Home > 4th International Conference on Novel Psychoactive Substances, Budapest, 30‒31 May 2016.

Boyle, Michelle (2016) 4th International Conference on Novel Psychoactive Substances, Budapest, 30‒31 May 2016. Drugnet Ireland, Issue 59, Autumn 2016, pp. 19-20.

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On 30 and 31 May 2016, the 4th Annual Conference on Novel Psychoactive Substances (NPS) took place in Budapest, Hungary.1 There has been a dramatic increase in the number of NPS that have emerged worldwide in recent years. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) monitors 560 substances with approximately 100 reported for the first time in 2015. Therefore, it is imperative to share accurate, evidence-based information at an international level on the analysis of these substances and their effect on society. This conference, now in its fourth year, is a forum to foster collaboration between all those working in the area of NPS from law enforcement, forensic, clinical and toxicological analysis to research, front-line medical staff, addiction services and community workers.


Synthetic cannabinoids

A common theme in many of the presentations was the harm being caused by synthetic cannabinoids in Europe and worldwide, e.g. users reporting that the adverse side-effects far outweigh the feeling of well-being when the substances are taken initially. In addition, more negative side-effects are being experienced with synthetic cannabinoids than with other types of NPS, e.g. synthetic cathinones.


A study by Waterford Institute of Technology entitled ‘Dependent user experiences of withdrawal from herbal smoking mixtures’ was presented at the conference. The study was carried out in a settled Traveller community in the border counties in Ireland, where littering of herbal mixture product packaging was widespread. The packaging labelled Clockwork Orange and Happy Joker contained herbal material that was found to contain 5F-AKB-48 and 5F-PB-22. Users reported dependent use with intense cravings, compulsive behaviours and an inability to cease due to the fear of psychosis. The report recommends expedited responses from both addiction and mental health services.


New substances with potential for harm

New synthetic cathinones and cannabinoids are being identified in Europe and worldwide on a weekly basis. However, concern was raised by many speakers at the emergence of synthetic opioids and novel benzodiazepines.


The synthetic opioids are a cause for concern with many overdoses and deaths reported in the USA, Canada and Europe. Examples of such compounds are fentanyl derivatives and analogues, such as acteylfentanyl, furanylfentanyl, ocfentanil, and compounds such as W-18, AH-7921, U-47700, MT-45, all of which have a much higher potency than morphine. Users believe they are buying heroin or oxycodone but the product in fact contains a synthetic opioid, where only a fraction of the dose usually taken is required to have an effect or cause serious harm. Many countries are now in the process of controlling these substances.


Addiction to benzodiazepines was also discussed with a warning that insufficient attention is being paid to this issue. Novel benzodiazepines, such as etizolam and phenazepam, are widely available, and in many countries are not yet controlled under drugs legislation. Many products containing these drugs are manufactured to look like legitimate pharmaceuticals, e.g. diazepam and alprazolam.


Across Europe, there is an increasing trend in injecting NPS. Hungary has reported an increase in hepatitis C infections in 2014 (24%‒48.8%) with the highest prevalence rate around NPS injectors (73.9%). Many users at drug treatment centres, who were injecting, reported that their first injecting experience was with an NPS.


Guidelines for front-line staff

The EMCDDA reported on data collected across Europe with respect to current approaches and challenges in responding to NPS-related harm. Services and guidance for dealing with these substances vary from country to country with staff relying on knowledge of traditional drugs to tackle NPS. Those involved in intervention reported a need for training and NPS-specific guidance. Problems associated with drug treatment were also highlighted with services not available in rural areas or to recreational users.


In response to these issues, a guidance document published by the NEPTUNE project, entitled Guidance on the clinical management of acute and chronic harms of club drugs and novel psychoactive substances, is available on the EMCDDA website.2 It offers information and guidelines for front-line medical staff and those working in addiction services on how to tackle NPS-related issues.


Internet forums

Since the introduction of generic and specific psychoactive substances legislation in many countries, the number of high street shops selling NPS has dramatically reduced. This in turn has resulted in a vast online market for these products. The Internet is also a place where users of NPS communicate with each other to make purchases, discuss products and dosages, and share experiences. Many researchers presenting at the conferences are using these online forums to analyse the information being shared by NPS users. This information provides a valuable insight into different groups from recreational users who are looking to experiment and relax to dependent or harmful users. Many online surveys have also been conducted across Europe, where NPS users answer specific questions on their usage and experiences. Recreational users reported taking NPS in a social setting to get high and bond with friends. However, only 50% of users had any knowledge of safe dosages.


Also discussed was the CASSANDRA project (Computer Assisted Solutions for Studying the Availability aNd Distribution of novel psychoActive substances), which is a multidisciplinary project that uses technology and social media to investigate the supply chain and diffusion of NPS.



Analysis and identification of NPS continues to pose challenges for border control, forensic and toxicological services. These include developing new analytical methods, adding new substances to existing methods and sourcing reference standards. Many speakers emphasised the need for continued collaboration between testing laboratories and academic institutions to identify new substances, whether it is providing access to standards or scientific techniques, e.g. nuclear magnetic resonance (NMR) spectroscopy. This research is also being combined with pharmacological-based studies in order to evaluate the potential for harm of newly identified compounds.


For more information on the conference and online access to presentations and posters, see www.novelpsychoactivesubstances.org



1 For more information on the conference and online access to presentations and posters, visit http://www.novelpsychoactivesubstances.org

2 Guidance on the clinical management of acute and chronic harms of club drugs and novel psychoactive substances. Available online at


Item Type
Publication Type
International, Open Access, Article
Drug Type
New psychoactive substance
Intervention Type
Harm reduction
Issue Title
Issue 59, Autumn 2016
October 2016
Page Range
pp. 19-20
Health Research Board
Issue 59, Autumn 2016

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