Novel Psychoactive Substances

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.

“Aegis has truly been eye-opening in identifying usage of designer drugs, which seem to be rising in usage over the past years and are not identified through other drug testing platforms. This allows us to further assess each patient’s adherence to treatment and avoid dangerous interactions that can come from prescribing specific medications to patients who are using designer drugs illicitly.”

Halie L. Ory, MAPS, PA-C, Psychiatry CAQ
Resource Management Services
Lake Charles, LA

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.

READ MORE

Aegis NPS Resources