Alcohol, tobacco & other drugs in Australia

New (and emerging) psychoactive substances (NPS) may be defined as substances, whether in a pure form or preparation, where most are not controlled by international drug control conventions but which may pose a public health threat (UNODC 2019). NPS often mimic the effects of existing illicit substances such as cannabis, ecstasy (MDMA) and hallucinogens, or have chemical structures very similar to those substances (AIHW 2017). There are several main types of NPS, including:

• synthetic cannabinoids—designed to mimic or produce similar effects to cannabis. 
• phenethylamines—a class of drugs with psychoactive and stimulant effects and includes amphetamine, methamphetamine and MDMA (ecstasy). NPS phenethylamines include the ‘2C series’, the NBOMe series, PMMA and benzodifurans.
• tryptamines—psychoactive hallucinogens found in plants, fungi and animals.
• piperazines—typically described as ‘failed pharmaceuticals’ and are frequently sold as ecstasy due to their central nervous system stimulant properties.
• synthetic cathinones—have an amphetamine-type analogue including mephedrone (‘meow meow’) and methylone.
• novel benzodiazepines—are less well categorised and understood than other NPS (NSW Ministry of Health 2017).

Other names given to this group of drugs include research chemicals, analogues, legal highs, herbal highs, bath salts, novel psychoactive substances and synthetic drugs (NDARC 2016).

Availability

There is evidence that NPS are now available in over 100 countries around the world.

In Australia, the NPS market is highly dynamic with fluctuations in the types of NPS available (Burns et al. 2014). The Australian Criminal Intelligence Commission (ACIC 2019) recently reported:

• An 85% decrease in the number of NPS border seizures selected for further analysis, from 182 in 2016–17 to 28 in 2017–18.
• A 63% decrease in the weight of analysed NPS border seizures, from 89.0 kilograms in 2016–17 to 33.1 kilograms in 2017–18.
• Since 2008–09, cathinone-type substances have accounted for the highest proportion of the total number of analysed NPS seizures (44.5% in 2016–17). However, in the 2017–18 reporting period amphetamine-type substances accounted for the greatest proportion of seizures (32.1%).
• By number, the second most commonly detected substance in 2017–18 was other substances (28.6%), followed by cathinone-type substances (21.4%), and tryptamine-type substances (17.9%). There were no seizures of synthetic cannabinoids analysed in 2017–18.
• By weight, amphetamine-type substances accounted for 46.5% of the weight of analysed seizures in 2017–18, followed by cathinone-type substances (38.1%), tryptamine-type substances (9.3%), and other substances (6.1%) (ACIC 2019).

Consumption

Synthetic cannabinoids

The use of synthetic cannabinoids in Australia is low.

• The NDSHS showed that in 2016 although lifetime use of the synthetic cannabis more than doubled among the general population between 2013 and 2016 (from 1.3% to 2.8%), recent use dropped dramatically from 1.2% to 0.3% (Figure NPS1).
• Regular ecstasy and other stimulant users interviewed as part of the EDRS reported infrequent use of synthetic cannabinoids in 2019, with 3% of the sample reporting use in the past 6 months (Peacock et al. 2019) (Table S2.56).
• The low reported use of synthetic cannabinoids has been attributed to the fact that these synthetic cannabinoids do not produce the kinds of effects that people are seeking.
• Similarly, the use of NPS among secondary school students is also uncommon. The Australian Secondary School Survey showed the majority of students (97%) reported they had never used synthetic cannabis or any new synthetic drug in the last 12 months (Guerin & White 2018) (Table S2.57).
• The National Wastewater Drug Monitoring Program no longer monitors the 2 synthetic cannabinoids JWH-018 or JWH-073, as they had not been detected since monitoring commenced in August 2016. While methylone and mephedrone (synthetic stimulants) continue to be detected, consumption was mostly below levels at which it could be reliably quantified (ACIC 2020).

Other NPS

The use of other NPS among the Australian general population is similarly low (AIHW 2017).

• The NDSHS showed that in 2016 lifetime use of other psychoactive substances such as ‘meow meow’ and N,N-dimethyltryptamine (DMT) increased from 2013 (from 0.4% to 1.0%) but recent use remained stable at about 0.3% in 2016 (tables S2.31 and S2.32) (Figure NPS1).
• The consumption of NPS among regular ecstasy and other stimulant users is disproportionately high compared with the general population; in 2019, 30% reported recent use of any NPS in the past 6 months (Table S2.56). However, NPS are used infrequently with most reporting use on a median of 1–2 days in the 6 months prior (Peacock et al. 2019).

Harms

Due to the wide variety of NPS and their ever-changing purity and composition, information on the long-term adverse effects or risks are still largely unknown (UNODC 2015).

The use of NPS has been linked to health problems, including (but not limited to):

• cardiovascular problems
• memory and cognitive impairment
• psychiatric problems
• aggression and acute psychosis
• breathing difficulties
• fatigue
• headaches
• nausea and persistent vomiting
• abnormally fast heartbeat (tachycardia)
• seizures
• tolerance and dependence (ACIC 2019; NSW Ministry of Health 2017; UNODC 2015).

Policy context

The laws surrounding NPS are complex and vary between Australian jurisdictions.

• To deal with the rapid growth of NPS, some Australian jurisdictions such as New South Wales have implemented blanket bans on selling any substance that has a psychoactive effect (exempting alcohol, tobacco and food).
• In other jurisdictions, such as Western Australia, specific NPS are banned with additional substances regularly added to the list.
• Commonwealth legislation also bans any psychoactive substance not covered by legislation elsewhere (NDARC 2016).

References

ACIC (Australian Criminal Intelligence Commission) 2019. Illicit Drug Data Report 2017–18. Canberra: ACIC. Viewed 7 August 2019.

ACIC 2020. National Wastewater Drug Monitoring Program Report 9, 2020. Canberra: ACIC. Viewed 3 April 2020.

AIHW (Australian Institute of Health and Welfare) 2017. National Drug Strategy Household Survey 2016: detailed findings. Drug statistics series no. 31. Cat. no. PHE 214. Canberra: AIHW. Viewed 14 December 2017.

Burns L, Roxburgh A, Matthews A, Bruno R, Lenton S & Buskirk JV 2014. The rise of new psychoactive substance use in Australia. Drug Testing and Analysis 6:846–849.

Guerin N & White V 2018. Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2017. Victoria: Centre for Behavioural Research in Cancer. Viewed 11 March 2019.

NDARC (National Drug and Alcohol Research Centre) 2016. New (and emerging) psychoactive substances (NPS) fact sheet. Viewed 21 December 2017.

NSW Ministry of Health 2017. A quick guide to drugs & alcohol, 3^rd edn. Sydney: National Drug and Alcohol Research Centre.

Peacock A, Karlsson A, Uporova J, Gibbs D,  Swanton R, Kelly G, Price O, Bruno R, Dietze P, Lenton S, Salom C, Degenhardt L & Farrell M 2019. Australian Drug Trends 2019: Key findings from the National Ecstasy and Related Drugs Reporting System (EDRS) Interviews. Sydney: National Drug and Alcohol Research Centre, University of New South Wales.

UNODC (United Nations Office on Drug and Crime) 2015. UNODC early warning advisory on new psychoactive substances. Viewed 21 December 2017.

UNODC 2019. World Drug Report 2019. Vienna: UNODC. Viewed 16 July 2019.