A critical review of published case reports from January 2017 through December 2020 identified 1,319 cases of adverse events associated with novel psychoactive substances (NPS), including 378 overdose fatalities, 771 cases requiring clinical treatment or hospitalization, and 170 cases of driving under the influence. The review covers chemistry, pharmacology, user profiles, and clinical symptoms for over 60 NPS, with 50 substances reported for the first time compared to the previous four years. Cases span synthetic cannabinoids, NPS stimulants, hallucinogens, benzodiazepines, and opioids. The findings aim to improve awareness and characterization of emerging international drug threats.
Among people attending electronic dance music festivals, self-reported use of Ecstasy, Molly, or MDMA often does not match what is actually in their system. Over four years, oral fluid from 223 participants who said they had recently used one or more of those terms was tested. Only 54.3% had MDMA alone; 29.6% tested positive for a novel stimulant instead. Most participants (91%) used only one term, with Molly the most common (60.6%), followed by MDMA (27.1%) and Ecstasy (12.3%). The findings indicate that the terms Ecstasy, Molly, and MDMA are not used interchangeably or accurately, and that users may unknowingly consume novel psychoactive substances.