Novel psychoactive substances (NPS), sometimes referred to as “legal highs,” have surged in popularity in recent years. These drugs, which aim to mimic the effects of illegal substances like marijuana, cocaine, and ecstasy, are designed to skirt existing drug laws by tweaking chemical structures. While marketed as safe and legal alternatives to illicit drugs, NPS carry serious health risks that consumers often overlook.
The Dangers of Unknown Substances
A major risk posed by novel psychoactive substances is that in most cases, little is known about their chemical composition, effects, and potential for harm. Manufacturers continually experiment with molecular structures to stay one step ahead of legislation banning certain formulations. This means new substances are hitting the market all the time before there is research into their physical and mental health impacts. When consumers ingest these untested chemicals, they become unwitting guinea pigs.
Health organizations have detected hundreds of NPS varieties over the last decade. Drug testing labs cannot keep pace with identifying new formulations, let alone study their effects. All of this leaves users vulnerable to substances that could damage their health in unexpected ways. Simply put: abstinence is the only way to completely avoid risks when so little is known about these constantly changing compounds.
The Risk of Toxic Reactions
While NPS are often labeled “not for human consumption” to skirt regulations, many users ingest them by smoking, swallowing, snorting or injecting. Without safety screening, dangerous reactions can occur inside the body. Some chemicals have been linked to kidney and heart damage, seizures, or death due to toxic overdose. The synthetic cannabinoids often found in synthetic marijuana variants can greatly accelerate heart rate and blood pressure, which in some cases has resulted in heart attacks.
Other NPS variants carry unknown risks. When one patient was admitted to an emergency room after consuming an unknown NPS powder, doctors detected bleeding in the brain, kidneys, lungs, and gastrointestinal system. The drug seemed to simultaneously attack multiple organ systems, which the medical team had never encountered before. While the patient eventually recovered, it illustrates the unpredictability of untested chemicals’ effects inside the human body.
The Threat of Addiction
The euphoric and psychoactive effects intentionally designed into NPS pose addiction risks. In particular, synthetic cathinones like those found in bath salts can be highly addictive, similar to methamphetamine. Animal studies show cathinones lead to compulsive redosing, drug cravings, and withdrawal symptoms during abstinence.
A 2021 study of over 2,500 NPS users found that 22% showed signs of dependence, increasing to 48% for frequent users. Two of the most addictive substance categories were synthetic cathinones and synthetic cannabinoids. Alarmingly, dependent users reported stronger urges to use, less control over usage, and continuing use despite negative consequences. While more research is needed, these preliminary findings point to the addictive potential of many NPS variants.
Risk of Mental Health Crises
For some, NPS use triggers severe mental health episodes requiring emergency care. Synthetic marijuana variants are linked to acute psychosis, often involving hallucinations, delusions, agitation, and violent outbursts. Patients can appear terrified and delirious. These frightening psychic breaks typically dissipate within days after intoxication, but in some vulnerable individuals, symptoms have persisted for weeks.
Other NPS, like substituted cathinones and psychedelic phenethylamines carry psychosis risks. Experts believe that people with underlying mental illnesses or a family history of conditions like schizophrenia may be most susceptible to triggering latent issues through NPS use. However, even those without known vulnerabilities have experienced sudden psychotic breaks. The terrifying temporary loss of contact with reality serves as a reminder that we do not fully grasp these drugs’ psychological effects.
The Role of Prohibition
Seeking an altered state of mind may always be part of the human experience. However, the unknown risks of NPS illustrate that prohibition often exacerbates drug harms more than it curtails use. Pushing substances into unregulated spaces removes quality control, dosing standards, medical oversight, and research into effects. The perpetually one step ahead game between manufacturers and legislators leaves consumers as uninformed guinea pigs.
A public health-centered approach is needed. Legal regulation of psychoactive substances would enable safety screening, purity controls, dose recommendations, and addiction treatment options. Coupled with drug education focused on harm reduction instead of scare tactics, it would cultivate more informed choices and access to medical help without stigma. An emphasis on safety and science over prison sentences could limit the collateral damage caused by prohibition today.
The Way Forward
NPS will likely remain part of recreational drug culture due to human appetites for consciousness alteration. However, their unpredictable health effects raise troubling questions. Why do some compounds trigger heart attacks or kidney failure, while related chemicals do not? Why do perfectly healthy people suffer psychotic breaks from substances that give others only mild euphoria? What undiscovered risks lurk within the hundreds of mystery chemicals still untested in controlled settings?
These questions highlight gaps in the scientific understanding of NPS that require further study. Until researchers can elucidate the risk factors making some more vulnerable to adverse effects, abstinence is the safest approach. For those who choose to use despite the unknowns, avoiding mixing with other drugs, staying cool and hydrated, and using with trusted companions are vital harm reduction steps. Yet information voids will remain with prohibition hindering open science. Ultimately, society must weigh drug laws’ benefits against their unintended consequences, including the health risks inevitably created by unregulated, ever-changing NPS.