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Reports of Adverse Events Associated With Use of Novel Psychoactive Substances, 2013-2016: A Review

NCJ Number
Date Published
April 2017
38 pages

This article documents and discusses adverse effects of intoxications from novel psychoactive substances (NPS) such as cannabinoids, stimulants, hallucinogens, benzodiazepines, and opioids, spanning January 2013 through December 2016.


These data are based on reports of emergency departments, death investigations, impaired driving cases, and other forensic contexts. A summary is provided on the chemistry, pharmacology, and adverse events associated with novel drug classes. Adverse effects of symptoms linked to ingestion of more than 45 NPS are categorized in tables that include data on demographics, case history, clinical or behavioral symptoms, autopsy findings, and drug confirmations with quantitative results. Based on these findings and gaps in the available data, the article outlines recommendations for future toxicological testing for evolving substances. Among the recommendations are the development and management of a national monitoring program that provides real-time clinical and toxicological data, confirmed analytically, on emerging drugs and their known toxidromes and side effects. It is also recommended that there be increased efforts to confirm analytically the agents responsible for clinical intoxications that involve adverse events in emergency department admissions or hospitalizations. In addition, evidence-based community preparedness among analytical laboratories must be improved for the sharing of toxicological findings and trends in NPS, so as to enable early detection of new drugs in forensic and clinical populations.

Date Published: April 1, 2017