To Measure or Not to Measure? That is the NPS Question

Over the last 5 years, the explosion of novel psychoactive substances (NPS) and their potential involvement in forensic and clinical toxicology casework has led to many challenges for laboratories that need to detect, identify and quantify such drugs in a variety of different clinical and postmortem matrices. The number of such substances now exceeds 400 (1–4), and these include a range of stimulant, sedating and hallucinogenic compounds with particularly large numbers of synthetic cathinones and synthetic cannabinoids (3, 4). Much of the information about the new drugs identified comes from the analysis of pills, powders and plant material, which is relatively easy due to the concentrations of components present. It is far more important to have broad based, up to date screening approaches to determine if a drug and/or metabolite is responsible for a particular case presentation or death investigation. Without an effective toxicovigilant effort by analytical toxicology laboratories supporting clinical or forensic endeavors, there will never be a true picture of the NPS epidemic seen around the globe.