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Following deaths and hospitalisations in Melbourne, Victoria, Australia, related to the unwitting consumption of a combination of 25C-NBOMe and 4-FA, a community-led unauthorised drug checking service was rapidly established at a subsequent music festival. We aim to demonstrate the value of community-led drug checking, even when conducted in less-than-ideal conditions, by describing this service and reporting on its outcomes.

In all, 131 samples were tested with between 1 and 4 (M = 2.24 and SD = 0.61) reagents (Mandelin, Marquis, Mecke and Simons), and behavioural intentions of service users were reported.

People whose results indicated that the drug tested was what they expected, or was a drug familiar to them, were more likely to report an intention to take the drug compared to those whose results indicated that the drug was not what they had expected. For example, in 11 cases where the expected substance was not identified and novel substances including 2 C-X (including the NBOMe series), methylone, mephedrone, PMA and MXE were indicated, most reported an intention to discard (8/11).

The guerrilla service appeared to dissuade some people from consuming substances with higher risk profiles. It was also quick to identify substances of concern consistent with the NBOMe/4-FA combination for broader community action. The authors urge governments in Australia and elsewhere to reconsider their opposition to drug checking services, given their utility as vital health services during times of volatile drug market shifts.

While these data are five years old, it has only been in the past year that the Coroners Court of Victoria finalised their report on the deaths associated with this drug outbreak, providing context for the rapid peer response.

The purpose of this paper is to analyse dynamics amongst members to better understand in what terms and to what extent marketplace forums can be seen as new forms of harm reduction.

This is a qualitative analysis focused on conversations about psychoactive substances on the forum community of AlphaBay Market. A sample consists of 100 online threads. The data, collected in July 2016, were analysed by applying the grounded theory approach with the support of Atlas.ti.

Conversations in the marketplace forum focus mostly on the purchase. Concerns and disputes are voiced in a significant proportion of them, and interactions are affected by a climate of distrust where stigmatisation processes can emerge between users of different drug categories. This casts a certain amount of doubt on the thesis that marketplace forums – like online forums – are new forms of harm reduction and peer-led communities.

The study focuses on only one marketplace forum. Other such forums should be analysed to corroborate its findings.

Harm reduction interventions in the online environment should take different form according to the forum type, and take the differences and boundaries that separate users of different substances into account.

Thanks to its infrequently used qualitative approach, the study provides a more thorough understanding of the relationships on marketplace forums.

The purpose of this paper is to describe and summarize the recent emergence of NPS onto the drug market. To show the international and national responses, legal and guidance. To indicate some of the challenges NPS present to jurisdictions. To indicate some of the challenges NPS present to treatment agencies. To outline what is known about prevalence and effects.

A narrative account of the substances becoming known and the response made by jurisdictions.

The use and effects of NPS are slowly becoming known and exchanged between jurisdictions and treatment agencies. The user group appears to differ from the “traditional” substance users groups with which agencies are familiar. The use of the internet is a characteristic of this new market and user group.

New substances are constantly being identified. Previous treatment approaches may not be fully relevant to NPS. The new area of cognition enhancement is being gradually realized.

Treatment agencies need to develop new approaches, both to treat the effects of NPS use and to attract NPS users, who do not identify as “drug users”.

A new user group appears to be emerging. Cognition enhancement is a feature of NPS composition and use/attraction.

An attempt to summarize existing understanding of NPS use and marketing and to predict future trends and needs.

Drug-related web forums have been argued to be an effective way to investigate the latest generation of drug users. The purpose of this paper is to explore discussions about drugs and new psychoactive substances (NPS) on an Italian psychonauts’ online community in order to gain a better understanding of the psychonauts’ profiles by scrutinising their main motives for consumption, which is mainly addressed to psychedelic drugs.

To collect data, a keywords list was used in the forum search engine. The first five most recent conversations (threads) for each of ten most frequently mentioned substances were selected. In addition, ten posts written by new forum members to introduce themselves were added to the data set, bringing the total number of threads to 60. The data were coded using Atlas.ti 7 applying a template model analysis (King, 1998).

The forum members present themselves as well-educated, informed drug users, and connoisseurs of the pharmacological properties of chemical compounds: accordingly, they claim to be aware of drug effects and possible risks. The analysis of the motives for using psychedelic drugs substantially confirms previous studies, indicating that the main reasons include spiritual needs, self-exploration and self-treatment. The shift from a recreational use towards more “committed” aims such as self-development is seen as a step forward in a drug user’s career. A generalised interest in harm reduction suggests that the psychonauts’ attitude may be a protective factor against adverse consequences of drug use. The most problematic users represented in the data are those who use drugs for self-treatment, since their discourse focusses on suffering rather than on pleasure.

Most efforts to analyse and monitor drug-related forums have focussed on “leading edge” English-language international websites. No studies have dealt with Italian forums. Furthermore the study address a misleading use of the term e-psychonauts recently introduced by some scholars whose’s studies were focussed on NPS.

“Spice” products are synthetic cannabimimetics (SC; also called “synthetic cannabinoids”)-based designer drugs used as a legal alternative to cannabis for their very strong tetrahydrocannabinol (THC)-like effects. The purpose of this paper is to provide an analysis of more recent clinical and pharmacology/toxicology findings relating to SC and describe how they could impact on health, with a particular focus on mental health.

A systematic search and descriptive analysis of the available evidence on psychopathological issues related to misuse was performed here, whilst taking into account the Pubmed/Medline databases, a range of conference proceedings and national/international agencies’ reports.

While THC is a partial agonist, SC are full agonists on the cannabinoid receptors (CB-rs) and the administration of multiple SC can produce additive and/or synergistic agonistic interaction effects on the endocannabinoid system. These levels of strong CB-rs’ activation may be high enough to produce severe physiological and psychological disturbances. The available evidence suggests an existing relationship between SC use and psychosis (“Spiceophrenia”). The acute SC intoxication is usually characterized by tachycardia/hypertension; visual/auditory hallucinations; mydriasis; agitation/anxiety; tachypnoea; nausea/vomiting; and seizures.

The absence of clinical trials and longitudinal studies, together with the heterogeneity of SC compounds does not facilitate a precise assessment of the health risks related to their use, with long-term effects being of particular concern.

Appropriate, non-judgemental, prevention campaigns with a special focus on the differences between SC and cannabis may need to be organized on a large scale. At the same time, clinicians need to be regularly updated about novel psychoactive substances, including SC, to promptly recognize signs/symptoms of intoxication.

The purpose of this paper is to provide health professionals with novel psychoactive substances (NPS) clients with up to date information relating to the background, clinical pharmacology and, when possible, clinical management for each of these categories.

The world of NPS is complex and diverse, including a range of different molecules such as: psychedelic phenethylamines; synthetic cannabinoids, cathinone derivatives; novel stimulants; synthetic opiates/opioids; tryptamine derivatives; phencyclidine-like dissociatives; piperazines; GABA-A/GABA-B receptor agonists; a range of prescribing medications; psychactive plants/herbs; and a large series of performance and image-enhancing drugs. These molecules are sought by users for their psychactive effects.

The NPS categorization and classification provided here is an attempt to identify and better understand some of these substances. Given the vast range of medical and psychopathological issues associated with the NPS described it is crucial for health professionals to be aware of the effects and toxicity of NPS. The EU-MADNESS project aims to both better understand the pharmacology of the available/forthcoming NPS and to disseminate the most current NPS-related information to practising and training health professionals.

Further studies are required to identify a range of evidence-based, NPS-focused, clinical management and treatment strategies.

The rapid pace of change in the NPS online market constitutes a major challenge to the provision of current and reliable scientific knowledge on these substances.

The present review will provide an overview of the clinical and pharmacological issues related to a few hundred NPS.

The purpose of this paper is to present the results and context of the drug checking service (DCS) performed by the harm reduction project Échele Cabeza (EC) in Colombia.

Data from several years are presented with a focus on data from 2021. In 2021, data were derived from 2,339 questionnaires filled out by DCS users and a total of 2,868 drug checking test results from samples collected at the fixed-site service in Bogotá and 30 music festivals in 8 cities nationwide.

The tusi phenomenon is gaining strength in Colombia revealing a problem associated with the changing makeup of tusi and, thus, polydrug use. MDMA adulteration and misrepresentations have increased in comparison to 2019. There is an increasing number of people who want to use the DCS in Colombia, which is encouraging but also exposes the limitations of the drug checking methods available to EC.

This paper offers the first publication of the pioneering drug checking organization EC in Latin America.