Novel Psychoactive Substances

December 23, 2025 | Fact Sheets, Novel Psychoactive Substances, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet, an UPDATE in a series highlighting these dangerous drugs, examines tianeptine, an unapproved drug commonly sold in gas stations and on the internet as a dietary supplement and causes opioid-like withdrawals....

October 7, 2024 | Controlled Substances, Fact Sheets, Fentanyl, Novel Psychoactive Substances, Opioids, Substance Misuse

“Tusi” is the name given to a new synthetic drug combination that first emerged in the 2010s in Latin America and Europe and is becoming increasingly popular in the United States. The name is a play on “2C,” a group of psychedelic drugs common among clubgoers, which tusi is rarely found to contain. Also called “pink cocaine,” though it usually does not contain cocaine, it is a powder that is dyed with pink food coloring that smells of strawberries. It is typically snorted, pressed into pill form, or mixed with water (called “happy water”). Because tusi is new on the drug scene, not much is currently known about the effects of the drug on those who use it. People who use drugs should be aware of the dangers of using tusi due to confusion regarding the names by which it is known as well as the different drugs used to make it and should use harm reduction practices to prevent adverse effects from its use....

July 12, 2024 | Fact Sheets, Medication Assisted Treatment (MAT), Novel Psychoactive Substances, Opioids, Recovery, Substance Misuse, Treatments

Methadone is one of the three medications approved by the U.S. Food and Drug Administration used for the treatment of opioid use disorder (OUD). Evidence shows that for patients who suffer a nonfatal overdose, subsequent methadone treatment reduces the likelihood of a future fatal opioid overdose by over 50 percent. In 2024, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued the first substantive changes to its federal methadone regulations in over 20 years. This final rule updated and modified several aspects of existing regulations with the goal of expanding the use of methadone for OUD treatment. As part of the revisions, SAMHSA clarified that a hospital, long-term care entity, or correctional facility, if appropriately registered with the Drug Enforcement Administration, can provide and initiate methadone as a treatment for OUD to those with a primary diagnosis other than substance withdrawal or OUD. In this fact sheet the Legislative Analysis and Public Policy Association details changes to the definition of "primary diagnosis" other than OUD regulation. The fact sheet also covers the federal regulatory scheme for methadone to treat OUD and explains what led SAMHSA to revise its regulations. ...

June 28, 2024 | Fact Sheets, Novel Psychoactive Substances, Opioids, Stimulants, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet examines medetomidine, a powerful veterinary sedative that has been appearing as an adulterant in fentanyl mixtures in the U.S. Medetomidine is a synthetic alpha-2 agonist that is used as a sedative in veterinary medicine and sold under the brand name Domitor®. Medetomidine belongs to the same drug class as xylazine, but its potency is 200 times greater, and has a longer duration of action, than xylazine. The U.S. Food and Drug Administration has only approved medetomidine for use in veterinary medicine, and information about the use of the substance in humans is limited. The effects of medetomidine on humans are not well understood but include prolonged sedation, slow heart rate, slowed breathing, and low blood pressure. Similar to xylazine, the combination of medetomidine with other substances, like fentanyl, can enhance or prolong the effects of the substance and place the individual at a higher risk of overdose than from the...

March 18, 2024 | Fact Sheets, Novel Psychoactive Substances, Opioids, Public Safety, Stimulants, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet,  examines xylazine, a powerful veterinary sedative increasingly appearing as an adulterant in heroin and fentanyl mixtures in the U.S., particularly since 2020. Xylazine has a chemical structure similar to compounds called phenothiazines and operates by decreasing the release of norepinephrine and dopamine in the central nervous system, resulting in analgesia, sedation, and muscle relaxation. Xylazine intoxication can result in central nervous system depression, low blood pressure, and slow heart rate. Respiratory depression can also occur, which increases the risk of overdose when combined with opioid-induced respiratory depression. ...

October 31, 2023 | Fact Sheets, Novel Psychoactive Substances, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet examines bromazolam, a novel benzodiazepine that is structurally related to alprazolam (Xanax), which has been a Schedule IV controlled substance in the U.S. since November 1981. Bromazolam is typically found in tablet or powder form and sold mainly via online drug markets under its own name or as “XLI-268.” It has been found mixed with opioids, including fentanyl, and in counterfeit Xanax pills. There is not much information about the illicit use of bromazolam and its effects on the human body in scientific literature, so most of the information currently available about the substance is anecdotal. ...

September 18, 2023 | Fact Sheets, Novel Psychoactive Substances, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association (LAPPA) continues to monitor the emergence of novel psychoactive substances (NPS) appearing on the illicit drug market in the United States. The term “novel” does not denote a brand new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet, the fifth in a series highlighting these dangerous drugs, is an examination of nitazenes....

June 6, 2023 | Fact Sheets, Novel Psychoactive Substances, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association (LAPPA) is monitoring the emergence of novel psychoactive substances (NPS) appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet, the fourth in a series highlighting these potentially dangerous drugs, examines isotonitazene, a synthetic opioid recently classified as a Schedule I controlled substance under the federal Controlled Substances Act....

January 6, 2023 | Controlled Substances, Fact Sheets, Fentanyl, Kratom, Marijuana, Methamphetamine, Novel Psychoactive Substances, Opioids, Prescription Drugs, Stimulants, Substance Misuse, Synthetic Drugs

Millions of people throughout the world use social media platforms (or “apps”) providing an easy avenue to reach a large number of people. Legitimate businesses are not the only ones to use social media apps as a marketing tool. In recent years, drug dealers have turned to such apps to solicit buyers and arrange sales. This fact sheet examines the growing use of social media, by drug suppliers, to surreptitiously advertise to a wide audience, by using apps that offer encrypted or disappearing messages....