Novel Psychoactive Substances (NPS). Are they really that big a deal?

Yes! They are. In fact, they are becoming a bigger deal every year. Traditional drugs of abuse (e.g., opioids, amphetamines, benzodiazepines, etc.) have always had a place in the drug testing laboratory. There are several examples of common psychoactive medications and illicit drugs that seem to have always been around. However, even these have evolved over time as new medications hit the market or existing medications gain new indications. For example, propoxyphene was originally marked for mild pain, and before 2009 (when it was banned by the FDA), it was a relatively common analyte detected in biological specimens (along with its metabolite norpropoxyphene). The FDA removed it from the market due to potentially serious side effects and a relatively low therapeutic index. It has since mostly vanished from detection, except for the occasional positive test after the drug was obtained illicitly. Changes in the relative appearance of drugs like propoxyphene can be predicted which allows the laboratory to adjust its methodology accordingly. Not so for NPS.

The major challenges when testing for NPS require new innovation in drug testing. Laboratories must respond quickly to the ever-changing landscape of NPS and they may even attempt to predict the latest trends based on historic data and chemical variations likely to be illicitly synthesized. However, this is expensive and must be conducted in accordance with the same laws and regulations governing all laboratory testing.

- Proficiency testing must be included in the laboratory quality management plan and the latest analytes often are not included in proficiency surveys from commercial vendors.

- New method development and validation must be conducted which requires the use of laboratory resources and equipment.

- Administrative aspects must be met, such as training, marketing, panel selection, and billing to name a few.

Even so, laboratories must continue to pursue the latest technology and make the necessary adjustments to identify NPS. Why? Because:

- NPS use has reached epidemic proportions; their easy access via the internet has allowed for alarmingly high rates of drug use.

- NPS's are now among the most commonly detected analytes in laboratories throughout the United States: Fentanyl analogues are now listed on the NFLIS (reference below) among the most commonly detected opioids.

- NPS's are impacting our youth; gone are the days of simple cannabis experimentation. Now, experimenting with the wrong NPS can cost a life.

(National Forensic Laboratory Information System, NFLIS, https://www.deadiversion.usdoj.gov/nflis/index.html)