© 2018 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Peer reviewedFinal Published versio

Schifano, Fabrizio

Brain Sciences

English

Over the last decade, the emergence of a vast range of new/novel/emerging psychoactive substances (NPS) has progressively changed drug market scenarios, which have shifted from the &lsquo;street&rsquo; to a &lsquo;virtual&rsquo;/online environment. [...

Fabrizio Schifano

Multidisciplinary Digital Publishing Institute

Recent Changes in Drug Abuse Scenarios: The New/Novel Psychoactive Substances (NPS) Phenomenon

Over the last decade, the emergence of a vast range of new/novel/emerging psychoactive substances (NPS) has progressively changed drug market scenarios, which have shifted from the &#8216;street&#8217; to a &#8216;virtual&#8217;/online environment. [...

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brainsciencesEditorialRecent Changes in Drug Abuse Scenarios:The New/Novel Psychoactive Substances(NPS) PhenomenonFabrizio SchifanoPsychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, University ofHertfordshire, Hertfordshire AL10 9AB, UK; f.schifano@herts.ac.ukReceived: 7 December 2018; Accepted: 9 December 2018; Published: 13 December 2018Over the last decade, the emergence of a vast range of new/novel/emerging psychoactivesubstances (NPS) has progressively changed drug market scenarios, which have shifted from the‘street’ to a ‘virtual’/online environment.Several definitions of NPS are in use, with the term ‘new’ not necessarily referring to newinventions but to substances that have recently been made available, possibly including failedpharmaceuticals or old patents which have been ‘rediscovered’ as ‘recreational’ molecules. Conversely,the term ‘novel’ can refer to something newly created, an old drug that has come back into fashion,or a known NPS molecule being used in an innovative or unusual way and hence presentinga ‘novelty’ appeal (Corkery et al., 2018) [1]. Though misleading, the terms ‘legal highs’ and‘research chemicals’ have been used alternately to describe these molecules. NPS includes syntheticcannabinoids, cathinone derivatives, psychedelic phenethylamines, novel stimulants, synthetic opioids,tryptamine derivatives, phencyclidine-like dissociatives, piperazines, GABA-A/B receptor agonists,a range of prescribed medications, psychoactive plants/herbs, and a large series of image- andperformance-enhancing drugs (IPED) (Schifano et al., 2015) [2]. Overall, users are typically attractedto NPS because of curiosity and the diffusion of social media users’ experiences, easy availability oraffordability from online drug shops, legality, intense psychoactive effects, and the likely lack of detectionin routine drug screenings (Schifano et al., 2015) [2].Between 2004 and 2017, some 700–800 examples of NPS were reported by related European andinternational drug agencies (UNODC, 2018 [3]; EMCDDA, 2018 [4]), with most molecules identifiedbeing synthetic cannabinoids, synthetic cathinones, phenethylamine derivatives, and synthetic opioids.However, it could be argued that the NPS scenario is much larger than that outlined by those moleculeswhich have been seized or formally identified by EU and international agencies. Since the online NPSscenario typically predicts the real life NPS scenario (Schifano et al., 2015) [2], identifying what is beingdiscussed online by web-based NPS enthusiasts, or ‘e-psychonauts’ (Orsolini et al., 2015) [5], may wellbe of interest. With this in mind, a crawling/navigating software (i.e., the ‘NPS.Finder®’) was recentlydesigned by our group. In November 2017, it started to automatically scan, on a 24/7 basis, a vastrange of psychonaut web forums for NPS. After a year of operation, it has been possible to estimate thatthe online/psychonaut web forum NPS scene may include some 4000 different molecules. The mostpopular examples of NPS mentioned in psychonaut forums have included synthetic cannabimimetics,synthetic opioids, phenethylamines, designer benzodiazepines, and prescribed drugs.NPS use, especially for synthetic cannabinoids and novel psychedelics, has been associated witha range of untoward medical consequences, including vomiting, seizures, cardiovascular complications,and kidney failure (Schifano et al., 2017) [6]. By contrast, the main focus of this special issue is on themajor psychopathological consequences of NPS use. Indeed, due to their complex pharmacodynamics,there are increasing levels of concern about the onset of acute or chronic psychopathological issuesassociated with NPS intake.Brain Sci. 2018, 8, 221; doi:10.3390/brainsci8120221 www.mdpi.com/journal/brainsciBrain Sci. 2018, 8, 221 2 of 3The occurrence of psychosis has been related to: (a) increased central dopamine levels, typicallyseen with novel psychedelic phenethylamines, novel stimulants and synthetic cathinones; (b) significantcannabinoid CB1 receptor activation, which is associated with high potency synthetic cannabimimetics;(c) 5-HT2A receptor activation, seen with latest generation phenethylamines, tryptamine derivatives andhallucinogenic plants; (d) antagonist activity at n-methyl-D-aspartate/NMDA receptors, observed withketamine, methoxetamine/MXE, and their latest derivatives; and (e) k-opioid receptor activation,which is typically associated with both Salvia divinorum and Mitragyna speciosa/‘Kratom’ intake.By considering the above, this special issue of Brain Sciences aims to provide an overview of a rangeof NPS-related issues. More precisely, Sahai et al. [7] present original preclinical data relating in silico andin vitro assessment of the psychoactive properties of a few dissociative diarylethylamines. Miolo et al. [8]focus on specific analytical chemistry issues relating to amphetamine-type stimulants and ketamine,while Parrott [9] argues that there are similarities between well-known recreational drugs and NPS in termsof mood fluctuations/psychobiological instability issues. Conversely, Cohen and Weinstein [10] present originalcognitive psychopharmacology data relating to the use of organic and synthetic cannabinoids. From a clinicalpoint of view, Bonaccorso et al. [11] introduce a case series of synthetic cannabinoid users presentingto acute psychiatric services with psychosis; Frisoni et al. [12] comment on the medical consequencesof novel opioid intake; Martinotti et al. [13] provide a thorough overview of hallucinogen-persistingperceptual disorder, a clear issue of interest for NPS users; Schifano et al. [14] reflect on the misuseand abuse of prescribed medicines (e.g., benzodiazepine derivatives, methylphenidate look-alikes,and fentanyl analogues) in the NPS context; and Gittins et al. [15] provide empirical data relating NPSuse by clients seeking treatment in the UK. Both Wadsworth et al. [16] and Miliano et al. [17] commentextensively on the role of the open/deep web in shaping and promoting changes in NPS scenarios. Finally,both Metastasio et al. [18] and Catalani et al. [19] offer original data which sheds further light on theexpanding phenomenon of IPED misuse/abuse.In conjunction with constant changes in basic structures from which emerging molecules canbe derived, designed, and synthesized, the NPS market will continue to expand. This will posea challenge, since NPS-related toxidromes are, per se, complex and unpredictable, and clinicians needto aim to be better educated in recognizing NPS-related toxicity issues. Drug control policies should beimproved worldwide, and the list of examples of NPS should be constantly updated as improvementsin analytical chemistry detection methods occur. Given the implications of NPS for mental health,psychiatric services should adapt to new drug scenarios while drafting new treatment strategies.Conflicts of Interest: The author declares no conflict of interest.References1. ReadCorkery, J.M.; Orsolini, L.; Papanti, D.; Schifano, F. Novel psychoactive substances (NPS) and recentscenarios: Epidemiological, anthropological and clinical pharmacological issues. In Light in Forensic Science:Issues and Applications; Miolo, G., Stair, J.L., Zloh, M., Eds.; Royal Society of Chemistry: London, UK,18 April 2018; Chapter 8, pp. 207–256.2. Schifano, F.; Orsolini, L.; Duccio Papanti, G.; Corkery, J.M. Novel psychoactive substances of interest forpsychiatry. World Psychiatry 2015, 14, 15–26. [CrossRef] [PubMed]3. United Nations Office on Drugs and Crime (UNODC). World Drug Report 2018, Volume 3—Analysis of DrugMarkets: Opiates, Cocaine, Cannabis, Synthetic Drugs; United Nations Office on Drugs and Crime: Vienna,Austria, 2018; Available online: https://www.unodc.org/wdr2018/ (accessed on 23 November 2018).4. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). EMCDDA–Europol 2017 AnnualReport on the Implementation of Council Decision 2005/387/JHA; Publications Office of the European Union:Luxembourg, 2018; Available online: http://www.emcdda.europa.eu/system/files/publications/9282/20183924_TDAN18001ENN_PDF.pdf (accessed on 23 November 2018).5. Orsolini, L.; Papanti, G.D.; Francesconi, G.; Schifano, F. Mind navigators of chemicals’ experimenters?A web-based description of e-psychonauts. Cyberpsychol. Behav. Soc. Netw. 2015, 18, 296–300. [CrossRef][PubMed]Brain Sci. 2018, 8, 221 3 of 36. Schifano, F.; Orsolini, L.; Papanti, D.; Corkery, J. NPS: Medical Consequences Associated with Their Intake.Curr. Top. Behav. Neurosci. 2017, 32, 351–380. [PubMed]7. Sahai, M.A.; Davidson, C.; Dutta, N.; Opacka-Juffry, J. Mechanistic Insights into the Stimulant Properties ofNovel Psychoactive Substances (NPS) and Their Discrimination by the Dopamine Transporter—In Silicoand In Vitro Exploration of Dissociative Diarylethylamines. Brain Sci. 2018, 8, 63. [CrossRef] [PubMed]8. Miolo, G.; Tucci, M.; Menilli, L.; Stocchero, G.; Vogliardi, S.; Scrivano, S.; Montisci, M.; Favretto, D. A Studyon Photostability of Amphetamines and Ketamine in Hair Irradiated under Artificial Sunlight. Brain Sci.2018, 8, 96. [CrossRef] [PubMed]9. Parrott, A.C. Mood Fluctuation and Psychobiological Instability: The Same Core Functions Are Disruptedby Novel Psychoactive Substances and Established Recreational Drugs. Brain Sci. 2018, 8, 43. [CrossRef][PubMed]10. Cohen, K.; Weinstein, A. The Effects of Cannabinoids on Executive Functions: Evidence from Cannabis andSynthetic Cannabinoids—A Systematic Review. Brain Sci. 2018, 8, 40. [CrossRef] [PubMed]11. Bonaccorso, S.; Metastasio, A.; Ricciardi, A.; Stewart, N.; Jamal, L.; Rujully, N.U.; Theleritis, C.; Ferracuti, S.;Ducci, G.; Schifano, F. Synthetic Cannabinoid use in a Case Series of Patients with Psychosis Presenting toAcute Psychiatric Settings: Clinical Presentation and Management Issues. Brain Sci. 2018, 8, 133. [CrossRef][PubMed]12. Frisoni, P.; Bacchio, E.; Bilel, S.; Talarico, A.; Gaudio, R.M.; Barbieri, M.; Neri, M.; Marti, M. Novel SyntheticOpioids: The Pathologist’s Point of View. Brain Sci. 2018, 8, 170. [CrossRef] [PubMed]13. Martinotti, G.; Santacroce, R.; Pettorruso, M.; Montemitro, C.; Spano, M.C.; Lorusso, M.; di Giannantonio, M.;Lerner, A.G. Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and TherapeuticPerspectives. Brain Sci. 2018, 8, 47. [CrossRef] [PubMed]14. Schifano, F.; Chiappini, S.; Corkery, J.M.; Guirguis, A. Abuse of Prescription Drugs in the Context of NovelPsychoactive Substances (NPS): A Systematic Review. Brain Sci. 2018, 8, 73. [CrossRef] [PubMed]15. Gittins, R.; Guirguis, A.; Schifano, F.; Maidment, I. Exploration of the Use of New Psychoactive Substancesby Individuals in Treatment for Substance Misuse in the UK. Brain Sci. 2018, 8, 58. [CrossRef] [PubMed]16. Wadsworth, E.; Drummond, C.; Deluca, P. The Dynamic Environment of Crypto Markets: The Lifespan ofNew Psychoactive Substances (NPS) and Vendors Selling NPS. Brain Sci. 2018, 8, 46. [CrossRef] [PubMed]17. Miliano, C.; Margiani, G.; Fattore, L.; De Luca, M.A. Sales and Advertising Channels of New PsychoactiveSubstances (NPS): Internet, Social Networks, and Smartphone Apps. Brain Sci. 2018, 8, 123. [CrossRef][PubMed]18. Metastasio, A.; Negri, A.; Martinotti, G.; Corazza, O. Transitioning Bodies. The Case of Self-PrescribingSexual Hormones in Gender Affirmation in Individuals Attending Psychiatric Services. Brain Sci. 2018, 8, 88.[CrossRef]19. Catalani, V.; Prilutskaya, M.; Al-Imam, A.; Marrinan, S.; Elgharably, Y.; Zloh, M.; Martinotti, G.; Chilcott, R.;Corazza, O. Octodrine: New Questions and Challenges in Sport Supplements. Brain Sci. 2018, 8, 34.[CrossRef] [PubMed]© 2018 by the author. Licensee MDPI, Basel, Switzerland. This article is an open accessarticle distributed under the terms and conditions of the Creative Commons Attribution(CC BY) license (http://creativecommons.org/licenses/by/4.0/).

Recent changes in drug abuse scenarios : The new/novel psychoactive substances (NPS) phenomenon

https://uhra.herts.ac.uk/id/eprint/8282/1/brainsci_08_00221.pdf

Recent changes in drug abuse scenarios : The new/novel psychoactive substances (NPS) phenomenon

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