10 Apr NPS Frontline Alert: Emerging Substances
BTMPS is a compound that is widely used as a light stabilizer in many commonly encountered materials (e.g., coatings, paints, adhesives, and sealants)...
Identification of use of high-risk substances is key to clinical decision-making.
Is your current testing method capable of identifying high-risk synthetic drugs?
Novel psychoactive substances (NPS) are compounds designed to mimic the effects of traditional illicit or prescription drugs and avoid regulation. They may also evade detection by some testing methodologies, as specialized definitive testing is required to identify these compounds. NPS can be described by numerous terms, including designer drugs, legal highs, or research chemicals labeled ‘not for human use.
NPS classes include:
Synthetic Cannabinoids
Synthetic cannabinoids are intended to mimic the effects of marijuana however, they can be much more potent and cause adverse health effects.
Synthetic Stimulants
These substances typically cause stimulant effects, with some also causing severe psychosis. More recently, non-cathinone stimulants have been introduced, with analogs of amphetamines, methylphenidate and phendimetrazine being detected.
Designer Opioids
These substances are much more potent than morphine and many are more potent than illicitly manufactured fentanyl (IMF). Fentanyl analogs have been the most detected substances over the last decade but, most recently, more new nitazene analogs have been introduced than new fentanyl analogs.
Designer Benzodiazepines
Designer benzodiazepines are intended to mimic the effects of prescription benzodiazepines, while evading drug regulation or traditional drug testing methods. They are often formulated as counterfeit versions of common prescription benzodiazepines.
Hallucinogens / Dissociatives
Most hallucinogens and dissociatives are intended to produce mind-altering effects or to enhance thoughts, emotions, or senses. In some cases, they can lead to erratic or dangerous behaviors.
NPS-Other
Other substances of concern include tianeptine, phenibut, xylazine, and medetomidine. Tianeptine and phenibut are sold as supplements and are used to blunt the effects of opioid withdrawal or anxiety, respectively. Xylazine and medetomidine are often adulterants in illicit opioid formulations intended to increase the effects of opioids. These two substances, which produce CNS depression, are not opioids and therefore do not respond to naloxone reversal.
The rise of NPS and Designer Drugs has created new clinical challenges that require a new approach to substance use monitoring.
Polydrug Use
Individuals seeking treatment for OUD/SUD often encounter illicitly manufactured substances within the drug supply either knowingly or unknowingly.
Regulation
NPS markets rapidly change in response to regulation from US and international agencies.
Interactions
NPS may cause or worsen existing drug interactions with prescription medications, leading to unintended overdoses.
Overdose Death
Synthetic and illicitly manufactured drugs are a major driver of increased overdose deaths in the US.
Early identification is key to appropriate treatment and reduction of overdose risk.
“Adding Aegis laboratory services to our treatment plans has had a profound impact on the quality of care we can provide. We are able to ensure legitimate specimens in a humane way so we can feel confident that our services are being used as intended and the medication we provide is not diverted. We are also able to know what novel substances are in the drug supply allowing us to be as current as possible in what our patients might be exposed to, most of which our patients are unaware of. This helps inform the appropriate treatment decisions. This level of information simply cannot be found in other laboratory partners we’ve come across.”
Kelly Dunn, MD
Vice Chair of Dept. of Psychiatry and Behavioral Sciences, Oklahoma State University
Executive Director of Treatment, National Center for Wellness and Recovery
Staying Up to Date
Aegis stays on the forefront in maintaining testing for surveillance of new, high-risk substances.
Detection of rapidly changing synthetic drugs in at-risk populations requires responsible utilization of enhanced, definitive testing. Aegis’s NPS testing menu is reviewed regularly to add and drop analytes to maintain clinical relevance and cost-effectiveness.
Aegis Adopts Self-Regulatory Standards for Novel Psychoactive Substance Testing
To stay current with the rapidly changing landscape of new and emerging drugs, Aegis has committed to bi-annual NPS test menu updates to include the tier one and tier two recommendations established collaboratively by the Center for Forensic Science Research and Education (CFSRE) and the Society of Forensic Toxicologist (SOFT) NPS Committee.
Aegis Frontline Alert: Emerging Drug Adulterant – BTMPS
The rise of NPS and Designer Drugs has created significant clinical challenges, including increased risks for adverse events and overdose, that require a new approach to substance use monitoring. Aegis frontline alerts are designed to inform healthcare providers of emerging substances identified. BTMPS is now being identified in the illicit drug supply.
Aegis NPS Resources
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Apr 2025 Prevalent Adulterants Found in the Illicit Drug Supply
Adulterants are unreported substances added to a product, often to reduce production costs, enhance the products effects, and may increase the severit...
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05 Mar Frontline Alert: Emerging Drug Adulterant – BTMPS
BTMPS is a compound that is widely used as a light stabilizer in many commonly encountered materials (e.g., coatings, paints, adhesives, and sealants)...
