Current Trends of Novel Psychoactive Substance Use and Abuse (1.5 CME)
(1.5 CME) In this conference recording from the 2018 Annual Conference, you will learn there continues to be widespread use of novel psychoactive substances (NPS) with the number of different novel psychoactive substances increasing worldwide every year. Understanding global trends is important as new agents are often used or “piloted” in other countries before they become popular in the United States.
Between the years of 2009 and 2016, 739 different NPS were reported by 106 countries to the United Nations Office on Drugs and Crime (UNDOC) (“World Drug Report 2017” 2017). In 2015, the majority of NPS reported to UNODC were synthetic stimulants including cathinones and phenethylamines (36%) and synthetic cannabinoid receptor agonists (32%) (“World Drug Report 2017” 2017) . Equally concerning is the occurrence of “mini epidemics” associated with synthetic drugs leading to hospitalization of multiple users at a time (Monte et al. 2014). 46 clusters of adverse drug events were reported in the US related to synthetic cannabinoid receptor agonists between 2012 and 2015 (Trecki, Gerona, and Schwartz 2015).
Yet, identifying the drugs responsible for these “mini-epidemics” is often challenging due to the challenges involved with laboratory testing. Indeed patients in treatment for substance use disorders may be using NPS particularly due to the difficulty in detection (Wiegand 2015) as development of laboratory assays cannot keep up with the development of new substances, and cost of testing may be prohibitive to substance use disorder treatment centers.
Recognition of use of NPS is thus often based on clinical evaluation (Ninnemann et al. 2016), and best practices for treatment of acute toxicity or chronic use are not well defined (Monte et al. 2017; Ninnemann et al. 2016). It is important for providers in the field of addiction to understand the evolution of novel psychoactive substances, who is using them, signs and treatment of acute toxicity, available laboratory testing, and what is known about long-term sequelae from use of these agents including the potential for addictive disorders (Montanari et al. 2017) and withdrawal in chronic use (Nacca et al. 2013). This knowledge will allow providers to identify and manage patients at risk from complications of use of these substances.
JoAn Laes, MD, Attending Physician, Division of Addiction Medicine, Hennepin County Medical Center, Minneapolis, MN; Core Medical Toxicology Faculty, Minnesota Poison Control System, Minneapolis, MN; Medical Director, Mission Detox Center, Plymouth, MN and 1800 Detox, Minneapolis, MN, ASAM Medical Toxicology workgroup Chair.Dr. Laes' practice is focused on inpatient addiction medicine and toxicology consultation and outpatient treatment of opioid and other substance use disorders. She is board certified in Internal Medicine, Addiction Medicine, and Medical Toxicology. She completed internal medicine residency at Hennepin County Medical Center and medical toxicology fellowship at Regions Hospital in St. Paul, Minnesota.
Dr. Christine Murphy is an Associate Professor in Emergency Medicine and Medical Toxicologist at Carolinas Healthcare System in Charlotte, North Carolina. Dr. Murphy is the Director for the Medical Toxicology Fellowship Program. She received both her bachelor’s and master’s degrees in chemistry from the College of William and Mary and her medical degree from the Medical College of Virginia. She completed her residency training in Emergency Medicine at Virginia Commonwealth University and a fellowship in Medical Toxicology at Carolinas Medical Center. Dr. Murphy is board certified in Emergency Medicine, Medical Toxicology, and Addiction Medicine. Her current research interests include alternative uses for existing antidotes, pediatric addiction, and trends in recreational drugs of abuse.
Matthew Peter Stripp
Dr. Matthew Stripp is a Junior Faculty Member in Emergency Medicine and a Medical Toxicology Fellow at Carolinas Healthcare System in Charlotte, NC. He received his BA in Cell/Molecular Biology with an emphasis in Neuroscience at Washington & Jefferson College in Washington, PA. He received his medical degree at Temple University School of Medicine in Philadelphia, PA. He completed his residency training in Emergency Medicine at Northwell Health in Manhasset, NY. Dr. Stripp is board certified in Emergency Medicine. His current research interests include mushroom toxicity, synthetic cannabinoids, and other emerging drugs of abuse.
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABPM Maintenance of Certification (MOC)
The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1.5 LLSA credits towards ABPM MOC Part II requirements.
ABAM Transitional Maintenance of Certification (tMOC)
This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 1.5 AMA PRA Category 1 Credit(s)™ for completing this course.