New psychoactive substances: 25 years of early warning and response in Europe. An update from the EU Early Warning System

Abstract

The European Union Early Warning System on New Psychoactive Substances (EWS), operated by the EMCDDA in close cooperation with Europol, is the first step in a three-step legal framework designed to allow the European Union to rapidly detect, assess, and respond to health and social threats caused by new psychoactive substances (NPS). 16 June 2022 marks 25 years since legislation was adopted in the EU allowing it to rapidly react to threats caused by NPS. Since then, the market has undergone periods of significant growth and change. The anniversary provides an opportunity to reflect on these changes and the lessons learned. Event based data on seizure, collected samples and serious adverse events linked to NPS are reported to the EMCDDA by forensic and toxicology laboratories on ad hoc basis. These data are complemented by annual reports, which include aggregated data on seizures by law enforcement and from poisonings. At the end of 2021, the EMCDDA was monitoring around 880 NPS, 52 of which were first reported in Europe in 2021. The number of substances in circulation remains high with approximately 350–400 previously reported new psychoactive substances detected every year since 2015. Following a period of diminishing seizures in Europe, and despite pressures to supply chains given the COVID-19 pandemic, record amounts of seizures of NPS were reported in 2020. At least in part, this increase has been driven by a large increase in seizures of synthetic cathinones, in particular 3-CMC and 3-MMC. Information from suspected poisonings in certain parts of Europe suggests that the incidence of poisoning related to 3-MMC reported to poison centers has increased significantly between 2020 and 2021 compared to previous years and that this coincides with an increased availability and use of this substance. In addition, in 2020 and 2021 concerns continued to be raised over the adulteration of illicit drugs with NPS, such as reports of low-THC cannabis adulterated with synthetic cannabinoids and detections of these substances in fake medicines, in particular benzimidazole opioids in fake oxycodone tablets. Currently, the NPS market is characterised by complexity and increased integration with the market for established controlled drugs. The market continues to grow, is resilient and highly dynamic, and rapidly adapts to attempts to disrupt it. There is need to ensure that Europe continues to strengthen its ability to detect, assess, and respond to emerging threats in a timely and effective way in order to prevent or reduce the public health and social harms caused by new psychoactive substances. Reflecting on 25 years of monitoring NPS in Europe, the EMCDDA's experience is that effective actions are informed by the existence of good data and that forensic and toxicological information sources are critically important.