New Psychoactive Substances: 25 Years of Early Warning and Response in Europe: An Update from the EU Early Warning System: June 2022

2022·4.3 MB·English

New psychoactive
substances: 25 years
of early warning and
response in Europe
An update from the EU Early Warning System
June 2022
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Luxembourg: Publications Office of the European Union, 2022
© European Monitoring Centre for Drugs and Drug Addiction, 2022
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Photo credits for the front cover images: Central Bureau of Investigation, Polish Police (1); Forensic Science and
Toxicology Laboratory, State General Laboratory, Cyprus (2); Swedish Customs (3); Norwegian Customs Laboratory (4).
Print ISBN 978-92-9497-737-3 doi:10.2810/882318 TD-05-22-113-EN-C
PDF ISBN 978-92-9497-725-0 doi:10.2810/396103 TD-05-22-113-EN-N
Recommended citation: European Monitoring Centre for Drugs and Drug Addiction (2022), New psychoactive
substances: 25 years of early warning and response in Europe. An update from the EU Early Warning System
(June 2022), Publications Office of the European Union, Luxembourg.
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I Contents
2 I Introduction
I
3 PART 1
The EU Early Warning System:
25 years of monitoring the appearance of NPS in Europe
3 I The first 10 years, 1997-2007
6 I Legal highs and research chemicals, 2008-2015
7 I Greater complexity and integration with the illicit market, 2016-2022
8 I PART 2
Update on the work of the EU EWS in 2020-2021
8 I Number of NPS on the market
8 I Overview of law enforcement seizures
8 I Risk communications
10 I Synthetic cathinones
14 I Synthetic cannabinoids
22 I Opioids
25 I Benzodiazepines
29 I PART 3
Lessons learned from 25 years of monitoring NPS in Europe
29 I Global markets create glocal threats
30 I Build, maintain and strengthen early warning systems
30 I Conclusion
31 I References
35 I Acknowledgements
36 I Annex 1
38 I Annex 2
Authors: Michael Evans-Brown, Ana Gallegos, Rachel Christie, Rita Jorge,
Joanna De Morais, Gregorio Planchuelo and Roumen Sedefov
New psychoactive substances: 25 years of early warning and response in Europe
I Introduction Reflecting this work and its world-leading expertise, the
EMCDDA plays a key role in supporting organisations
New psychoactive substances (NPS) are a broad range of across the globe to build and strengthen their early
drugs that are not controlled by the United Nations Drug warning and risk assessment capabilities in response to
Control Conventions. They include stimulants, synthetic the public health threats posed by NPS. This includes
cannabinoids, opioids, benzodiazepines (and other supporting and contributing to the work of the World
sedative-hypnotics), hallucinogens and dissociatives. Health Organization (WHO) and the United Nations Office
Many of these substances are intended to mimic the on Drugs and Crime (UNODC).
effects of internationally controlled drugs and are sold as
‘legal’ replacements for them. The purpose of this report is to overview the NPS situation
in Europe today and to highlight emerging threats to
A three-step legal framework of early warning, risk support early warning, preparedness planning and
assessment and control measures allows the EU to rapidly response measures. In addition, 16 June 2022 marks 25
detect, assess and respond to threats caused by NPS. The years since legislation was adopted in the EU allowing it to
EMCDDA is responsible for the first two steps of this rapidly react to threats caused by NPS (Council of the
system, namely operating the EU Early Warning System European Union, 1997). Since then, the market has
(EU EWS) on NPS in close cooperation with Europol and undergone periods of significant growth and change. The
conducting risk assessments. The European Commission anniversary provides an opportunity to reflect on these
is responsible for proposing control measures. changes and the lessons learned. This will help inform the
direction of work and policy so that the EU remains
Operational since 1997, the EU EWS was the first regional prepared and at the forefront of the response to NPS,
early warning system to be established to monitor NPS. As helping protect public health.
these substances have spread around the world, the
European system has been recognised as a model for The report is divided into three parts. The first looks back at
national, regional and international early warning systems. the major developments, challenges, accomplishments
and lessons learned from the NPS phenomenon over the
last 25 years. The second provides an update on the NPS
Learn more about this work situation up to the end of December 2021, including a
more in-depth look at synthetic cathinones, synthetic
cannabinoids, opioids and benzodiazepines. The third part
Early Warning System on NPS: looks forward and builds on the lessons from the last 25
https://www.emcdda.europa.eu/publications/ years and reflects on the benefits that could accrue from
topic-overviews/eu-early-warning-system_en working together at the international level to respond to the
future challenges posed by NPS.
2
An update from the EU Early Warning System I June 2022
I
PART 1
Early warning and risk assessment
The EU Early Warning System:
activities from 1997 to 2021
25 years of monitoring the appearance
of NPS in Europe
n 884 NPS were formally notified for the first time;
52 were formally notified in 2021;
Europe has been at the forefront of the response to NPS n 283 500 seizures of NPS have been reported in
since before they were widely recognised as a global policy the EU since 2005; 21 200 seizures were reported
issue and public health threat (CND, 2005, 2010, 2012). in the EU in 2020;
n 31.6 tonnes of NPS have been seized in the EU
The NPS market has been fuelled by globalisation, the since 2005; 5.1 tonnes were reported in the EU in
internet and attempts to circumvent new control 2020;
measures, and by exploiting differences in drug laws and n 168 public health risk communications were
regulatory approaches (EMCDDA, 1998, 2015a, 2015b, issued by the EMCDDA to the EWS Network;
2018, 2020a) (Figure 1 and box ‘Early warning and risk
7 were issued in 2021;
assessment activities from 1997 to 2021’).
n 37 substances were risk assessed by the
EMCDDA; 2 were risk assessed in 2021:
During the last 25 years, the health risks associated with
the use of NPS have also grown. During this period, we • 27 substances were brought under EU control;

have seen the introduction of more novel and sometimes 2 were controlled in 2021;
highly potent substances from a wider set of chemical • 26 of these substances were subsequently
classes. As regulatory measures have increased, we have controlled internationally.
also seen greater interaction between the established
illicit drug market and the market for NPS, including growth
in illicit production of some substances within the EU. We
have also seen the adulteration and mis-selling of both I The first 10 years, 1997-2007
established controlled drugs and NPS products. This can
mean that consumers may be unknowingly exposed to The EU EWS was established in 1997 after concerns that
highly potent and toxic substances. the emergence of ecstasy (MDMA) had revealed a lack of
capacity in Europe to identify and respond to the
In response to these developments, EU legislation has appearance of uncontrolled substances that could be used
been strengthened twice over the last 25 years with the for their psychoactive properties and cause harm.
intention of providing a stronger and faster response to
this complex public health issue. The EU response has also However, the period between 1997 and 2007 was
provided added value to national and international actions. characterised by the appearance of only a relatively small
The system is based on the foundation that ‘good number of NPS. Overall, this was a small group of esoteric
decisions begin with good data’. Critical information on synthetic substances, often known at the time as ‘new
NPS from across Europe is shared in a timely manner synthetic drugs’ but also some plant-based substances,
through the EWS. This is intended as ‘information for so-called ‘herbal highs’, such as Salvia divinorum and
action’ to raise awareness and support preparedness and magic mushrooms. The new synthetic drugs appearing at
response activities. A focus on cross-border threats has this time were typically stimulants and hallucinogens/
helped reduce the impact of NPS on public health across psychedelics often made in small illicit laboratories in
Europe and beyond. The development of standards and Europe. Some were mis-sold as amphetamine or ecstasy.
best practice in the early warning and risk assessment PMMA, for example, was often sold as ecstasy (MDMA)
fields, such as operating guidelines, standardised data and was linked with a number of deaths. The internet also
collection tools and a pan-European information system, began to emerge as a platform for selling NPS during this
has also provided a stronger basis for evidence-based period. BZP, often sold as ‘party pills’, was perhaps the first
decision-making. synthetic substance more widely known from being sold
online (EMCDDA, 2009a). Signals also began to be
The work of the EU in this area has also promoted networking detected during this period suggesting that companies in
and supported research programmes. It has developed China were playing a role in the supply of bulk quantities of
expertise within Europe, and informed the training of the next NPS, marking a transition away from production in
generation of scientists, public health practitioners, law small-scale illicit laboratories in Europe. However, it was
enforcement and early warning specialists. with the emergence and detection of Spice — a herbal
3
New psychoactive substances: 25 years of early warning and response in Europe
FIGURE 1
Timeline of major developments and responses
to new psychoactive substances in the European Union
(1997-2022)
1998
MBDB is the first
25 NPS risk assessed
EU EARLY 1999 2020
1997
First operating guidelines for New risk assessment operating
YEARS WARNING Fonir snte EwU p lseygcishloaatciotniv e tphueb rliisshk eads s| e4s-sMmTeAn its o tfh Ne PfiSrs t bengziumididelainzoelse | o Ipsoiotiodn ritisakz eanses eiss sthede fiarnsdt 2021
SYSTEM substances (NPS): NPS controlled following risk controlled | MDMB-4en-PINACA and 3-MMC and 3-CMC
Joint action 97/396/JHA assessment 4F-MDMB-BICA risk assessed | risk assessed | Alerts:
concerning the information Alerts: impact of COVID-19 benzimidazole opioids in fake
exchange, risk assessment pandemic on drug markets; low-THC medicines; risks posed by
ON NEW PSYCHOACTIVE and control of new synthetic cannabis adulterated with synthetic cannabis edibles | Outbreak of
SUBSTANCES drugs | EU Early Warning cannabinoids | 46 NPS notified | bleeding linked to brodifacoum
1997–2022 System (EWS) on NPS 21 200 seizures, amounting in Israel | 52 NPS notified |
established to 5.1 tonnes EMCDDA monitoring 884 NPS 2022
2000
EMCDDA celebrates
Ketamine and GHB risk
25 years of early warning and
assessed following their
response to NPS in Europe |
emergence in Europe
EU control measures on
3-MMC and 3-CMC adopted
2001
2019
2017
First annual meeting
New EWS operating guidelines |
of the EWS network in MDMB-CHMICA is the first synthetic
New EDND launched |
Lisbon | Norway joins cannabinoid controlled | Alert: increase
Alerts: flualprazolam, etizolam |
the EWS | PMMA risk in carfentanil seizures and deaths |
Isotonitazene is the first
assessed | Cooperation Acryloylfentanyl, furanylfentanyl,
2002 benzimidazole opioid notified |
agreement with AB-CHMINACA, ADB-CHMINACA,
Working arrangements with EU
PMMA controlled Europol 5F-MDMB-PINACA, CUMYL-4CN-BINACA,
agencies: ECHA, EFSA |
4F-iBF, THF-F and carfentanil risk-assessed |
53 NPS notified
51 NPS notified
2003
TMA-2, 2C-I, 2C-T-2,
2C-T-7 risk assessed 2018 2015
2005 and controlled New legislation strengthens the EWS Toxicovigilance, signal
management, open source
New legislation strengthens the EU and brings faster response to NPS: 2016 information monitoring and
exchr2eao0snf0p gn5oe9en/,1w0 3sr3i0 e8sp Nk7sts oe/yPa JicNsSzHhsu PnoeArSeaos osscta: in mCtmfioi veotfeoh eduNnu e nsttPn ouicatSn biintlnf hsrodDgeter a epmc tEnocooaWic rn2sttetiie Srooskdonng ||l, 21fCo0zll0e oncweh0wiina 4gM, EEesUmto benneialra ,S rHgtauetmnegsea njrotyi:,n CL tayhptevr iuEas,W , S RDfaMcAroiygsleireerckecgetrl nehoutocsc poltf|a:i i xroveWftoyeeicsopano c:( nycEtruEla kef(CpUineEtnayD)niUgl tl2sftCi )oea a0 i,2nnnn r1Ert0ay af7aMll1a nn/rek7Aig2yxse/,le1pk 2Eamm 0oa1nus3ees0dru dsone1 repitnec ssao ti tsnnewlo eer|d i dts i nh ;| t EoU MfiDrnosaAoctc tMf sr1ierfiyyi9nDslenot kMd(tay Bha nl|BfeZs ie6l-tsO nCi6scet-o H saNHclsnMdaPEey naXISdlCn sOd |naA heXAob aeitIlisZtenrifi hotroIehDtisinsdd e)|;: reicAbBsiosyslZ ett nkshPar cty,ceb :enmo l‘firiMtmsnehrhs opem|te cht αfdiuaece- nrPd |ncz iArVtc’ao amaPcnnnte naeiritolia,s ys cnb2slkfa i 5se pnuaynIooss-stNiisiatsdneeBnosgsmynO s|Eli s eMnU dge |,
Lithuania, Malta, Poland, Slovakia fentanils; CBD e-liquids adulterated | 46 000 seizures, AH-7921, MDPV controlled
2006 and Slovenia with synthetic cannabinoids | amounting to 3.2 tonnes internationally | 98 NPS notified |
34 200 seizures, amounting to
First EMCDDA–Europol annual report on 55 NPS notified | 33 600 seizures,
4.6 tonnes
NPS | First internet monitoring study on amounting to 4.1 tonnes
hallucinogenic mushrooms | European
Database on New Drugs (EDND) launched
2014
Cooperation on NPS strengthened with
World Health Organization and United
Nations Office on Drugs and Crime |
Turkey joins EWS | AH-7921 is the first
opioid risk assessed and controlled |
2007 2008 2009 2010 2011 2012 2013 MDPV, 25I-NBOMe, methoxetamine,
5-IT risk assessed | MT-45, 4,4′-DMAR risk assessed |
First operating guidelines for Mephedrone and Expert meeting on Spice | New guidelines for the risk First international forum on First international conference EU enlargement: Alert: MDMB-CHMICA poisonings |
the EWS published | BZP is the JWH-018 notified | EWS alert on Spice | assessment of NPS | Working NPS in Lisbon | First meeting on NPS in Budapest | Croatia joins EWS | 101 NPS notified
first piperazine risk assessed | BZP controlled | 21 NPS notified arrangement with European on wastewater analysis of NPS | 4-Methylamphetamine
Alerts: AH-7921 deaths;
EU enlargement: Bulgaria and First e-POD study Medicines Agency (EMA) | Alert on 4-methylamphetamine risk assessed | Alert on
25I-NBOMe poisonings |
Romania join EWS | Emergence of on GHB and GBL | Mephedrone is the first cathinone deaths | 314 internet shops 5-IT deaths | National
Online interactive resource
Spice and mephedrone in Europe | 13 NPS notified risk assessed and controlled | identified | 48 NPS notified EWS profiles published |
on synthetic cannabinoids |
14 NPS notified 170 internet shops selling NPS 693 internet shops Identified |
81 NPS notified | 25 200
identified | 41 NPS notified | 74 NPS notified
seizures, amounting
6 500 seizures, amounting
to 1.9 tonnes
to 1.1 tonnes
4
An update from the EU Early Warning System I June 2022
FIGURE 1
Timeline of major developments and responses
to new psychoactive substances in the European Union
(1997-2022)
1998
MBDB is the first
25 NPS risk assessed
EU EARLY 1999 2020
1997
First operating guidelines for New risk assessment operating
YEARS WARNING Fonir snte EwU p lseygcishloaatciotniv e tphueb rliisshk eads s| e4s-sMmTeAn its o tfh Ne PfiSrs t bengziumididelainzoelse | o Ipsoiotiodn ritisakz eanses eiss sthede fiarnsdt 2021
SYSTEM substances (NPS): NPS controlled following risk controlled | MDMB-4en-PINACA and 3-MMC and 3-CMC
Joint action 97/396/JHA assessment 4F-MDMB-BICA risk assessed | risk assessed | Alerts:
concerning the information Alerts: impact of COVID-19 benzimidazole opioids in fake
exchange, risk assessment pandemic on drug markets; low-THC medicines; risks posed by
ON NEW PSYCHOACTIVE and control of new synthetic cannabis adulterated with synthetic cannabis edibles | Outbreak of
SUBSTANCES drugs | EU Early Warning cannabinoids | 46 NPS notified | bleeding linked to brodifacoum
1997–2022 System (EWS) on NPS 21 200 seizures, amounting in Israel | 52 NPS notified |
established to 5.1 tonnes EMCDDA monitoring 884 NPS 2022
2000
EMCDDA celebrates
Ketamine and GHB risk
25 years of early warning and
assessed following their
response to NPS in Europe |
emergence in Europe
EU control measures on
3-MMC and 3-CMC adopted
2001
2019
2017
First annual meeting
New EWS operating guidelines |
of the EWS network in MDMB-CHMICA is the first synthetic
New EDND launched |
Lisbon | Norway joins cannabinoid controlled | Alert: increase
Alerts: flualprazolam, etizolam |
the EWS | PMMA risk in carfentanil seizures and deaths |
Isotonitazene is the first
assessed | Cooperation Acryloylfentanyl, furanylfentanyl,
2002 benzimidazole opioid notified |
agreement with AB-CHMINACA, ADB-CHMINACA,
Working arrangements with EU
PMMA controlled Europol 5F-MDMB-PINACA, CUMYL-4CN-BINACA,
agencies: ECHA, EFSA |
4F-iBF, THF-F and carfentanil risk-assessed |
53 NPS notified
51 NPS notified
2003
TMA-2, 2C-I, 2C-T-2,
2C-T-7 risk assessed 2018 2015
2005 and controlled New legislation strengthens the EWS Toxicovigilance, signal
management, open source
New legislation strengthens the EU and brings faster response to NPS: 2016 information monitoring and
exchr2eao0snf0p gn5oe9en/,1w0 3sr3i0 e8sp Nk7sts oe/yPa JicNsSzHhsu PnoeArSeaos osscta: in mCtmfioi veotfeoh eduNnu e nsttPn ouicatSn biintlnf hsrodDgeter a epmc tEnocooaWic rn2sttetiie Srooskdonng ||l, 21fCo0zll0e oncweh0wiina 4gM, EEesUmto benneialra ,S rHgtauetmnegsea njrotyi:,n CL tayhptevr iuEas,W , S RDfaMcAroiygsleireerckecgetrl nehoutocsc poltf|a:i i xroveWftoyeeicsopano c:( nycEtruEla kef(CpUineEtnayD)niUgl tl2sftCi )oea a0 i,2nnnn r1Ert0ay af7aMll1a nn/rek7Aig2yxse/,le1pk 2Eamm 0oa1nus3ees0dru dsone1 repitnec ssao ti tsnnewlo eer|d i dts i nh ;| t EoU MfiDrnosaAoctc tMf sr1ierfiyyi9nDslenot kMd(tay Bha nl|BfeZs ie6l-tsO nCi6scet-o H saNHclsnMdaPEey naXISdlCn sOd |naA heXAob aeitIlisZtenrifi hotroIehDtisinsdd e)|;: reicAbBsiosyslZ ett nkshPar cty,ceb :enmo l‘firiMtmsnehrhs opem|te cht αfdiuaece- nrPd |ncz iArVtc’ao amaPcnnnte naeiritolia,s ys cnb2slkfa i 5se pnuaynIooss-stNiisiatsdneeBnosgsmynO s|Eli s eMnU dge |,
Lithuania, Malta, Poland, Slovakia fentanils; CBD e-liquids adulterated | 46 000 seizures, AH-7921, MDPV controlled
2006 and Slovenia with synthetic cannabinoids | amounting to 3.2 tonnes internationally | 98 NPS notified |
34 200 seizures, amounting to
First EMCDDA–Europol annual report on 55 NPS notified | 33 600 seizures,
4.6 tonnes
NPS | First internet monitoring study on amounting to 4.1 tonnes
hallucinogenic mushrooms | European
Database on New Drugs (EDND) launched
2014
Cooperation on NPS strengthened with
World Health Organization and United
Nations Office on Drugs and Crime |
Turkey joins EWS | AH-7921 is the first
opioid risk assessed and controlled |
2007 2008 2009 2010 2011 2012 2013 MDPV, 25I-NBOMe, methoxetamine,
5-IT risk assessed | MT-45, 4,4′-DMAR risk assessed |
First operating guidelines for Mephedrone and Expert meeting on Spice | New guidelines for the risk First international forum on First international conference EU enlargement: Alert: MDMB-CHMICA poisonings |
the EWS published | BZP is the JWH-018 notified | EWS alert on Spice | assessment of NPS | Working NPS in Lisbon | First meeting on NPS in Budapest | Croatia joins EWS | 101 NPS notified
first piperazine risk assessed | BZP controlled | 21 NPS notified arrangement with European on wastewater analysis of NPS | 4-Methylamphetamine
Alerts: AH-7921 deaths;
EU enlargement: Bulgaria and First e-POD study Medicines Agency (EMA) | Alert on 4-methylamphetamine risk assessed | Alert on
25I-NBOMe poisonings |
Romania join EWS | Emergence of on GHB and GBL | Mephedrone is the first cathinone deaths | 314 internet shops 5-IT deaths | National
Online interactive resource
Spice and mephedrone in Europe | 13 NPS notified risk assessed and controlled | identified | 48 NPS notified EWS profiles published |
on synthetic cannabinoids |
14 NPS notified 170 internet shops selling NPS 693 internet shops Identified |
81 NPS notified | 25 200
identified | 41 NPS notified | 74 NPS notified
seizures, amounting
6 500 seizures, amounting
to 1.9 tonnes
to 1.1 tonnes
5
New psychoactive substances: 25 years of early warning and response in Europe
mixture containing synthetic cannabinoids — and n the E-POD studies that triangulated information from a
mephedrone that led to growing public and professional wide range of formal and informal sources (EMCDDA,
interest in what was known at the time as the ‘legal highs’ 2006, 2008);
and ‘research chemical’ phenomenon. At this stage,
n monitoring of online sales of NPS (EMCDDA, 2011a);
however, few people were aware of the significance that
these substances would play in the future (Griffiths et al., n analysis of wastewater and injecting equipment to
2010; Hillebrand et al., 2010). detect and track NPS use.
This period also saw the EWS beginning to develop its Monitoring by the EMCDDA identified a rapid increase in
approach to detecting new substances appearing in online shops selling NPS (EMCDDA, 2011a; EMCDDA,
Europe. The system was established as a multidisciplinary 2012a), from 170 in January 2010 to 314 in January 2011 and
network composed of the EMCDDA, Europol, 15 national 693 in January 2012 — a 300 % increase in just two years.
early warning systems, and the European Medicines
Agency. The EWS used common reporting tools and Much of the growth in the market was driven by sales of
benefitted from shared EU and national investment. Spice, sold as a ‘legal’ replacement to cannabis (EMCDDA,
Around this period, the term ‘new psychoactive 2009b), as well as mephedrone and other synthetic
substances’ started to replace ‘new synthetic drugs’, and cathinones, sold as a ‘legal’ replacement to MDMA,
this term was used in new EU legislation introduced during amphetamine and cocaine (EMCDDA, 2011b; EMCDDA
2005 (Council of the European Union, 2005) to broaden and Europol, 2010). Both 2014 and 2015 saw the
the scope of substances that could be monitored and to appearance of 100 new substances in Europe. Most were
strengthen the system overall. In 2006, the European synthetic cannabinoids and cathinones, but a broad range
Database on New Drugs (EDND) was established. The of other substances were also reported, including
EDND was the first multidisciplinary information system on ketamine-like substances, and over time benzodiazepines
NPS in the world. It provided experts from across Europe and opioids. Seizures by law enforcement also grew
with detailed information on NPS, including law rapidly, as did poisonings reported by the network. During
enforcement seizures, collected samples, poisoning cases, 2015, over 34 000 seizures of NPS amounting to 4.6
chemistry and identification methods, pharmacology, tonnes were reported in the EU.
toxicology, epidemiology, harms, and response measures.
In response, the EMCDDA developed new methods to
Of the 60 or so substances notified between 1997 and strengthen the ability of the EWS to detect, assess,
2007, risk assessments were carried out on 10 of them, prioritise and respond to threats in a timelier manner. They
most of which were stimulants: MDMB, 4-MTA, GHB, included:
ketamine, PMMA, TMA-2, 2C-T-2, 2C-T-7, 2C-I and BZP. Of
n a toxicovigilance system that harmonised the way that
these, 4-MTA, PMMA, TMA-2, 2C-T-2, 2C-T-7, 2C-I and BZP
information on serious adverse events, particularly
were brought under control throughout the EU.
acute poisonings and deaths, was reported and
Subsequently, 4-MTA, GHB, PMMA and BZP were
analysed;
controlled under the UN system.
n a methodology for monitoring open source information
that used the internet to detect serious and urgent
I Legal highs and research chemicals, 2008-2015 threats, such as outbreaks, and other key information;
n a signal management approach that provided a more
This period was characterised by a rapid increase in the
robust method for identifying and assessing emerging
number, type and availability of NPS in Europe. Most were
threats based on their type, seriousness and urgency in
produced by chemical and pharmaceutical companies in
order to prioritise them and identify response options;
China and imported into Europe. They were attractively
packaged and sold openly on the high street and the n a risk communication system that strengthened the
internet in hundreds of branded products marketed as way alerts were shared within the EWS Network.
‘legal highs’ and ‘research chemicals’ in attempts to
circumvent legal controls. The period also saw increased national and EU investment
in this area, including creating new national and EU-funded
This period was also marked by the development and use projects, such as test-purchase programmes targeting
of a range of novel methodologies by the EMCDDA to NPS of concern; strengthening forensic and toxicology
strengthen the monitoring of NPS, specifically to detect, capacity; and helping to increase awareness of the public
track and understand emerging trends. They included: health threats of NPS. In 2013, the UNODC also set up the
6
An update from the EU Early Warning System I June 2022
Early Warning Advisory to provide early warning Just over 320 substances were notified in this period, with
information at the global level. risk assessments carried out on 17 substances. These were
mostly synthetic cannabinoids and opioids (typically fentanyl
Increasingly, countries responded to these developments derivatives): MDMB-CHMICA, acryloylfentanyl,
by restricting the availability of NPS, including their open furanylfentanyl, AB-CHMINACA, ADB-CHMINACA,
sale (EMCDDA, 2015b). National early warning systems 5F-MDMB-CHMINACA, CUMYL-4CN-BINACA, 4F-iBF, THF-F,
were also strengthened (EMCDDA, 2012b). carfentanil, cyclopropylfentanyl, methoxyacetylfentanyl,
isotonitazene, MDMB-4en-PINACA, 4F-MDMB-BICA,
Almost 480 substances were notified during this period. 3-methylmethcathinone and 3-chloromethcathinone. Twelve
Risk assessments were carried out on 10 of them: were brought under control throughout the EU, with five being
mephedrone, 4-MA, 5-IT, AH-7921, methoxetamine, simultaneously assessed and controlled internationally.
25I-NBOMe, MDPV, MT-45, 4,4′-DMAR and α-PVP. All of
them were brought under control throughout the EU. This It was also a period of growing integration with the
work also informed international assessments by the established illicit drug market. This was partially reflected in
WHO, leading to many of these substances being the increased use of new benzodiazepines to make falsified
controlled at the international level. Most of the (fake) versions of commonly prescribed benzodiazepine
substances that were assessed were stimulants; medicines, such as Valium and Xanax. Greater
however, two were opioids (AH-7921 and MT-45), a class diversification of the supply chain also appears to have
of drug that would become increasingly important in the taken place, making the market more resilient to control
future. measures — with India becoming a prominent source of
synthetic cathinones from around 2019-2020. There were
also more reports of illicit production of synthetic
I Greater complexity and integration with the illicit cathinones in Europe.
market, 2016-2022
Towards the end of 2018, new legislation came into force
This period was characterised by a shift away from ‘legal intended to further strengthen the EU system and make it
highs’ and ‘research chemicals’, and a drop in the number respond faster (European Parliament and Council of the
of substances appearing each year to around 50. We also European Union, 2017a, 2017b). New EU EWS and risk
began to see growing complexity as more highly potent assessment operating guidelines were published
substances emerged that were often linked to more (EMCDDA, 2019; 2021c), along with common reporting
problematic patterns of use or targeting more marginalised tools. This also included the launch of a redesigned EDND
or chronic and long-term drug-using populations. They in 2019, providing the EU with a next-generation
included new opioids, with large numbers of fentanyl information system capable of electronic data
derivatives appearing. These were often linked to management. Together, these updates provide a more
outbreaks of poisonings or deaths but tended to disappear efficient response to NPS, allowing the EU to react to
quickly only to be replaced by other opioids, including substances posing EU-level threats in just over 10 weeks.
highly potent benzimidazole opioids. The number of new
benzodiazepines appearing also increased during this
period (EMCDDA, 2019).
7
New psychoactive substances: 25 years of early warning and response in Europe
I
PART 2 I Risk communications
Update on the work of the EU EWS
in 2020-2021 Risk communications are regularly produced by the EWS
and intended to provide timely evidence-based messages
that raise awareness and knowledge, and increase the
I Number of NPS on the market understanding of the public health and social threats
associated with NPS. This includes highlighting important
By 31 December 2021, the EMCDDA was monitoring 884 gaps in information as well as stimulating the reporting of
NPS that had appeared on Europe’s drug market since data that can facilitate further assessment and
monitoring began in 1997; this includes 52 substances understanding. Risk communications also provide material
that were notified for the first time in 2021 (Figure 2 and to inform preparedness planning and response activities,
Annex 1). including information on possible response options.
The number of NPS notified in 2021 continues the trend During 2021, the EMCDDA issued seven public health risk
seen since 2016 of around 50 new substances appearing communications to the EWS Network based on
for the first time each year; this is down from the high of EU-relevant threats (Annex 2). These included advisories
100 substances observed in both 2014 and 2015. This on the spread of low-THC cannabis adulterated with
drop likely reflects sustained efforts to control and synthetic cannabinoids in Europe, and the detection of
otherwise restrict the sale of NPS in Europe as well as fake opioid analgesic medicines containing highly potent
measures introduced to restrict the production and trade opioids. An alert on the detection of tablets containing
in source countries, such as China. DOC, a potent hallucinogen, that were mis-sold as 2C-B
was also issued. An alert was also issued describing an
Since 2015, around 400 previously reported NPS are also outbreak of poisonings outside of Europe caused by a
identified each year as still being present on the market in highly toxic rat poison in synthetic cannabinoid smoking
Europe. This suggests that many substances remain in mixtures. Some of these threats are discussed below.
circulation, albeit in varying amounts and with some in very
small quantities.
I Overview of law enforcement seizures
In 2020, just over 21 000 seizures amounting to more than
5 tonnes of NPS were reported to the EU EWS by the
Member States (Figure 2). In addition, approximately 230
litres of liquids and 840 000 tablets and capsules
containing NPS were reported. Over 41 000 seizures
amounting to 6.9 tonnes of NPS were reported in total by
EU Member States plus Norway and Turkey (EU+2).
The seizure data collected on NPS in this report should be
regarded as minimum estimates due to the lack of
standardised reporting in this area. The data are not
directly comparable with the data on established illicit
drugs.
Synthetic cathinones dominated the seizures made in
2020. Mostly these were trafficked to Europe from India
and seized at the external EU border by customs agencies.
Overall, 65 % of the materials seized (3.3 tonnes) were
cathinone powders. In addition, almost 1.2 tonnes of the
materials seized (23 % of the total) were
arylcyclohexylamines, of which ketamine accounted for
almost all the quantity seized (1.1 tonnes (93 %).
8