Novel Psychoactive Substances

Synthetic cannabinoids are intended to mimic the effects of marijuana however, they can be much more potent and cause adverse health effects. 

These substances typically cause stimulant effects, with some also causing severe psychosis. More recently, non-cathinone stimulants have been introduced, with analogs of amphetamines, methylphenidate and phendimetrazine being detected. 

These substances are much more potent than morphine and many are more potent than illicitly manufactured fentanyl (IMF). Fentanyl analogs have been the most detected substances over the last decade but, most recently, more new nitazene analogs have been introduced than new fentanyl analogs.

Designer benzodiazepines are intended to mimic the effects of prescription benzodiazepines, while evading drug regulation or traditional drug testing methods. They are often formulated as counterfeit versions of common prescription benzodiazepines.

Most hallucinogens and dissociatives are intended to produce mind-altering effects or to enhance thoughts, emotions, or senses. In some cases, they can lead to erratic or dangerous behaviors. 

Other substances of concern include tianeptine, phenibut, xylazine, and medetomidine. Tianeptine and phenibut are sold as supplements and are used to blunt the effects of opioid withdrawal or anxiety, respectively. Xylazine and medetomidine are often adulterants in illicit opioid formulations intended to increase the effects of opioids. These two substances, which produce CNS depression, are not opioids and therefore do not respond to naloxone reversal.