Novel psychoactive substances: What educators need to know

Novel psychoactive substances (NPS) are synthetic drugs that act on the brain and that are not under international control. Sometimes called “designer drugs” or “legal highs,” NPS are often sold as alternatives to classic street drugs (e.g., ecstasy, LSD, marijuana, heroin) and pose a serious public health concern because of their toxic, sometimes fatal, effects.

As of 2015, the European Monitoring Centre for Drugs and Drug Addiction was monitoring 463 NPS, many of which can cause serious harm. There is a need for prevention initiatives directly aimed at harms related to NPS.

However, preventing NPS-related harms is difficult for a number of reasons:

1.Playing catch-up: NPS come and go at an extremely fast rate. For those attempting to monitor the presence of and harms associated with NPS, these substances appear and disappear so fast that they have difficulty keeping up.

2.Limited information on NPS: There is almost no information available on the pharmacology or toxicity of many NPS. By the time people have gathered enough information on a substance, it has either disappeared from the drug market or has already caused significant harm. The constant replacement of NPS with other slightly modified versions means there is little or no reliable information on these substances.

3.People do not know what they are taking: People using drugs cannot be sure that what they are consuming is what they think they are consuming. They may think they are taking one drug, but really be using something that is or contains NPS. They are also taking drugs produced in labs that lack quality or cleanliness standards needed to produce pure, reliable substances. The purity and dose of substances can vary a lot, even within one pill or dose. People who use these drugs can then experience accidental overdose or unknown drug-drug interactions in cases where users are consuming more than one substance.

The people who use drugs and those who work among them need to be aware of the uncertainty and unpredictability of the effects of NPS. To prevent the negative consequencies associated with NPS use, it is important to know that people often do not know what they are taking or its potency – and to raise awareness about this lack of knowledge. Without highlighting this key message, there is risk that people will assume there fewer harms associated with NPS use because of the lack of information available on the potential harms. It is important to continue to educate people who decide to use drugs about the likelihood of not knowing what they are consuming.

This update is courtesy of the Prevention Hub, Canada (

For more information: Patterson, Z., Young, M.M., & Vaccarino, F.J. (2017). Novel psychoactive substances: what educators need to know. Clinical Pharmacology & Therapeutics, 101(2), 173–175. Available at is external).