2026-2027 | On-Demand Session | Novel Psychoactive Substances | October 2026-Novel Psychoactive Substances Recording

Video Transcription

Video Summary

Dr. Ashley Haynes and Dr. Seth Chohan reviewed the rapidly changing landscape of novel psychoactive substances (NPS), including synthetic stimulants and cathinones, synthetic cannabinoids, hallucinogens, designer benzodiazepines, and newer opioid-like products. Online sales and constantly modified chemical structures make these substances difficult to track, identify, and detect with routine drug screens. Products’ names and labels are unreliable, and substances sold as MDMA, LSD, cannabis, or supplements may contain entirely different drugs.<br /><br />The speakers described varied toxic effects, from severe agitation, hyperthermia, seizures, and rhabdomyolysis to prolonged sedation and respiratory depression. They emphasized treating the patient’s clinical presentation rather than waiting for confirmatory testing, which may take days. Management generally includes supportive care, monitoring, and symptom-directed treatment—often benzodiazepines for agitation or stimulant-like toxicity, and naloxone when opioid-related respiratory depression is suspected. Clinicians should also consider medical causes of altered mental status and use collateral information when available.<br /><br />The presentation also covered retail and supplement products, including kratom and concentrated 7-hydroxymitragynine, tianeptine, hemp-derived cannabinoids, and “mushroom” products. These may cause dependence and withdrawal, contain undisclosed compounds, or have unpredictable potency. Finally, the speakers reviewed adulterants and contaminants in the illicit supply, including xylazine, medetomidine, levamisole, and emerging chemicals, which can complicate overdose and withdrawal care.<br /><br />Overall, the key message was that drug contents and effects are increasingly unpredictable. Clinicians should recognize toxidromes, treat promptly, and counsel patients that drug-checking tools can reduce—but not eliminate—risk.

Keywords

novel psychoactive substances

synthetic stimulants

cathinones

synthetic cannabinoids

designer benzodiazepines

online drug sales

toxic effects

supportive care

benzodiazepines

naloxone

kratom

tianeptine

xylazine

drug adulterants

toxidromes