Current NPS Market Worldwide and

Historical Perspectives

Rachel Christie, PhD – Action on new drugs, Risks to public safety and security unit, EMCDDA

Symposium on Novel Psychoactive Substances (NPS), Science History Institute, Philadelphia,

13 November 2018

Historical perspective: the future of drugs of abuse?

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In 1988 Henderson made some predictions about the future drugs of abuse…..

• Future drugs of abuse will be synthetics • Synthesised from readily available precursors

• Derivatives of pharmaceuticals • Very potent

• Often very selective • Marketed very cleverly

Henderson GL. Designer drugs: past history and future prospects. Journal of Forensic Science. 1988 Mar 1;33(2):569-75

The future of drugs of abuse?

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The future of drugs of abuse?

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NPS: from imitation to innovation

Phenethylamines Tryptamines Piperazines Cathinones Synthetic CBs

1980s 1990s 2000s 2005 2008

Research

chemicals

Herbal

highsParty

pills

Legal

highs

‘Legal highs’

‘Designer drugs’

Quest for new ‘ecstasy’ SpiceMephedroneBZP

Who we are, what we do

Factual, Objective, Reliable, Comparable

Substances monitored by the EU EWS

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>650 substances monitored in 13 categories (2005–2017):• 179 synthetic cannabinoids• 127 synthetic cathinones• 38 opioids• 23 benzodiazepines

2018: 47 new substances so far

NPS detections in the EU

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More than 300,000 seizures of NPS reported by law enforcement from 2005–2016

Almost 71,000 seizures of NPS in 2016

Synthetic cannabinoids and cathinonesaccount for almost 80% of all seizure cases reported in 2016

NPS quantities in the EU

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More than 24 tonnes of NPS seized by law enforcement from 2005–2016

Just over 4 tonnes of NPS seized in 2016

Synthetic cannabinoids and cathinonesaccounted for 80% of all seizure cases and quantities seized in 2016

What caused the flood?

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What caused the flood?

In 2016, China, Spain, the Netherlands and the UK were the most frequently reported NPS origin countries based on seizures reported to the EWS

China▪ In 2015 almost 1.2 tonnes of the total quantity of NPS substances seized in the EU

originated in China.

▪ 11 single seizures at airports in Spain, almost 1.1 tonnes of cathinones.

▪ October 2015: the People’s Republic of China subjected 116 NPS to control

▪ In 2016, just over 300 kg of NPS seized in the EU had originated in China.▪ Almost 90% of those seizures occurred at airports in Spain and consisted of cathinones,

cannabinoids and other NPS.

Responding to harmsPublic health alerts issued in

2016 and 2017 included:

• Serious adverse events

associated with the use of

cannabinoids

• Deaths associated with the

use of potent opioids and

fentanils

• Superman logo ecstasy

tablets containing PMMA

• Deaths associated with

CUMYL-4CN-BINACA

Responding to harms: risk assessments completed 1998 - 2018

2007 2008 2009 2010 2011 2012 2013 2014 2015

BZP mephedrone 4-MA 5-IT Methoxetamine

MDPV

25I-NBOMe

AH-7921

4,4’-DMAR

MT-45

α-PVP

1998 1999 2000 2001 2002 2003 2004 2005 2006

MBDB 4-MTA Ketamine

GHB

PMMA 2-CI

2-C-T-2

2-C-T-7

TMA-2

2016 …. 2017 …. 2018 ….

MDMB-CHMICAAcryloylfentanyl

Furanylfentanyl

AB-CHMINACA

ADB-CHMINACA

5F-MDMB-PINACA

CUMYL-4CN-BINACA

4F-iBF

THF-F

Carfentanil

Cyclopropylfentanyl

Methoxyacetylfentanyl

Fentanils

Fentanils: 1979-2010

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(Iso)butyryl-F-fentanyl N-benzyl analogue

Isobutyrylfentanyl

Notifications of fentanils, 2012–2018

2012 2013 2014 2015 2016 2017

Carfentanil

Ocfentanil

Despropionyl-2-fluorofentanyl

4-Methoxybutyrfentanyl

Furanylfentanyl

Butyrfentanyl

Acetylfentanyl

Valerylfentanyl

Acryloylfentanyl

2-Fluorofentanyl

4-Chloroisobutyrylfentanyl

4-Fluoroisobutyrylfentanyl

3-Fluorofentanyl

Methoxyacetylfentanyl

Tetrahydrofuranylfentanyl

Cyclopentylfentanyl

Benzodioxolefentanyl

Benzoylfentanyl

3-Phenylpropanoylfentanyl

Tetramethylcyclopropanefentanyl

Cyclopropylfentanyl

Thiophenefentanyl

Benzylfentanyl

Benzoyloylbenzylfentanyl

Acetylbenzylfentanyl

2018

3-Methylcrotonylfentanyl

4-Hydroxybutyrfentanyl

4-Fluoro-

cyclopropylbenzylfentanyl

Furanylbenzylfentanyl

2-Methylacetylfentanyl

7 risk assessments

2017–2018

Acryloylfentanyl (47 deaths), Furanylfentanyl (23),

Tetrahydrofuranylfentanyl (14), 4-Fluoroisobutyrylfentanyl (20),

Carfentanil (61), Cyclopropylfentanyl (78), Methoxyacetylfentanyl

(13)

Fentanils: easier to get hold of, easier to use

• More than 30 detected since 2012

• Surface web, darknet, street-level

• Sold as ‘legal’ replacements to illicit opioids

• Sold as heroin, fake medicines, cocaine

• Novel dosage forms (nasal sprays and e-liquids)

• Rapid onset of life-threatening respiratory depression

• Increase in poisonings (inc outbreaks)

Seizure of nasal sprays containing acrylfentanyl, 2016. © Swedish Police Seizure of carfentanil, 2017. © Norwegian National Criminal Investigation Service

Fentanils: availability in the EU

Fentanils: forms detected

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Methoxyacetylfentanyl sold as ‘ching’ (Slovenia, 2017)

Carfentanil detected in blotters (Canada, 2018)

Ocfentanil detected in hashish-like substance (Sweden, 2016)

Acryloylfentanyl detected in capsule (Denmark, 2016)

Fentanils: sold as medicines

Fentanils: associated death cases

Synthetic Cannabinoids

Synthetic cannabinoids: 2006 - present

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Synthetic cannabinoids: potent, disposable, cheap

• Sold as legal replacements to cannabis

• Highly potent & efficacious (often full agonists at CB1 & CB2; other targets?)

• Disposable (appear, controlled, replaced)

• 178 detected in Europe since 2005

• Increase in severe poisonings and deaths

• Outbreaks of mass poisonings (overwhelm emergency responders/ hospital

emergencies)

• A reputation as a cheap and powerful intoxicant with vulnerable groups

• Sold as other drugs

Synthetic cannabinoids: availability in the EU

Seizures by law enforcement of synthetic cannabinoids reported to the EU Early Warning System. Trends in number and quantity seized, 2005–16.

0

5

10

15

20

25

30

35

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Formal notifications

Synthetic cannabinoids: smoking mixtures

Synthetic cannabinoids: expect the unexpected

• Poisonings reported in Oldham & Rochdale, United Kingdom, June 2017

• Crystals sold as MDMA (ecstasy)

• Analysis identifies ADB-FUBICA & ADB-FUBINACA (high purity, >99% by

GC-MS)

• ADB-FUBINACA sold as ecstasy caused 15 poisonings in Hungary in May

2015

• Patients took 1 tablet, 20% had mild, 73.3% moderate and 6.7% severe

intoxication

© Dr Oliver Sutcliffe & Matthew Hulme © Hungarian National Focal Point

Synthetic cannabinoids: associated death cases

20 years of monitoring – overall trends

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• Decrease in the number of new substances identified for the first time in 2016 and 2017

• However, a large increase observed in:

• Availability of NPS in Europe

• Detections reported by law enforcement agencies

• Serious adverse events i.e. non-fatal intoxications, deaths and other harms

• Consumer groups of NPS have broadened

• Trend towards highly potent substances

• Growing interactions between the NPS and the established illicit drug market

emcdda.europa.eu

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Email: Rachel.Christie@emcdda.europa.eu

http://www.emcdda.europa.eu/activities/action-on-new-drugs

Acknowledgment and thanks to the Reitox network and the national early warning system correspondents

http://www.emcdda.europa.eu/system/files/publications/8870/2018-2489-td0118414enn.pdf