New (and emerging) psychoactive substances

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 2021). NPS often mimic the effects of existing illicit substances (AIHW 2020). 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).

Key findings

New (and emerging) psychoactive substances (NPS) often mimic the effects of existing illicit substances

Introduction

The NPS market is highly dynamic, with fluctuations in the types of NPS available

Availability

There was a decrease in NPS border detections, from 687 in 2017–18 to 575 in 2018–19

Availability

In 2019, 0.2% of the general population reported using synthetic cannabinoids in the previous 12 months

Consumption

In 2019, only 0.1% of the general population reported recent use of other NPS (excluding synthetic cannabinoids)

Consumption

People who use psychostimulant drugs such as ecstasy are more likely to use NPS than the general population

Consumption

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Availability

Currently, NPS have been reported in 125 countries and territories in all regions of the world. Over 1,000 substances have been reported to the United Nations Office on Drugs and Crime (UNODC) Early Warning Advisory, by Governments, laboratories and partner organisations (UNODC 2020).

The number of NPS found globally has been stabilising in recent years – 541 substances in 2019, with 71 of these newly identified psychoactive substances, a decline from 213 newly identified substances in 2013 (UNODC 2021).

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) collects national illicit drug seizure data annually from federal, state and territory police services, including the number and weight of seizures to inform the Illicit Drug Data Report (IDDR). According to the latest IDDR:

  • An increase of 6% in the number of NPS border detections, from 575 in 2018–19 to 609 in 2019–20.
  • By number, amphetamine-type substances and cathinone-type substances each accounted for 50% of the total number of analysed seizures made and examined by the Australian Federal Police. There were no seizures of synthetic cannabinoids, tryptamine-type substances or other NPS in 2019–20.
  • By weight, amphetamine-type substances accounted for 82% of the weight of analysed NPS seizures in 2019–20. Cathinone-type substances accounted for 19% of the weight of analysed NPS seizures (ACIC 2021a).

Consumption

Synthetic cannabinoids

The use of synthetic cannabinoids in Australia is low.

  • The 2019 National Drug Strategy Household Survey (NDSHS) showed that although lifetime use of synthetic cannabinoids doubled between 2013 and 2019 (from 1.3% to 2.6%), recent use dropped dramatically from 1.2% to 0.2% (Figure NPS1).
  • People who regularly use ecstasy and other stimulants interviewed as part of the Ecstasy and Related Drugs Reporting System (EDRS) reported infrequent use of synthetic cannabinoids in 2021, with 2% of the sample reporting use in the past 6 months (Sutherland et al. 2021) (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.
  • The National Wastewater Drug Monitoring Program (NWDMP) ceased monitoring the synthetic cannabinoids JWH-018 and JWH-073 from October 2017. These NPS had not been detected since monitoring commenced in August 2016 (ACIC 2018).

Other NPS

The use of other NPS among the Australian general population is similarly low.

  • The 2019 NDSHS showed that between 2016 and 2019 there were significant decreases in the lifetime and recent use of other psychoactive substances (from 1.0% to 0.7% for lifetime use; and from 0.3% to 0.1% for recent use) (tables S2.31 and S2.32) (Figure NPS1). The estimate for recent use of other psychoactive substances has a relative standard error of 25% to 50% and should be used with caution.
  • Methylone and mephedrone (synthetic stimulants) were previously included in the National Wastewater Drug Monitoring Program (NWDMP) as examples of NPS. However, due to low levels of detection, they were replaced by ketamine from December 2020.  Early signs are that consumption of ketamine is higher in capital cities than regional areas, with minor fluctuations in consumption to date (ACIC 2022).

In 2021, the EDRS changed reporting of NPS to allow for comparability across different reporting methods. From 2021, the EDRS will report recent 6 month use of any NPS as ‘including plant based NPS’ and ‘excluding plant based NPS’.

In 2021, EDRS participants reporting recent 6 month use of:

  • Any NPS, including plant-based, increased to 16%, from 15% in 2020.
  • Any NPS, excluding plant-based increased to 14% in 2021, from 12% in 2020 (Table S2.56).
  • Ketamine increased significantly to 52% of participants, from 43% of participants in 2020. This is the highest percentage of participants reporting recent use since the monitoring commenced (Sutherland et al 2021).

Figure NPS1: Lifetimeᵃ and recentᵇ use of synthetic cannabinoids or other new and emerging psychoactive substances, people aged 14 and over, 2013 to 2019 (per cent)

The figure shows the proportion of people aged 14 and over who recently used synthetic cannabis and new and emerging psychoactive substances in 2013, 2016 and 2019. Recent use of both synthetic cannabis and new and emerging psychoactive substances declined between 2013 and 2019 (from 1.2% to 0.2% and 0.4% to 0.1%, respectively).

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Harms

NPS comprise a wide range of chemical substances with unpredictable effects that can result in severe adverse health consequences, including death (UNODC 2021). 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).