The new drug phenomenon

This special issue provides a multidisciplinary snapshot of recent developments of the broader, arguably phenomenal, changes to the drug market that have occurred in the past decade related to the rise of the new drug phenomenon. This change is largely a result of the growing commodification by entrepreneurs, and increasingly, by criminal groups, of a huge range of psychoactive substances not controlled under drug laws and fuelled by their sale on an open market. The issue includes papers that were presented at the Third International Forum on New Drugs, organized by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and held in Lisbon in June 2013. The aim of the forum was to bring together experts from around the world to exchange experiences, identify information gaps and research needs, as well as anticipate future developments and challenges related to the emergence of new drugs. The issue builds on and provides an update to the papers published in the special issue on new psychoactive substances published in Drug Testing and Analysis in 2011 (Vol. 3, issues 7–8). Other issues dedicated to psychoactive substances (‘illicit drugs’ and ‘psychedelic substances’) were also published in 2011 (Vol. 3, issue 9) and 2012 (Vol. 4 issues 7–8), respectively. In every issue of the journals in the fields of pharmacology, medicinal chemistry, the botanical sciences, and biochemistry, articles appear that advertise the isolation, synthesis, or evaluation of materials which have some pharmacologic action. Any article describing a new family of compounds (‘Potential Centrally Active Stimulants Evaluated in Experimental Animals’, for example) will encourage an unknown number of synthetic repetitions by underground researchers and manufacturers (with immediate pharmacologic evaluation in man). These studies follow none of the recognized guidelines for clinical investigation and are not responsible to any regulatory agency. If the results are undesirable or unacceptable, the matter is forgotten. If the results are considered virtuous or marketable, a new product appears briefly, under some popularly recognizable name and achieves, de facto, a broadly based " clinical" evaluation. When the product survives this initial marketing experiment, a new drug problem has made its appearance on the drug-abuse scene. However, if the product proves unacceptable (dysphoric, debilitating, lethal), the inquiry is dropped. Such explorations continue outside of the awareness of the social body politic.7 Keeping Dr Shulgin's observations in mind, one cannot help but think that little has changed. Over the past few years, the new drug phenomenon has become largely defined by both the growing number of substances being detected from increasingly broader chemical and pharmacological families, and the open sale of many of these substances as ‘legal highs’, ‘bath salts’, or ‘research chemicals’ from bricks and mortar and online shops that specialize in the sale of such substances and/or cannabis seeds and drug paraphernalia (so-called head shops or smart shops), but they are also sold by street-level drug dealers.5, 6 Others have emerged as a result of their diversion and misuse as medicines,5, 6, 8 while to a lesser degree, new drugs continue to emerge as a result of their production in either hobbyist or clandestine laboratories. In the latter case, this includes new drugs, which emerge either deliberately or unintentionally as a result of the use of unlisted precursors, such as 4-methylamphetamine synthesized from 4-methylphenyl-2-propanone.9 Most new substances first emerged as a result of chemical curiosity either from formal or informal study, and were commodified by entrepreneurs who saw the potential value of the substance based on initial human experimentation. From a historical point of view, perhaps only a comparatively small number have emerged on the drug market and gained a foothold beyond experimental use by psychonauts and diffused to broader sections of the population. Ketamine, 3,4-methylenedioxymethamphetamine (MDMA) or γ-hydroxybutyrate (GHB) may serve as prominent examples.3, 4, 10 In some cases the diffusion of these substances appeared to be a rather slow process compared to how they may be presented in the media. For example, experimental use of MDMA began, if not in the late 1960s, then certainly by the early 1970s, with broader use only occurring from the 1980s onwards. Of note is that ketamine, MDMA and GHB did not emerge as ‘legal’ replacements to controlled drugs, although it seems reasonable to assume that their non-controlled status under drug laws in some countries ultimately helped their diffusion: during the early 1980s, MDMA tablets, for example, were sold by entrepreneurs in Texas as ‘Sassyfras’ in bottles, mislabeled as a health food product while mainstream marketing techniques of mail order using a toll-free phone number and payment by credit card were used as well as sale in bars which were subject to sales tax.3 The appearance of new psychoactive substances (NPS) on the drugs market that are not controlled under international and national drug control laws is not a new phenomenon; many of the substances themselves were first synthesized years ago. The ‘cat and mouse game’, whereby there is a continuous circumvention of existing legislation as new substances appear, can be traced back to the early years of the twentieth century with international attempts to control esters of morphine.11 In recent years, however, there has been an increasing commodification of the market in new substances. This has been fuelled by entrepreneurs, and increasingly organized crime groups, who have exploited a growing manufacturing capacity in countries such as China and India and globalized trade. Here, the Internet has played a key role in both the advertisement and sale allowing an open market to develop. This is reflected in the rapid rate of appearance of NPS, which in Europe over the past few years has averaged one new substance every 5–6 days. Indeed in 2013, 81 NPS were detected on the European drug market compared to 74 in 2012, 49 in 2011, and 41 in 2010. In the first five months in 2014, 37 were detected.6 Similarly, monitoring of Internet shops typically selling new substances as ‘legal and ‘research chemicals’ to European by the shops in 2013, to the in 2012 and the and shops in 2011 and a number of such as to appear in the 1960s, a in the late 1970s, and in the 1980s with the emergence of the of of and and which were the drugs’ by The was of compounds with pharmacological by underground for sale on the which for example, that MDMA and its were not considered as has been however, that in the of drugs appeared only in the while it to in which also increasing with provides some of drug many substances been deliberately to drugs such as or of be substances by the as potential but largely for unknown were as an increasingly of the new drug phenomenon in recent years has been the of these as a potential for on the drug market. is little that the of in and in the for substances. the many new substances on the market were of which been in and have been as drugs. 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