{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T18:45:32Z","timestamp":1790448332464,"version":"4.1.0"},"reference-count":161,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T00:00:00Z","timestamp":1546992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: In the last decade there has been a progressive increase in the use of new psychoactive substances (NPSs) that are not yet under international control. In particular, novel synthetic opioids (NSOs) have reappeared on the recreational drug market in the last few years. As a result, the use of NSOs has increased rapidly. This poses an emerging and demanding challenge to public health. Aim: To raise awareness among clinicians and other professionals about NPSs, especially NSOs, to summarize current knowledge about pharmacological properties, forms of NSO on the market, pattern of use, effects and consequences of use. Methods: An electronic search was carried out on the Medline\/PubMed and Google Scholar databases to find selected search terms. Results: Some NPSs are already controlled, while others can be legally sold directly on the drug market (mainly via internet, less so by drug dealers) or be used as precursors for the synthesis of other designer drugs that mimic the psychoactive effects of controlled substances. Potential side-effects of NSOs include miosis, sedation, respiratory depression, hypothermia, inhibition of gastrointestinal propulsion, death (from opioid overdose). Conclusions: The severity of the opioid crisis has intensified with the introduction of highly potent NSOs on the drug market. As long as addicts are dying from overdose or similar causes, there is something more constructive to do than waiting for addicts to overdose on heroin at a place located near a remedy, as if to say, within reach of naloxone.<\/jats:p>","DOI":"10.3390\/ijerph16020177","type":"journal-article","created":{"date-parts":[[2019,1,10]],"date-time":"2019-01-10T03:22:31Z","timestamp":1547090551000},"page":"177","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Non-Medical Use of Novel Synthetic Opioids: A New Challenge to Public Health"],"prefix":"10.3390","volume":"16","author":[{"given":"Barbara","family":"Lovrecic","sequence":"first","affiliation":[{"name":"National Institute of Public Health, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Lovrecic","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, 1000 Ljubljana, Slovenia"},{"name":"Centre for Psychiatry and Addiction Medicine, Izola Health Centre, 6310 Izola, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3885-1308","authenticated-orcid":false,"given":"Branko","family":"Gabrovec","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1447-4947","authenticated-orcid":false,"given":"Marco","family":"Carli","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Pacini","sequence":"additional","affiliation":[{"name":"G. De Lisio Institute of Behavioral Sciences, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo G. I.","family":"Maremmani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Versilia Zone, 55049 Viareggio, Italy"},{"name":"Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, 55045 Lucca, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Icro","family":"Maremmani","sequence":"additional","affiliation":[{"name":"G. De Lisio Institute of Behavioral Sciences, 56100 Pisa, Italy"},{"name":"Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), Pietrasanta, 55045 Lucca, Italy"},{"name":"Vincent P. Dole Dual Disorder Unit, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,1,9]]},"reference":[{"key":"ref_1","unstructured":"UNODC (2013). The Challenge of New Psychoactive Substances, UNODC. Available online: http:\/\/www.unodc.org\/documents\/scientific\/NPS_Report.pdf."},{"key":"ref_2","unstructured":"UNODC (2017). Global Synthetic Drugs Assessment, UNODC. Available online: http:\/\/www.unodc.org\/documents\/scientific\/Global_Drugs_Assessment_2017.pdf."},{"key":"ref_3","unstructured":"EMCDDA (2017, July 10). 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