New psychoactive substances - Overview

Focus on synthetic cannabinoids.

Grand format
Cristaux - produits de synthèse

Introduction/Background

NPS is the acronym for New Psychoactive Substances. This term is defined in the Directive (EU) 2017/2103 as “a substance in pure form or in a preparation that is not covered by the 1961 United Nations Single Convention on Narcotic Drugs, as amended by the 1972 Protocol, or by the 1971 United Nations Convention on Psychotropic Substances but may pose health or social risks similar to those posed by the substances covered by those Conventions”.

These molecules can be classified in various categories, based on their pharmacological characteristics and/or their chemical structures.

Certain substances, though not necessarily new, are emerging in recreational use and can fit this definition. For instance, ketamine is an anaesthetic that is often misused outside of its medical purpose.

In France, the most commonly observed substances within these categories are synthetic cathinones and synthetic cannabinoids.

Synthetic cannabinoids are synthetic molecules which bind to the same cannabinoid receptors as THC. These molecules have varied chemical structures and, for the most part, are not structurally akin to typical cannabinoids. They are also known as “synthetic cannabinoid receptor agonists”. Their effects and potencies differ greatly from those of cannabis. They can be used as powders sprayed on plant material, which is often lowly psychoactive (“spice”) or tobacco (referred to as “chimique” in Mayotte and Réunion), or as e-liquids. Depending on the cannabinoid, the duration and potency vary greatly between one molecule and another.

In Europe, 209 new synthetic cannabinoids have been identified between 2008 and 2020, and 24 reported for the first time in 2022.

Production/supply

Seizures

Among the new psychoactive substances identified by the STUPS 2022 database (Standardised Narcotics Processing System), which compiles the data from the National Forensic Science Institute (SNPS) and the Forensic Sciences Institute of the French Gendarmerie (FSIFG), 52 records concerned synthetic cannabinoids, particularly ADB-BUTINACA, 4-F-MDMB-BUTINACA (4-F-MDMB-BICA), and MDMB-4en-PINACA (MDMB-PENINACA).

In 2022, a total of 26 new first identifications across the country were reported by the OFDT’s National Identification System for Toxics and Substances (SINTES) to the European Union Drugs Agency (EUDA) in the context of the Early Warning System. As in the previous year, these new molecules mainly belonged to the synthetic cannabinoid family.

In 2019, the EU member states were responsible for around 6 500 of the 18 700 seizures reported within the European Union, Norway, and Turkey, and 200 of the 900 kilograms seized.

Supply

Most synthetic cannabinoids are produced by companies in China and are mainly sold online. When certain substances are banned, manufacturers replace them with new ones that haven't been identified by regulatory authorities.

Some experienced users produce their own e-liquid using synthetic cannabinoids purchased on the Internet as powders. Other consumers buy these substances pre-packaged, sold under trade names (PTC - Pète ton Crâne (Brainfuck), Mad Hatter, Buddha Blues, etc.), which only cost a few tens of euros and often do not mention of the molecules contained. While synthetic cannabinoids are almost exclusively purchased on the Internet, physical market resales have been observed sporadically, with the substance then rarely appearing under its actual name.

These vials of e-liquids and sachets are also heavily marketed, to make them more accessible to young people, they are colourful and bear attractive names. Since there is no THC in synthetic cannabinoids, their use is not identifiable by tests typically used to identify cannabis.

Synthetic cannabinoids are sometimes found in the use of other adulterated substances, unbeknown to the user. For example, adulterated herbal cannabis, e-liquids, and heroin have recently been observed containing synthetic cannabinoids in France.

Use in the adolescent population

Few recent use of synthetic cannabinoids was measured in the adolescent population, its use is still marginal. In the Survey on Health and Drug Use on National Defence and Citizenship Day (ESCAPAD) in 2017, like in 2014, a question enabled the uses of NPS among young people in late adolescence to be described. In total, 3.8% of 17-year-olds stated to have used a substance that mimics the effect of a drug. However, only 11.8% of them specified which substance, mainly a synthetic cannabinoid.

In 2023, the survey did not explore the use of new psychoactive substances, but some rare spontaneous reports suggested the emergence of uses of synthetic cannabinoids.

Use in the adult population

In 2017, the Health Barometer survey of Santé publique France estimated the lifetime use among Frenche adults. In total, 1.3% of 18–64-year-olds declared to have smoked them, which represents 3% of lifetime users of cannabis, and 12% of users in the previous year. This percentage places synthetic cannabinoids at a similar level of use to that of cannabis. Lifetime users were predominately men (1.7% vs 0.8% of women), and under 35 years old. 3.5% of 18–34-year-olds (4.3% of men and 2.7% of women) had tried synthetic cannabis, in comparison with 0.2% of 55–64-year-olds. Synthetic cannabinoids continue to be the most frequently used type of NPS.

Impacts

Sales presentations on NPS pose the problem of the user’s knowledge of the true nature of their content. They cast doubt on the synthetic nature of substances (presented in herb form) or use forms which suggest that the compositions and doses are checked beforehand.

Yet, there is a large variability in doses between NPS, and therefore perceived and/or undesirable effects.

An acute intoxication with synthetic cannabinoids may be characterised by cardiovascular, digestive, or pulmonary disorders, such as tachycardia, seizures, respiratory problems, visual and auditory hallucinations, mydriasis, restlessness and anxiety, nausea and vomiting, headaches, etc. When the drug is in e-liquid form, the user does not have control over their dose. In case of error, that may be highly damaging. This is the case for Buddha Blues, the synthetic cannabinoid of which is 5F-AKB-48.

The OFDT’s National Identification System for Toxics and Substances (SINTES) has evidenced herb samples adulterated with synthetic cannabinoids (for only 3 substances). Three molecules have been found: 4F-MDMB-BICA paired with JWH-210 and ADB-BUTINACA. In 2022, the SINTES system observed that among the samples of vaping liquids adulterated with synthetic cannabinoids, the age of the user mentioned in the questionnaires was under 18 years old in 15 cases among the 23 samples of synthetic cannabinoid e-liquids.

Since 2021, a coordinating body for the Emerging Trends and New Drugs (TREND) scheme has been established in La Réunion island, at the request of the Regional Health Agency (ARS). It has shed light on the specificities of this overseas territory, regarding the trafficking and use of drugs, access to healthcare, and more generally on public responses to these phenomena. Among users, investigations identified several specificities. The use of synthetic cannabinoids is a local characteristic whose health and social consequences (loss of consciousness, dizzy spells, aggressiveness, restlessness, development of addiction, etc.) have been serious causes for concern since the late 2010s. However, in 2022, people indicated to have stopped using and reselling the substance due to its overly intense effects, giving rise to undesirable health impacts.

The long-term use of synthetic cannabinoids may be associated with an onset of tolerance, addiction, prolonged and pronounced withdrawal symptoms, characterised by an irresistible urge, tachycardia, a rise in blood pressure, irritability, restlessness, shivers, strong sweating, diarrhoea, insomnia, etc.

Legal framework and recent public guidelines

In France, 12 families and 10 substances of synthetic cannabinoids are classified as narcotics by legislative order of 31 March 2017.

Their use is banned: article L3421-1 of the Public Health Code imposes fines (up to €3 750), and imprisonment (up to 1 year).

The incentive to use, traffic, and present a substance in an auspicious way: article L3421-4 of the Public Health Code imposes fines (up to €75 000), and imprisonment (up to 5 years).

Trafficking is banned: articles 222-34 to 222-43 of the Penal Code impose fines (up to €7 500 000) accompanied by imprisonment (up to 30 years of imprisonment).

  • [in French] Order of March 31, 2017 amending the order of February 22, 1990 establishing the list of substances classified as narcotics