Novel psychoactive substances (NPS) is the medical term for the many new substances which are chemically related to established recreational drugs such as MDMA and cannabis.

Often referred to as legal highs - a misnomer as their distribution and sale have been illegal since 2016

Stimulants

• similar to MDMA, amphetamines and cocaine, resulting in increased levels of serotonin, dopamine and noradrenaline, resulting in a 'high' and feeling of euphoria
• a common example is a stimulant NPS is mephedrone ('bath salts','M-CAT'.'meow meow'). It is a cathinone and structurally similar to khat, a plant found in East Africa
  • another example is benzylpiperazine ('Exodus', 'Legal X', 'Legal E')
• typically swallowed as a pill/powder ('bombing') or snorted
• adverse effect profile similar to MDMA/cocaine, with the risk of serotonin syndrome

Cannabinoids

• termed synthetic cannabinoid receptor agonists
• commonly referred to as 'spice'
• typically sprayed on to herbal mixtures which are then smoked. Also available in liquid form which is then inhaled using e-cigarettes
• similar adverse effects to cannabis

Hallucinogenics

• can be either dissociatives and psychedelics
• dissociatives produce a similar effect to ketamine, with a sense of not being connected to the physical body or time. A common dissociative NPS is methoxetamine ('mexxy')
• psychedelics have a similar effect to LSD although NPS versions may also be a stimulant