in greater access to cannabis through legalization by states, leading to more consumption by workers. As more states adopt cannabis access laws, and as more workers choose to consume cannabis products, the implications for existing workplace policies, programs, and practices become more salient. Past workplace practices were grounded in a time when cannabis consumption was always viewed as problematic, considered a moral failing, and was universally illegal. Shifting cultural views and the changing legal status of cannabis indicate a need for research into the implications and challenges relating to cannabis and work. This commentary suggests research needs in the following areas: (a) data about industries and occupations where cannabis consumption among workers is most prevalent; (b) adverse health consequences of cannabis consumption among workers; (c) workplace supported recovery programs; (d) hazards to workers in the emerging cannabis industry; (e) relationship between cannabis consumption and occupational injuries; (f) ways to assess performance deficits and impairment from cannabis consumption; (g) consumption of synthetic cannabinoids to evade detection by drug testing; (h) cannabis consumption and its effect on occupational driving; and (i) ways to craft workplace policies and practices that take into consideration conflicting state and federal laws pertaining to cannabis. 1 | INTRODUCTION Cannabis sativa is one of the oldest and most widely used plants in the world. 1 Native to Asia, the different cultivars of C. sativa have been used for a wide variety of industrial, medical, and nonmedical uses for thousands of years. 2 Despite its long history, the use of cannabisderived products remains a source of controversy across the fields of medicine, law, and occupational safety and health. 3-6 More favorable public attitudes about cannabis in the United States have resulted in greater access to cannabis through legalization by states and led to more consumption. In 2018, 40.3 million Americans aged 18 or older used cannabis at some time during that year. 7 Increases in use were greater in states that adopted medical cannabis access laws than nonadopting states. 8 Nearly 18% of workers employed full-time, and nearly 21% of workers employed part-time, used

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New psychoactive substances: challenges for drug surveillance, control, and public health responses

Cited by 246 publications

References 84 publications

Lifetime prevalence of novel psychoactive substances use among adults in the USA: Sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007–2014

Lifetime prevalence of novel psychoactive substances use among adults in the USA: Sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007–2014

Adding more “spice” to the pot: A review of the chemistry and pharmacology of newly emerging heterocyclic synthetic cannabinoid receptor agonists

Cannabis and work: Need for more research

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