NPS TaxonomyA framework for classifying new psychoactive substances

Russell Newcombe3D Research, Liverpool,

UK26th March 2015

ESRC Seminar Series New Drugs: Drug Markets in Transition

Van Mildert College, Durham University

Three things the study of

NPS needs:1 Workable definition2 Clear naming system3 Useful classification system(s)

This presentation takes a quick look at 1 and 2, before focusing on 3

Definition of NPS #1New: newly made (recently re/discovered) newly formulated (eg. palcohol) newly marketed (mass-produced & sold) newly used (rise in use to notable levels)

Operational definition of ‘new’ in NPS:E.G. since 2009 – the year from which MoDA began to be routinely amended to control the growing numbers of NPS

Definition of NPS #2Psychoactive substance = drug Therefore: NPS = new drug [cf. seminar title]

– whether remaining a ‘legal high’ or recently controlled

Legal Controlled New (NPS) ethylphenidate benzofurans Traditional alkyl nitrites

methamphetamine

Naming NPS #1Big problems: spelling & pronunciation – apart from getting them wrong, confusion also caused by similar sounding drugs, for instance:mephedrone versusother cathinones, eg. methedrone, methylone

other drugs, eg. Methedrine, methadone

Naming NPS #24 types of naming systemStandard mephedrone amphetamineChemical 4-methylmeth- alphamethyl- cathinone phenethylamine

Trade Meow Benzedrine Miaow Dexedrine

Slang meph, drone, speed, whizz, m-cat, plant-food sulph, dexies

Classifying NPSMany good reasons for having (multiple) consensual classifications of NPS:

> systematic approach to research design (eg. surveys) and aiding comparability of findings

> generalizing research findings to related NPS/NPS-groups

> tailoring treatment/services/advice to users of related drugs

> improving communication about NPS between different professional groups, the mass media, and the public

> flexibility and scope to cover a variety of needs & applications

4 NPS classification systems

Type classified by…Source …where it comes fromLegal …how it is regulatedPsychopharmacological …how it affects brain Psycho-chemical… its mental effects and chemical groups

Sources of intoxication

Chemical Electronic

Natural Synthetic Sensory Electrical

plant fully synth.light-waves brain-

animal semi-synth. sound-waves waves

Intoxication without synthetic drugs

Plant green plant leaves, stalks, seeds, roots, flowers, sap, etc.fungus mushrooms, filament, etc.

Animal body components organs, parasites, eg. dreamfish: Sarpa salpaexcretions/products eg. cane toad: Rhi. marina

Electronic sensory light displays, binauralsbrain-waves brain tuners etc.

Legal status of NPS:UK, March 2015

Medicines Act 1968 prescription only medicine (POM) pharmacy medicine (P) general sales list (GSL)

Misuse of Drugs Act 1971 classes A to C (& TCDOs): max. penalties for offences

schedules 1 to 5: prescribing & dispensing regulations

Drugs banned in UK since 2009

Sch class A class B class C

1 4,4’-DMAR benzofurans khat MT-45 AH-7921 cannabinoids piperazerines tryptamines methoxetamine lysergamides desmethyltramadol NBOMe 2DPMP cathinones

2 ketamine [from C4i] lisdexamphetamine phenazepam 3 tramadol pipradols 4i zopiclone zaleplon GBL, 14BD

20092010 2012 2013 2014 2015 [none in 2011]

Psychopharmacological classification of

drugsPart of brain affected (module, pathway)Neurotransmitters affected: - type of neurotransmitter (anandamides, amino acids, monoamines, peptides, cholinergics) - NT stage affected: release, reuptake, reception - NT level affected: direction (rise/fall) & amount

UK govt considering a ban on drugs which affect CB1 receptor

Neurotransmitter functionsAnandamides modulator; pleasure, motivation

Glutamate accelerator; learning & memoryGABA brakes; relaxationDopamine pleasure, cognition, movementSerotonin mood, memory, drives (ASS)Noradrenaline alertness, aggressionEndorphin pain inhibitionAcetylcholine movement, alertness

NT profiles for drug families SED OPI S1 S2 S3TRYP CANDIS

Anandamides ^Glutamate v GABA ^ ^Dopamine ^ ^ ^ ^ ^ ^ ^Serotonin ^ ^Noradrenaline v ^ ^ ^Endorphin ^Acetylcholine ^ ------------------------------------------------------------------------------------------------------

SED sedative OPI opioid ^ increased v reduced S1 euphoriant stimulant S2 eugeroic stimulant S3 entactogen

TRYP tryptamine CAN cannabinoid DIS dissociative

Psycho-chemical classification

Classification by type of psychological effects andClassification by chemical group --------------------------------------------------------------------

Drug Wheel: 1- level psycho-chemical classification plus 1-level legal status classification

NPS Taxonomy: 4-level psycho-chemical classification: class, family, group & specific drug

Designed by Mark Adley & Drugwatch, 2014/15

.

Inner circle: uncontrolled drugs Outer circle: controlled drugshttp://www.thedrugswheel.com/downloads/TheDrugsWheel_1_2_3_RN.png

Psycho-chemical classification:

3 classes & 9 families(Measham & Newcombe

2015)Depressant Stimulant HallucinogenInebriant Euphoriant PsychedelicSedative Eugeroic DissociativeAnalgesic Entactogen Deliriant

Classification of NPS & uncontrolled drugs. Definitions provided in taxonomy report.

Class: DepressantsFamily Group Specific drugs (examples)Inebriant alcohol ethanol, methanolSedative benzodiazepine phenazepam, etizolam anti-histamine diphenhydramine cyclizine z-drug zopiclone, zaleplon GHB-type GBL, 14BD, GBK kavalactone methysticin, kavain

Analgesic opioid MT-45, AH-7921 kratom mitragynine, hydroxymitra.

Class: StimulantsFamily Group Specific drugs (examples)Euphoriant amphetamine fluoroamphetamine, 4-methylamphet. cocaine dimethocaine, fluorotropacocaine pyrollidine naphyrone, pyrovalerone, MDPV piperazine BZP, TFMPP, mCPP, MeOPP piperidine pipradol, 2DPMP, DPMP, ethylphenidate thiophine methiopropamine, theothinone oxazoline methylaminorex, dimethylaminorex aliphatic amine dimethylamylamine (geranamine)Eugeroic pyridine nicotine, arecoline, cotinine xanthine caffeine, theobromine/theophylline ephedrine pseudo-ephedrine, cathine benzhydril-sulfinyl modafinil, adrafinil, armodafinilEntactogen phenethylamine 25B-NBOMe,25I-NBOMe,bk-2CB cathinone mephedrone, methylone, methedrone aminoindane MDAI, MMAI, 5-IAI, 2-AI, TAI, ETAI benzofuran 5-APB, 6-APB, bromo-dragonFLY, 2CB-FLY

Class: HallucinogensFamily Group Specific drugs (examples)Psychedelic lysergamide LSA, LSH, ALD-52, AL-LAD, LSZ tryptamine AMT, AET, 5-MeO-DALT cannabinoid JWH-018, AM-2201, CP-47 harmala harmaline, harmine

Dissociative arylcyclohexylamine methoxetamine, diphenidine other NMDA-RA N2O, dextromethorphan diterpenoid salivinorin-A isoxazole muscimol, ibotenic acid

Deliriant alkyl nitrite amyl nitrite, isopropyl nitrite anti-cholinergic atropine, scopolamine hydrocarbon toluene, butane haloalkane chloroform, chlorofluorocarbon

NPS Products Four possibilities

Product contains 1 2 3 4

Listed drug(s) Y N Y NUnlisted drug(s) N Y Y N-------------------------------------------------------------------------------

Uncontrolled drugs Y N Y NControlled drugs N Y Y N-------------------------------------------------------------------------------

E tabs have been found to contain 10+ drugs (traditional & NPS)Mutant NPS products: 2 NPS found to interact, and produce a third

ReferencesMeasham F & Newcombe R (2015). What’s So New About New Psychoactive Substances: definitions, classifications, motivations and key user groups.

In Kolind T, Thom B and Hunt G. The SAGE Handbook of Drug & Alcohol Studies, Volume 1. Sage Publications, 2015 (in press).

AcknowledgementsThanks for help in developing the NPS taxonomy to Fiona Measham and Mike Linnell.

Thanks for comments and feedback on drafts of this presentation to Cher White.

director@3Dresearch.org www.3Dresearch.org