Hair testing for psychoactive substances (NPS): The challenges

Clockwork Orange, Black Mamba, Benzo Fury, Bromo-Dragonfly. These are just a few of the new psychoactive substances (NPS) in existence across the globe - also known as “legal highs”, “herbal highs” or “designer drugs”.

The “new” in their name is misleading, as many of these substances were identified several years ago. The “legal” is also misleading, as the 2016 Psychoactive Substances Act now restricts their production, sale and supply.

The name remains, however. So, what exactly are new psychoactive substances, how are they being tracked and tested, and what are some of the challenges involved?

NPS: The basics

New psychoactive substances is a term that incorporates a number of drugs that were, until the 2016 Psychoactive Substances Act, legal (hence “legal highs”), and designed to replicate the effects of illegal substances such as ecstasy, cocaine, cannabis and others.

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Around 2008/2009 these drugs started to become commonplace on the UK drug scene, and it is suggested the trend began with the heroin drought caused by a drastic fall in both Afghanistan and Thailand’s opium growing capacity. In New Zealand in the 1990s, benzylpiperazine (BZP) was produced and sold online across the globe as a “safe” alternative to methamphetamine (to MDMA in the UK), and numerous other “legal highs” followed suit.

NPS fall into four main categories:

• Stimulants: Drugs that mimic those such as ecstasy, cocaine or amphetamines.
• Downers/Sedatives: Drugs that mimic anti-anxiety drugs or tranquilisers.
• Psychedelics/Hallucinogens: Drugs that mimic those such as LSD.
• Synthetic Cannabinoids: Drugs that mimic the effects of cannabis.

Reported NPS use in the UK

It is relatively low: the 2015/16 Crime Survey for England and Wales reported that only 0.7% of 16-59 year olds had used a NPS in the last year, and 2.7% of adults in their lifetime, with men significantly more likely to have used them than women. These figures were higher, however, for the 16-24 age group, in which 2.6% had used these substances in the last year - again, with the prevalence higher amongst men than women. Worryingly, 2% of 11-15 year olds also stated that they had used NPS in the last 12 months.

There are hundreds of known NPS varieties out there - but potentially also hundreds of unknown new varieties that are being traded and used under the radar of the authorities. This is not only concerning from a health point of view, but also presents challenges when it comes to drug testing.

Current NPS testing methods

New psychoactive substances can be a challenge to detect - meaning they’ve become a popular drug of choice in prisons. However, in 2016 a new bill was passed making NPS illegal in prisons - and 320 sniffer dogs were trained to detect such substances.

These sniffer dogs, however, can only find NPS before it is ingested - and there are two means currently used to test presence within the body.

Sniff it out: Testing is not the only challenge with NPS, police have had to train sniffer dogs for detection

High volume, low cost approach

Urine testing is one such means, using immunoassay testing to measure the presence and concentration of a NPS within the sample. This is a high volume, low cost approach - but it comes with a major drawback: it can take months to develop the materials required for a kit to test for a specific substance, which can be problematic when testing for new NPS.

Agility of response to new substances as they are identified is vital. Hair testing is the preferred method, using mass spectrometry to extract the drug so levels can be tested. While the kit is more expensive, the MS approach speeds up the process: once the lab has the sample and the substance is identified, the details can be plugged into the screening programme within hours.

The challenges of testing

The first major challenge for NPS testing is there is no universal or easy way of conducting an unknown screen.

Every current testing process will be searching for specific, targeted substances. The testing itself is reliable - but blanket tests are not currently possible: labs must know which substance they are looking for before administering a test. We believe that blanket tests are coming, but it could be a decade or more before such testing is possible.

The second challenge is knowing which NPS actually exist.

A 2016 report from the United Nations Office on Drugs and Crime stated that “more than 600 substances have been reported to the UNODC Early Warning Advisory (EWA) on NPS by Governments, laboratories and partner organisations”, but the actual figure could be far higher.

Figures from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) show 560 different NPS being monitored by the centre in 2015, with numbers growing each year. New substances are always being developed, and until a new NPS is used, it is impossible for organisations to create, administer and process suitable tests.

The World Health Organization and the United Nations Office on Drugs and Crime signed an agreement in February 2017 to strengthen drug treatment and care, which includes the analysis of new psychoactive substances. The WHO keep a secret list of NPS (secret, to avoid illicit drug manufacturers knowing which they are aware of), and the scientific community share data between them - but global tracking is difficult, and can be expensive too.  

With the sands constantly shifting...

The challenges of NPS testing are likely to be long-term challenges. New “legal highs” are produced and discovered every single year, and with no singular blanket testing method currently available, testing requires continued research and development.

The usage of such substances remains fairly low compared with “traditional” drugs according to the NHS, but with a higher ease of access and faster developments amongst this set of substances, we’re constantly working to ensure that use of the most common NPS can be tested and proven with a high degree of accuracy.

Only mass spectrometry hair testing has the speed of response required to test newly identified NPS types, and, as such, is the only robust testing approach available today.

Picture credit:
Featured image via Wikimedia Commons

Sniffer dog via Wikimedia Commons