Established in 2013 under the United Nations Commission on Narcotic Drugs Resolution 56/4 (2013), the UNODC Early Warning Advisory (EWA) was the first global monitoring system on new psychoactive substances (NPS). Managed by the UNODC Laboratory and Scientific Service’s SMART forensics, EWA serves as a tool for effective, evidence-based policy responses by monitoring, analysing, and reporting global and regional trends on NPS. Since its inception, UNODC EWA has served as a voluntary online data system that gathers and consolidates both regular and ad-hoc submissions from forensic drug testing and toxicology laboratories, Member States, and partner organisations on NPS. This information contributes to the identification of the most persistent, prevalent, and harmful NPS which pose the greatest threat to public health, thus, assisting in the prioritisation of substances for placement under international control, as well as legislative responses at the national level. Since 2015, over 70 NPS have been placed under International Control and these substances continue to included in the EWA to assist in and monitor the implementation of international scheduling decisions. The following report presents the latest information on NPS that has been reported to UNODC and an analysis of over 1,200 cases submitted from toxicology laboratories within 12 Member States from the Americas, Europe, Asia and Oceania between December 2021 and May 2023. Although the analysis allows for a broader understanding of the associated harm of NPS, it is not an exhaustive representation of the variety and toxicity of NPS present globally.