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 2020b). 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).

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 2020a).

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 2020) recently reported:

  • a decrease of 16% in the number of NPS border detections, from 687 in 2017–18 to 575 in 2018–19
  • by number, other NPS (39%) accounted for the highest proportion of NPS seizures made and examined by the Australian Federal Police, followed by amphetamine-type substances (28%), tryptamine-type substances (28%) and cathinone-type substances (6%). Similar to 2017–18, there were no seizures of synthetic cannabinoids analysed in 2018–19
  • by weight, amphetamine-type substances accounted for 99% of the weight of analysed NPS seizures in 2018–19. Cathinone-type substances, tryptamine-type substances  and other NPS accounted for 1% of the weight of analysed NPS seizures (ACIC 2020).

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 the synthetic cannabis 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 2019, with 4% of the sample reporting use in the past 6 months (Peacock et al. 2020) (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) no longer monitors synthetic cannabinoids JWH-018 or JWH-073. While methylone and mephedrone (synthetic stimulants) continue to be detected, consumption was mostly below levels at which it could be reliably quantified and will no longer be reported (ACIC 2021).

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.
  • The consumption of NPS among people who regularly use ecstasy and other stimulants is disproportionately high compared with the general population. In 2020, 23% reported recent use of any NPS in the past 6 months (Table S2.56). However, NPS are used infrequently, with most people reporting use on a median of 1–2 days in the 6 months prior (Peacock et al. 2020).

Figure NPS1: Lifetime and recent use of synthetic cannabis 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 2020b). 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).