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.
Aegis offers industry-leading testing for 100+ novel psychoactive substances. Aegis’s NPS testing is available as an add-on by drug class. Providers may choose one or multiple classes based on medical necessity. Available in oral fluid for cases where urine collection is not optimal (or possible).
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 Etomidate, Medetomidine, Phenibut, Phenylbutazone, Tianeptine and Xylazine. Substances within this testing category include novel adulterants found in illicit drugs as well as non-traditional substances with the potential for misuse that are currently unregulated within the United States.
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
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 stays on the forefront in maintaining testing for surveillance of new, high-risk substances.
Aegis Sciences Corporation regularly updates its NPS and emerging drugs testing menu to align with evolving guidance and substance use trends. Test development is guided by CFSRE Tier 1 and Tier 2 recommendations (in collaboration with the SOFT NPS Committee), with updates—including additions, modifications, or exclusions—based on emerging evidence, clinical demand, and population relevance.
Emerging Drug Trends
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. View the latest findings related to evolving substance use patterns, newly detected compounds, and emerging substances of concern.
