During its annual meeting in March 2023, the Commission on Narcotic Drugs (CND) accepted all recommendations from the WHO Expert Committee on Drug Dependence (ECDD). This brings seven novel psychoactive substances (NPS) under international control to improve country-wide detection and monitoring of harmful psychoactive substances.
NPS can often have unpredictable or more toxic side-effects compared to controlled drugs or medicines, with a lack of evidence on their potential risks to users. In addition, they are often mis-sold as other substances, and can therefore be taken unknowingly by users resulting in overdoses. The substances listed below were reviewed by WHO and considered for international control due to reports of their potential to cause harms to public health.
Four synthetic opioids, 2-Methyl-AP-237, Etazene, Etonitazepyne and Protonitazene, were recommended by WHO to be controlled under Schedule I of the Convention on Narcotic Drugs, 1961. All four showed similar ill effects to other opioids controlled under this Schedule. These substances were reported to have been associated with adverse effects, including death, with no therapeutic value reported.
Two synthetic cathinones, alpha-PiHP and 3-MMC were recommended to be placed under Schedule II of the Convention on Psychotropic Substances, 1971. They showed effects similar to other psychostimulants such as methamphetamine that are listed under this Schedule. They have also been associated with adverse effects, including death, with no reported therapeutic value. They have been reported in tablet, capsule and liquid forms mis-sold as other substances including MDMA, which could pose a risk to users who consume it unintentionally.
One synthetic cannabinoid, ADB-BUTINACA was recommended to be placed under Schedule II of the Convention on Psychotropic Substances, 1971. ADB-BUTINACA showed effects similar to those synthetic cannabinoids currently controlled under this Schedule. Its use resulted in individuals attending hospital emergency departments with severe adverse effects such as loss of consciousness, as well as reports of fatal intoxications. Its mechanism of action suggests the likelihood of abuse and potential for dependence. In addition, there is no reported therapeutic value of the substance. It has been reported to be sprayed onto plant material or paper and mis-sold as other cannabinoids including cannabis, which could pose a risk to users who consume it unintentionally.
In addition, the ECDD conducted critical reviews of two non-medical benzodiazepines, adinazolam and bromazolam and one medicine, zopiclone which were recommended to be placed under surveillance.
For more information on these substances and the ECDD recommendations, please review the 45th ECDD meeting report.