Current NPS Market Worldwide and Historical Perspectives · Party pills Legal highs ... (Slovenia,...
Transcript of Current NPS Market Worldwide and Historical Perspectives · Party pills Legal highs ... (Slovenia,...
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.
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5
10
15
20
25
30
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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
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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