Novel Psychoactive Drugs - The Saga Continues…

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About this Research Topic

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Background

There has been growing clinical, public and media awareness and concern about the availability and potential harmfulness of Novel Psychoactive Substances (NPS) also known as ‘legal highs’. NPS include a wide range of products, from natural plant-originated substances to synthetic compounds often sold online, and are pharmacological analogues of compounds prohibited under current drug laws such as amphetamines, ketamine, and cannabis. According to the last World Drug Report 2018 (United Nations publication, Sales No. E.18.XI.9), by the end of 2017 synthetic cannabinoids and synthetic cathinones represented the largest class of NPS, with 251 and 148 compounds detected, respectively. Yet, synthetic opioids, new hallucinogens, dissociative drugs, several designer benzodiazepines and other downer/tranquilizer-type drugs have emerged carrying psychotic states, unpredictable behaviors and a high risk of overdose.

NPS mimic psychoactive effects of illicit drugs of abuse, but very little is known about their psychopharmacological effects and long-term risks. Based on the spectrum of their actions on cognitive processes, mood and behavior, NPS are typically classified into four basis categories: amphetamine- and ecstasy-like stimulants, synthetic cannabinoids, hallucinogens/dissociatives and opioid-like compounds. NPS may, however, exhibit a combination of these actions due to their designed chemical structure, as modifications in chemical structures can lead to heterogeneity in physiologic response and clinical symptoms, even within the same category of drugs. New compounds are being synthetized worldwide and more than 800 NPS have been reported in 2009-2017. The number of intoxicated people presenting with emergencies is constantly increasing, causing concern for health authorities due to dangerous health and social consequences. Yet, available information on the potential acute toxicity associated with the use of these substances is still limited.
In our first Research Topic on these synthetic drugs (https://www.frontiersin.org/research-topics/5249/novel-psychoactive-drugs#overview) we collected leading groups of scientists working in the field to investigate NPS at several levels, from epidemiology to marketing, from clinical to mechanistic studies, including in vitro and in vivo studies. As a result, the first Research Topic brought together 16 papers of excellent quality and broad impact (over 60.800 views at the time of writing) which covered the main classes of NPS and explored the effects of these drugs in modulating brain neurotransmission and behavior. At present, the phenomenon is still present worldwide and new substances are appearing on the market, for many of which information about the long-term adverse effects or risks are very limited if not absent, which poses a considerable challenge for prevention and treatment.

We feel that the time has come to provide an updated snapshot of the state-of- the-art of this complex global health and social problem, with the ultimate goal to increase the awareness on the health consequences of NPS use and the knowledge on their peripheral and central actions. The main goal of this follow-up Research Topic is, therefore, to expand and review studies on epidemiological analysis, pharmacological and toxicological characterization of NPS, validation of detection tools and prevention strategies as well as clinical studies on mental health problems arising from NPs. Both animal and clinical studies will be collected, including case reports, reviews, and mini-reviews. The effects of acute and chronic use of NPs on brain functioning, emotional responses and behavior will be evaluated, and their mechanisms of actions investigated at multiple levels.

Keywords: novel psychoactive substances, synthetic cathinones, synthetic cannabinoids, hallucinogenic drugs, dissociative drugs

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