New psychoactive substances, or designer drugs, are compounds that are not controlled under the 1971 Convention on Psychotropic Substances. These include the new hallucinogens, which are mainly phenethylamines, tryptamines and arylalkylamines.
In this master thesis, we addressed the incidence and safety of new hallucinogens in the group of new psychoactive substances in Europe between 2010 and 2022. First, we gave an overview of new hallucinogens and their desired effects. The analysis of the incidence was done using data obtained from the European Drug Reports published annually by the European Monitoring Centre for Drugs and Drug Addiction. We found that the number of all new psychoactive substances increased during the period under review until 2014, followed by a generalised decline, most likely due to the tightening of market and sales controls. The increase in numbers was only observed again in 2020. In the group of new hallucinogens, phenethylamines were the most represented. They were followed by tryptamines, lysergamides and other substances. We also found that the new hallucinogens were less represented than the other groups of new psychoactive substances (cathinones, synthetic cannabinoids and benzodiazepines).
The safety of the new hallucinogens was analysed using data from the United Nations Office on Drugs and Crime website. Toxicological evaluation of the new hallucinogens was carried out using literature describing acute intoxications and serious side effects. These include serotonin syndrome, flashbacks, and persistent hallucinogenic cognitive impairment. Other potential risks of the use of new hallucinogens are transmission or infection with HIV or hepatitis C and withdrawal syndrome. Also, many compounds are still unexplored and toxicological analyses are limited.
The market for new hallucinogens is constantly and rapidly expanding and needs to be properly controlled. Some of the new hallucinogens are classified in classes defined by the 1971 Convention on Psychotropic Substances. Of the 43 compounds described below, 24 are already classified in Class I. These are substances with a high potential for abuse and have no prescribed medical use. Only compound 2C-B is in Class III, the rest are still allowed and have not been classified so far.
Specific treatment for poisoning with the newer hallucinogens is not yet known. Currently, symptomatic treatment is the mainstay. However, treatment of serotonin syndrome depends on the severity of the symptoms and ranges from withdrawal to hospitalisation, where oxygen may be added, rehydration introduced, fever lowered and even intubation.
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