GENEVA, Switzerland – September 2018: The Fifth WHO-UNODC Expert Consultation on NPS was held on 24 to 25 September 2018 at the WHO in Geneva. This year, the consultation focussed specifically on addressing challenges of the non-medical use of opioids, including synthetic opioids. An increasing trend in the non-medical use of opioids, both medicines and new psychoactive substances (NPS) with opioid effects, such as fentanyl analogues, has recently been observed. Several of these substances are extremely potent and harmful posing challenges to public health and law enforcement authorities in many countries. Approximately 50 experts from different regions of the world discussed related challenges and presented examples, which are already implemented at country, regional and global level. A number of additional options for response were identified, including enhancing collaboration between police services and the health sector, updating existing international guidelines on prevention and treatment to incorporate options for addressing the non-medical use of synthetic opioids, strengthening early warning systems, particularly at the national and regional level, improving monitoring systems to prevent the diversion and misuse of pain medication while ensuring adequate access, supporting international scheduling on NPS and precursors, and promoting and making better use of existing tools to exchange intelligence across borders.

Source: UNODC

For more information, please see:

WHO Essential Medicines and Health Products

UNODC Global Opioid Strategy

CHIANG RAI, Thailand – September 2018: At the 10th Regional SMART Workshop for East and South-East Asia, a majority of countries in the region confirmed the increasing seizures of methamphetamine and continued to report the emergence of NPS, pointing towards a persistent expansion of the synthetic drug market. Several new developments were observed, such as strong indications of a geographical shift of some large-scale methamphetamine manufacture and newly identified NPS. Moreover, the range of NPS is expanding in the region with a greater number of reports of stimulant NPS. The workshop, which was organized in partnership with the Office of Narcotics Control Board (ONCB) in Thailand, was held on 28 - 30 August 2018 in Chiang Rai, Thailand, and brought together synthetic drug experts from the ASEAN group of states, including Australia, China, Japan, Republic of Korea, Timor Leste, the United States, as well as the World Customs Organization (WCO) Regional Intelligence Liaison Offices for Asia/Pacific (RILO/AP).

Source: UNODC Bangkok Office

For more information, please see:

APAIC website – Latest news on synthetic drugs

UNODC World Drug Report 2018 – Booklet 3 on Analysis of Drug Markets

MAASTRICHT, The Netherlands – September 2018: We are pleased to announce the Sixth International Conference on NPS to be held from 8 to 9 April 2019 at Maastricht University, The Netherlands. The conference is jointly organised by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), United Nations Office on Drugs and Crime (UNODC), University of Hertfordshire, University of Maastricht University of Maastricht and the World Anti-Doping Agency (WADA).

To date, the five International Conferences on NPS, held in Budapest (2012; 2015) Swansea (2013) and Rome (2014), and most recently, at the United Nations in Vienna, Austria, were extremely successful events to share knowledge and strengthen collaboration on NPS among multidisciplinary professionals at the international level.

The main objectives of the sixth event are to share evidence-based information on NPS and latest trends of use; improve the understanding of clinical treatment and management of NPS use; explore policy and legislative responses to NPS; develop innovative prevention measures for vulnerable individuals; identify public health implications of NPS and explore motivations and socio-cultural factors underlying NPS use. To attend this conference please register on the conference webpage. Abstract submission is open until Saturday, 1 December 2018.

Source: VI International Conference on NPS

For more information, please see:

VI International Conference on Novel Psychoactive Substances (NPS) web page

VIENNA, Austria – September 2018: The current issue provides insight into the dynamics of the rapidly expanding methamphetamine market by analysing the key trends and drivers of the methamphetamine market. From a market when manufacture was concentrated in specific subregions, it has evolved to a market with global trafficking flows and global seizure quantities growing more than 6 times since 2008. Despite an increasing number of reports on harms and deaths relating to methamphetamine use, the extent of the threat might nevertheless be greatly underestimated. Methamphetamine is often used in combination with other substances, which poses a significant challenge in determining the spread of methamphetamine use and in associating methamphetamine use to treatment cases and fatalities.

For more information, please see:

Global SMART Update Volume 20 “Methamphetamine continues to dominate synthetic drug markets”

UNODC Report “Global Synthetic Drugs Assessment”

https://www.unodc.org/documents/scientific/Global_Synthetic_Drugs_Assessment_2017.pdf

MARYLAND, United States – September 2018: The Center for Substance Abuse Research (CESAR) at the University of Maryland recently released the results of a study involving the re-testing of biological samples, which was conducted with emergency department physicians at two hospitals in Maryland. Following a number of suspected synthetic cannabinoid overdose cases, urine samples were re-assessed and results showed that only one-quarter of specimens were in fact synthetic cannabinoids. The study highlights the complexity of detecting substances and treating patients for severe drug-related events, as results revealed that the actual substance taken by patients often differed from the synthetic cannabinoid reported. Notably, one-fifth to one-third of specimens at each hospital tested positive for an NPS other than those reported, while two-thirds of patients at both hospitals tested positive for multiple substances (poly-substance use) with some specimens containing as many as six substances. The two synthetic cathinones, dibutylone and butylone, were the most commonly detected NPS.

This study also accentuates the importance of toxicology analyses to understand the severe adverse health events caused by NPS and their role in combination with other, traditional drugs, as well as the need for comprehensive hospital drug testing. In addition, the study sheds more light on the integration of NPS and other drug markets at the user level.

Source: Wish, E.D., Billing, A.S., Artigiani, E.E., Dezman, Z., Schwartz, B., and Pueschel, J. (2018). Drug Early Warning from Re-Testing Biological Samples: Maryland Hospital Study. Office of National Drug Control Policy. Washington, DC: Executive Office of the President.

For more information, please see:

NDEWS press release and full report: https://ndews.umd.edu/resources/drug-early-warning-re-testing-biological-samples-maryland-hospital-study

Wish ED, Billing AS, Artigiani EE, Dezman Z, Schwartz B, Pueschel J. “Drug Early Warning from Re-Testing Biological Samples: Maryland Hospital Study." Office of National Drug Control Policy. Washington, DC: Executive Office of the President. July 2018

UNODC Recommended Methods for the Identification and Analysis of NPS

BEIJING, China – August 2018: On 29 August 2018, China placed additional 32 new psychoactive substances under national control. The newly scheduled NPS include 20 synthetic cathinones (such as 4-Cl-alpha-PVP; Dibutylone; Mexedrone and Pentylone), 8 synthetic cannabinoids (for example, AMB-FUBINACA; ADB-FUBINACA; 5F-ADB and NM-2201) and other substances, including recently internationally controlled fentanyl analogues, namely 4-FIBF and THF-F.

Source: UNODC

For more information, please see:

Global SMART Update Volume 17 “Fentanyl and its analogues- 50 years on”  https://www.unodc.org/documents/scientific/Global_SMART_Update_17_web.pdf

UNODC EWA News Clip (March 2017) “Carfentanil, furanylfentanyl, acrylfentanyl and valerylfentanyl placed under national control”

UNODC EWA News Clip (October 2015) “China announces controls over 116 New Psychoactive Substances”

MONTEVIDEO, Uruguay – August 2018: The seizure of a multi-kilogram shipment of “ecstasy” (MDMA) in powder form earlier this year was unusual for Uruguay but did not yet ring the alarm bells for the staff of the Uruguayan Early Warning System in Montevideo. “However, when reports of young people suffering from an “ecstasy” overdose kept coming in from hospitals, we got really worried” said Héctor Suarez, who coordinates the system. It seemed that young people, who in Uruguay are more familiar with “ecstasy” sold as pills, were at risk of overdosing the crystalline and potentially higher potency MDMA which was coming into the country in comparatively large quantities in 2018. “It was at this point when we decided to go public to make sure this information reaches all relevant people and institutions and helps to minimize the risk of further overdoses”, Mr. Suarez informed the participants from other countries in Latin America and the Caribbean at a recent COPOLAD workshop in Montevideo (26-217 July 2018). In addition to drug experts from Antigua y Barbuda, Argentina, the Bahamas, Colombia Ecuador, Jamaica Paraguay, Peru, Trinidad and Tobago and Uruguay, participants from the Czechia, Poland, OAS/CICAD, EMCDDA and UNODC shared their experiences in early warning. “UNODC supports laboratories in Latin America and the Caribbean to ensure health-relevant information is available for early warning on drugs” said Martin Raithelhuber, who manages the UNODC Early Warning Advisory on New Psychoactive Substances. “This directly contributes to reducing health risks”, Mr. Raithelhuber added.

Source: UNODC

In November 2018, UNODC will conduct a forensic capacity building workshop for 13 countries in Latin America and the Caribbean which will receive modern handheld electronic field testing devices to enhance their capacity to detect new psychoactive substances which are a potential threat for public health. The data generated with the help of these devices is not only useful for law enforcement, border control or laboratories but also for national early warning systems which will receive faster and more detailed information about changes in the drug market.

A particular characteristic of the regional drug situation is – in addition to cannabis and cocaine use - the comparatively high prevalence of hallucinogenic drugs. The situation is complicated by the fact that drugs sold as “ecstasy“, “2C-B“ or “LSD“ do not always contain the expected psychoactive substances and a range of NPS have been identified in products sold under these drug names which have led to hospitalizations including fatal cases.


For more information, please see:

Workshop

Alert

United States – July 2018: According to a Health Alert Network Health Update from the Center for Disease Control and Prevention (CDC), drug submissions to the United States National Forensic Laboratory Information System (NFLIS) testing positive for fentanyl and fentanyl analogues have doubled from 14,440 in 2015 to 34,119 in 2016. The trend seems to continue with 25,460 reports for fentanyl and fentanyl analogues being recorded in the database in the first six months of 2017 alone. Among the fentanyl analogues, the number of reports for the highly toxic  Carfentanil increased from 1,251 in 2016 to 2,268 in 2017 while methylfentanyl, furanylfentanyl, and acrylfentanyl have also been rising in prominence.  Furthermore, the United States National Center for Health Statistics (NCHS) indicated that more than 55% of the opioid overdose deaths involved synthetic opioids in the 12-month period ending November 2017, accounting for more than 27,000 deaths.

An increasing number of synthetic opioids on the drug market, particularly fentanyl analogues, has also been reflected in reports of Member States to the UNODC Early Warning Advisory (EWA). By the end of 2017, 34 synthetic opioids were registered in the EWA. In June 2018, UNODC launched an integrated strategy responding to the global opioid crisis.

For more information, please see:

Global SMART Update Volume 17 “Fentanyl and its analogues- 50 years on” 
https://www.unodc.org/documents/scientific/Global_SMART_Update_17_web.pdf

Health Alert Network (HAN) Health Update on “Rising Numbers of Deaths Involving Fentanyl and Fentanyl Analogues, Including Carfentanil, and Increased Usage and Mixing with Non-opioids” https://content.govdelivery.com/accounts/USCDC/bulletins/1fdd9bf

NEW DELHI, India – July 2018: According to the Indian Narcotics Control Bureau, the quantity of mephedrone seizures in the country totalled 173 kg in 2017. In comparison, around 300 kg of mephedrone were reported to have been seized worldwide in 2016. In India, the majority of mephedrone seizures in 2017 were reported in New Delhi and smaller amounts were also reported in Gujarat, Madhya Pradesh and Maharashtra. That year, 110 kg of mephedrone were seized at 4 multi-drug manufacturing facilities dismantled in the country.

For more information, please see:

Narcotics Control Bureau, Ministry of Home Affairs – “Annual Report 2017”
http://narcoticsindia.nic.in/upload/download/document_id17c3433fecc21b57000debdf7ad5c930.pdf

VIENNA, Austria – June 2018: The range of psychoactive substances available on the market has probably never been greater. Close to 500 NPS were available on the global market in 2016. Among all NPS reported to UNODC by the end of 2017, synthetic cannabinoids constitute the largest category in terms of the number of different substances reported (251 substances), followed by the categories of “other substances” (155), synthetic cathinones (148) and phenethylamines (136). Only a comparatively small number of tryptamines, piperazines, aminoindanes and plant-based NPS are reported annually. The category of “other substances”, which includes structurally diverse substances, has grown considerably, especially since 2014, totalling 155 substances by the end of 2017. This category includes NPS-derivatives of prescription medicines, including fentanyl analogues and derivatives of benzodiazepine.

Figure 1. Number of new psychoactive substances reported annually, 2009–2016

Source: UNODC, early warning advisory on new psychoactive substances.

For more information, please see:

UNODC World Drug Report 2018 – Booklet 3
https://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_3_DRUG_MARKETS.pdf

VIENNA, Austria – June 2018: Only a few substances seem to have established markets of their own or replaced traditional drugs. Nevertheless, the harm caused by NPS use remains considerable. Some single substances have become cemented in niche markets, specifically among small and vulnerable population groups, while others have penetrated the existing established markets of controlled substances, increasing the complexity of the offer of products in the market.

In several countries, patterns of NPS use of among marginalized, vulnerable and socially disadvantaged groups, including homeless people and people with mental health disorders, continue to be widely documented. The injecting use of stimulant NPS also remains a concern, in particular because of reported associated high-risk injecting practices. In addition to the high number of daily injecting episodes, the rate of sharing and reusing of injecting equipment is high among people who inject drugs (PWID) that inject stimulants. NPS use in prison and among people on probation remains an issue of concern in some countries in Europe, North America and Oceania.

Figures 1. Psychoactive substances found in discarded injecting paraphernalia in Hungary, 2016

Source: Valéria Anna Gyarmathy and others, “Diverted medications and new psychoactive substances—a chemical network analysis of discarded injecting paraphernalia in Hungary”, 2017.

For more information, please see:

UNODC World Drug Report 2018 – Booklet 3
https://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_3_DRUG_MARKETS.pdf

VIENNA, Austria – June 2018: Quantities of synthetic cannabinoids and ketamine have dominated global seizures of synthetic NPS since 2012. The number of countries reporting seizures of synthetic cannabinoids has been relatively stable, but the quantities reported have declined sharply since 2014. However, in 2016, seizures of plant-based NPS surged. Some 500 tons of kratom were intercepted during 2016, triple the amount of the previous year, suggesting a boom in its popularity. Moreover, between 2012 and 2016, more than 700 tons of khat were seized by 35 countries. Although khat is not under international control, many national jurisdictions do not allow the import of khat leaves. Significant khat seizures are reported to UNODC each year, mainly by authorities of countries outside the areas of traditional use.

Figure 1. Annual quantities of new psychoactive substances seized globally, 2012 to 2016

Source: UNODC, responses to the annual report questionnaire, 2012–2016.

Note: Figures include ketamine and plant-based NPS.

For more information, please see:

UNODC World Drug Report 2018 – Booklet 3
https://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_3_DRUG_MARKETS.pdf

VIENNA, Austria – June 2018: The NPS market continues to be dynamic as new substances emerge but a slower rate than in previous years. Some substances have established themselves on the drug market whilst others have disappeared after a short while. In 2016, 72 NPS were reported for the first time, a much smaller number than in 2015 (137 NPS). About 70 of the 130 NPS reported at the start of UNODC global monitoring in 2009 have since been reported every year to date. 60 NPS have not been reported since 2013 and may have disappeared from the market, although this is difficult to determine given the complexity of NPS identification in many parts of the world.

Source: UNODC, World Drug Report 2018.

For more information, please see:

UNODC World Drug Report 2018 – Booklet 3
https://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_3_DRUG_MARKETS.pdf

VIENNA, Austria – June 2018: In recent years, kratom has gained popularity in countries in North America and Europe as a plant-based NPS. At the global level, 31 countries reported the detection of kratom between 2012 and 2017. Kratom products are derived from the leaf of the kratom tree, which is used in South-East Asia as a traditional remedy for minor ailments and for non-medical purposes. Few countries have placed kratom under national legal control, making it relatively easy to buy. There are now numerous products around the world advertised as containing kratom, which usually come mixed with other substances. People who use opioids in the United States have reported using kratom products for the self-management of withdrawal symptoms. Some 500 tons of kratom were intercepted during 2016, triple the amount of the previous year, suggesting a boom in its popularity.