SUSANA HENRIQUES
MARIA DAS DORES GUERREIRO
JOANA PAULA SILVA
New Psychoactive Substances:
towards a conceptual delimitation
Análise Social, liv (4.º), 2019 (n.º 233), pp. 804-826
https://doi.org/10.31447/as00032573.2019233.06
issn online 2182-2999
edição e propriedade
Instituto de Ciências Sociais da Universidade de Lisboa. Av. Professor Aníbal de Bettencourt, 9
1600-189 Lisboa Portugal — analise.social@ics.ul.pt
Análise Social, 233, liv (4.º), 2019, 804-826
New Psychoactive Substances: towards a conceptual delimitation. New Psychoactive Substances (nps) are a relatively
recent phenomenon characterized by continuous expansion
throughout more or less the entire world in the last decade.
They include a diversity of natural or synthetic substances that
are not yet on official lists and whose great variety and rapid
transformations make the nps concept itself hard to define.
Methodologically combining qualitative methods in order to
present a problematized systematization of national and public
policies, and quantitative ones presenting the results of a survey applied to users of nps in Portugal, the paper contributes to
a more precise definition of nps and their effects and to know
about the evolution of the applicable legal framework.
keywords: New Psychoactive Substances; conceptualization;
public policies; virtual dimension.
As Novas Substâncias Psicoativas (nsp): discussão conceptual. O fenómeno das Novas Substâncias Psicoativas (nsp)
é relativamente recente e caracteriza-se por um crescimento
contínuo na última década, um pouco por todo o mundo.
Inclui-se aqui uma diversidade de substâncias naturais ou
sintéticas, que não se encontram ainda enquadradas nas listagens dos organismos oficiais. A sua grande variedade e rápida
transformação configuram dificuldades de delimitação conceptual. Com base numa estratégia metodológica que combina
métodos qualitativos, na sistematização problematizada das
políticas públicas nacionais e quantitativos, nos resultados de
um questionário aplicado a consumidores portugueses destas
substâncias, o artigo apresenta um contributo para a definição
e evolução do enquadramento legal do fenómeno, das substâncias e dos seus efeitos.
palavras-chave: Novas Substâncias Psicoativas; discussão
conceptual; políticas públicas; dimensão virtual.
https://doi.org/10.31447/as00032573.2019233.06
SUSANA HENRIQUES
MARIA DAS DORES GUERREIRO
JOANA PAULA SILVA
New Psychoactive Substances:
towards a conceptual delimitation
I N T RODU C T ION
New Psychoactive Substances (nps) are a relatively recent phenomenon characterized by continuous expansion more or less all over the world in the last
decade. They include a variety of substances that can be either natural or synthetic and are not yet on the lists published by official entities, because their
effects have not yet been tested and because they enter the market so quickly
(emcdda, 2014). nps are thus a threat to public health (emcdda, 2011), particularly for young people, who account for most of their users (emcdda, 2015;
2016). In general these substances include: synthetic substances created to
mimic the effects of conventional substances and thereby circumvent the legal
restrictions in the drugs field; substances that were developed in pharmaceutical laboratories, but for some reason were either not put on the market as
medicines, or were marketed but then withdrawn; and natural or synthetic
substances sold with the indication that they are not for human consumption
(examples include bath salts, plant fertilizers, incense). These psychoactive
substances are constantly appearing, and are called “new” partly because they
are compounds that have just been created or recreated, but also because they
have only recently arrived on the drug market. They can be chemical innovations per se, or the way in which their components are used can have recently
changed.
This dynamic and continuous ability to transform, which characterizes
the new psychoactive substances field, is the subject of this article, because
it is what makes nps difficult to define and conceptually delimit, and thus in
turn imposes constraints on the development of knowledge about the topic.
This is especially true of the applicable legal framework, levels of prevalence,
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and consumption patterns. We have experienced these difficulties first-hand
as part of the project “nps: Transnational project on different user groups, user
characteristics, extent and patterns of use, market dynamics, and best practices
in prevention – nps:Trans”. This study was undertaken within the remit of a
transnational and interdisciplinary eu-funded research project (Benschop et
al., 2017) in six eu countries: Germany, Hungary, Ireland, the Netherlands,
Poland, and Portugal. The results will enable us to offer a number of illustrations of the Portuguese case throughout this article. Having said this, although
the article focuses on the Portuguese context, our reflection on the delimitation
of the nps concept will necessarily take account of the international framework
in general and the current European guidelines in particular.
nps derive their particularities from the dynamics of both the drug markets and the overall consumption of substances in today’s networked societies.
In other words, one of the characteristics of a networked society (Castells,
2002) is linked to the way the latter not only influences the dynamics of legitimate sectors of the economy, but also the way it affects developments in the
illicit market. Factors such as low-cost travel, the absence of hard borders
between eu states, and mobility programs like Erasmus mean that it has never
been this easy for people to move around. Never before have flows of information and interaction been so widespread and accessible. These two groups of
factors – personal mobility, and flows of information and interaction – have
huge impacts on the markets, in this case the market for illicit substances in
general and nps in particular (emcdda, 2016a).
In order to address the complex questions involving new psychoactive
substances, we must therefore begin by giving a general overview of the public
debate that has taken place since the issue first arose and as the relevant legal
framework has been developed. It is thus necessary to look at the phenomenon
from the time when it first surfaced until the present day, and to identify the
nps universe, from the point of view of both their appearance on the market
and what they signify for the subjects who use, produce, or simply sell them.
This in turn implies contextualizing and understanding the substances’ significance in contemporary technological consumer societies, which are divided
between the real and virtual planes on which individuals act, and singling out
their importance for and impact on the various dimensions – current, political, scientific – of the discourse linked to the subject.
M E T HOD S
We start with a brief overview of practical and ethical issues that were addressed
related with the methodology.
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
This article focuses on the Portuguese reality about nps, but it arises from
a transnational and interdisciplinary eu-funded research project, “nps: Transnational project on different user groups, user characteristics, extent and patterns of use, market dynamics, and best practices in prevention – nps-trans”
(see Korf et al., 2018 and Van Hout et al., 2018 for a detailed description of
the study methods). The project’s data-collection process included a document-based analysis of each country’s public policies on drugs, and a survey
among nps users.
Fieldwork occurred in 2016. Eligibility criteria among respondents for the
survey were: recent nps use (at least once in the past 12 months); resident of
the participating countries; and 18 years or older. The final sample of recent
nps Portuguese users consists of 281. The data were screened/cross-checked
for errors and analyzed using spss V.24. Analysis was conducted using anonymized data and involved descriptive statistics, including frequencies and
percentages.
In order to discuss the concept of nps in legal terms but also for its users
in Portugal, this article is based on data collected in the Portuguese country
report (Henriques et al., 2018) and the responses of Portuguese nps users. The
results of this inquiry are noted in the next section and whenever necessary are
complemented with European data.
P U B L I C P OL I C I E S A N D N P S
The nps phenomenon is essentially tied to the emergence of smartshops in
both Portugal (Calado, 2013) and other European countries – e. g. the Czech
Republic, Romania, and Poland (Grund et al., 2016). Between 2007 and
2013, there were 60 physical shops located all around the country (mainland
and islands, see Table 1) and another seven operating online (Goulão, 2013;
Calado, 2013). During this period, these new psychoactive substances were
usually bought from these specialized points of sale.
Identified and publicized as legal substances during the period in which
such smartshops existed (no longer the case), this physical and virtual trade
network tended to make the nps that were sold in Portugal cheaper and easier
to acquire than conventional drugs.
The ways in which these substances were initially referred to – “legal drugs”,
“smart drugs”, “legal highs” – conveyed false ideas that their use was legal, riskfree, had positive effects, and consequently engendered a certain permissiveness. The authorities started looking for a more proper designation for these
substances that would characterize the phenomenon and reverse the mistaken
idea of a lack of harm that was associated with the substances at the time. In
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TABLE 1
Smartshops in Portugal, by District and Municipality (Calado, 2013)
Number of shops by District
Number of shops by Municipality
Aveiro
1
Aveiro
1
Beja
1
Beja
1
Braga
2
Braga
2
Coimbra
2
Coimbra
2
Évora
2
Évora
2
Albufeira
2
Faro
1
Lagos
1
Portimão
2
Caldas da Rainha
1
Leiria
1
Cascais
1
Lisboa
14
Sintra
3
Torres Vedras
3
V. Franca de Xira
1
Porto
4
Póvoa do Varzim
1
Santarém
1
Entroncamento
1
Almada
2
Barreiro
1
Montijo
1
Setúbal
1
Faro
Leiria
Lisboa
6
2
22
Porto
5
Santarém
2
Setúbal
5
Viana do Castelo
1
Viana do Castelo
1
Vila Real
2
Vila Real
2
Viseu
2
Espinho
1
Viseu
1
Ponta Delgada
1
Ponta Delgada
1
Total
56
56
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
2010 the term “New Psychoactive Substances”, a designation that incorporates
a warning of the danger they entail (emcdda, 2011), was introduced in official, legal, and scientific discourse. However, the term was officially adopted in
Portugal only in late 2012.
New Psychoactive Substances were thereafter defined as “a new narcotic
or a new psychotropic, pure or in a preparation, which is not controlled by
the 1971 United Nations Convention on Psychotropic Substances, but which
may constitute a threat to public health comparable to that of the substances
listed in those conventions” (see the sicad website).1 In accordance with the
same logic, smartshops were also termed “points of sale of new psychoactive
substances” (Calado, 2013).
As to the legal framework for nps, Law no. 13/2012 of 26 March 2012
amended Executive Law n.º 15/93 of 22 January 1993 (the nineteenth time this
Law was amended), which approved the legal regime governing the trafficking in and use of narcotics and psychotropic substances. The list of controlled
substances was lengthened with the goal of adapting the official position in
relation to the growth of the nps phenomenon, and two nps (mephedrone and
tapentadol) were placed on the list of illicit substances. At around the same
time the Autonomous Madeira Region experienced a substantial increase in
the sale and use of nps, and this led to the publication of the first regional legislation with rules on protecting the population and reducing the offer of “legal
drugs” (Regional Legislative Decree n.º 28/2012/m of 25 October 2012). All six
shops in the Region were closed as a result.
This was an emerging phenomenon that changed considerably and
continually. The information available on the effects of harm linked to the
(ab)use of these new substances was always limited and confusing, with serious implications for public health. In this respect, the Portuguese Parliament
recommended that the government “approve rules for the protection of public
health and take measures in this regard. [Considering the] consensus that has
formed on the danger of new psychoactive substances that are already known,
and thus the likelihood that new administrative offences will be created in the
future, it was seen as indispensable to establish anti-nps health measures with
immediate effect” (Resolution no. 5/2013 of 28 January 2013).
Shortly thereafter the government issued new legislation defining the legal
regime governing the prevention of and protection against the advertising and
sale of the new psychoactive substances that were already known and others
that might appear on the market in the future (Executive Law n.º 54/2013 of
1
http://www.sicad.pt/pt/paginas/search.aspx?k=Novas%20Subst%C3%A2ncias%20Psicoativas.
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17 April 2013). Under these new rules, it became unlawful to produce, import,
export, advertise, distribute, sell, or possess nps or make them available. The
new legislation also included Ministerial Order n.º 154/2013 of 17 April 2013
(referred to in Art. 3 of the Executive Law), which approved the list of new
psychoactive substances and made 159 new substances illegal in Portugal.
These changes in the law immediately led to the nationwide closure of the
smartshops, and nps are currently available only on the illicit market.
Alongside the official definition of new psychoactive substances, studies
designed to monitor the situation were undertaken in/by various countries and
organizations. We mention two examples in particular: “nps in Europe”, which
focuses on nps among so-called problematic drug-users; and “nps:Trans”,
which is seeking to underatand nps usage patterns by looking at three groups
of users – online, recreational, and marginalized.
Another of the responses that accompanied the alterations in the law
entailed the exchange of information, risk assessments, and nps control
between official European organizations. In particular, emcdda, the Council
of Europe, and the European Union Agency for Law Enforcement Cooperation (europol) created a European Early-Warning System (ews) designed to
constantly flag and investigate the appearance of new psychoactive substances
on the market, thereby making it possible to quickly transmit and swap information on the manufacture of, use of, and trade in nps between the Member
States.
It is important to note that the appearance on the drug markets of new
substances that are not yet controlled by official national and international
mechanisms and the latter’s subsequent adaptation to the novelties is nothing new. What is new is the dynamic that the market has witnessed in recent
years in which new substances are concerned. This dynamic has resulted from
exploitation of the growing production capacity, not only in northern European countries (emcdda, 2016a), but also in China and India, as well as from
the globalization of commercial exchanges and the role of the internet (Brandt,
King, Evans-Brown, 2014).
N P S : E VOLU T ION , C AT E G OR I E S , A N D E F F E C T S
As mentioned above, the term “new psychoactive substances” refers to a vast
and heterogeneous range of substances that are used for recreational and other
purposes, and represent a growing and increasingly prevalent trend in the
drug market. In 2009 –2014, the eu’s Early-Warning System recorded 541 new
psychoactive substances – a figure suggesting that novelties were appearing on
the market in terms of both offer and demand. Seizures of nps grew six fold
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
between 2008 and 2013 (emcdda, 2015). In 2014 the ews database recorded
about 450 nps (compared to 430 in 2013), 69 of which were reported for the
first time (unodc, 2015).
The diversity of nps and the speed with which they appear explain why people have found it hard to categorize, identify, and list all of the nps on the market. Although a whole range of bodies have sought to establish nps typologies,
even when different approaches and designations are attempted, concretely
typifying nps is currently one of the greatest challenges, despite the efforts
that are being made to do so. The official United Nations Office on Drugs and
Crime2 website groups nps into nine categories based on their predominant
characteristics: aminoindanols; ketamine and phencyclidine-type substances;
phenethylamines; piperazines; plant derivatives; synthetic cannabinoids; synthetic cathinones; tryptamines; and others. Although the European Monitoring Centre for Drugs and Drug Addiction also divides nps into nine different
groups – piperazines; benzodiazepines; arylamines; tryptamines; opioids;
phenethylamines; synthetic cannabinoids; synthetic cathinones; and others –
its list includes new compounds. This way of organizing these substances highlights the role phenethylamines, cannabinoids, and synthetic cathinones have
been playing in the European context (emcdda, 2016b). More recently, other
ways of (re)organizing and presenting the groups of nps that exist on the drug
market have arisen. Examples include: synthetic cannabinoids; synthetic cathinones; piperazines; phenethylamines; ketamines and phencyclidine-type substances; tryptamines; benzofurans and synthetic opiates; and others (Zawilska,
Andrzejczak, 2015).
In Portugal, official and regulatory definitions of nps divide them into
seven main groups: phenethylamines and their derivatives; piperazines and
derivatives; cathinone derivatives; synthetic cannabinoids; cocaine derivatives/analogues; plants and their active principles; and others, including ketamine (Calado, 2013, p. 18). The case of ketamine illustrates another difficulty
with classifying nps, which is related to the fact that the reality of use in each
country can influence the decision whether or not to include some substances
in an nps category. In Portugal, ketamine is officially included in the “others”
group, but this is not so in other European countries, as we can see from the
emcdda (2016b) classification.
Highlighting the speed with which new psychoactive substances arise,
various authors (e. g. Zawilska, Andrzejczak, 2015) have been noting the existence of a “second generation of new substances” brought about by changes
to the compounds used in nps that have already been identified, which are
2
www.unodc.org
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made in order to try to circumvent legal and regulatory responses and amendments as they appear. The great variety and variability of the components in
new psychoactive substances lead to large differences in terms of biological
activity, pharmacological parameters, and effects on subjects, all of which have
major implications for their definition, classification, and identification, both
by agents involved at the political, social, chemical, medical, and other levels,
and by users themselves.
These difficulties are compounded by another, which is linked to the different denominations used to identify new psychoactive substances. The fact
is that nps are referred to by a wide range of “monikers” (street and brand
names) and the scientific names of compounds or chemical formulae. For
example, there are products whose composition includes α-pvp (α-pyrrolidinovalerophenone) with street names like “Ocean Breath”, “Fire Ball”, “Total
speed”, “Sensation”, “Speedway”, “Guarana Coco jumbo”, “Energy 3 (nrg-3)”,
and “Sextasy” (emcdda, 2015).
Given these difficulties with classifying and grouping these new substances, we propose a system that is based on the type of substance and its
primary effects on the central nervous system, and is capable of encompassing the various categories of nps: synthetic cannabinoids; synthetic stimulants;
hallucinogens/psychedelics; and opiate-type synthetics.
Like many other drugs, the origins of synthetic cannabinoids lie in experimental laboratory work, in this case in the middle of the first decade of the
21st century. The market for those substances then began to develop quickly
and clandestinely, culminating in large numbers of products coming onto the
market as cannabis alternatives (Castaneto et al., 2014). Over the course of
2014, the eu ews identified 134 nps of a synthetic cannabinoid type, which
makes them the largest group of nps available on the market. Current street
names include “Spice” in Europe, “k2” in the us, “Kronik” in Australia and
New Zealand, and “Fidel-Mix” in Portugal (sicad, 2013, 2014; Silva, 2012;
Zawilska, Wojcieszak, 2014).
Synthetic cannabinoids are sold as herbal mixtures for smoking, and they
are presented in packaging decorated with a variety of drawings and other
images. The majority are produced in China and combine a mixture of herbs
(e. g. melissa, mint, thymus, damiana) dissolved or pulverized in/with acetone,
ethanol, or methanol. After drying, this compound is generally presented in
the form of a powder (emcdda, 2015a). There is limited available information on the volume of synthetic cannabinoids that is consumed (emcdda,
2016b). In Portugal their use was more prevalent at the time of the smartshops,
between 2007 and 2013 (sicad, 2013; Silva, 2012), but it now appears to represent a smaller proportion of the overall market. In the “nps:Trans” project
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
in Portugal, around 20% of the respondents to the questionnaire-based survey
(not representative of the general population) said that they had used synthetic
cannabinoids in the last year.
The relative importance of these substances can be seen in the fact that
by December 2015, the eu ews had notified emcdda of the existence of 160
synthetic cannabinoids belonging to 14 chemical families (emcdda, 2016b).3
They are also important because emcdda has recorded a range of adverse
occurrences with serious effects for human health as a result of the use of these
substances (ibid). However, current knowledge about the pharmacological and
toxicological effects of some synthetic cannabinoids is still limited – a limitation that is accentuated by the speed with which new variations and evolutions
in the application of the substances appear on the market. One example is the
inclusion of synthetic cannabinoids in the liquid used in electronic cigarettes
and associated with the increasingly popular vaping phenomenon (ibid).
Turning to synthetic stimulants, cathinones are another large group of nps
that are available on the market. Synthetic cathinones and their derivatives
comprise compounds that are chemically related to cathinone, which in the
last decade was a class of substances that hit the market in a big way, namely in
the form of recreational drugs and alternatives to psychostimulant substances
that were already controlled (e. g. amphetamines, methamphetamines, and
mdma). Essentially presented as “plant fertilizers”, “bath salts”, or “research
chemicals”, these substances currently constitute the second-largest group of
nps available on the European market. Between 2005 and 2014 the eu ews
mechanism identified more than 80 cathinone-derivatives (emcdda, 2015a),
with the most popular seeming to be mephedrone, methylone, and mdpv
(3,4-dimethoxypyrovalerone).
Although many substances have been deliberately created in order to avoid
drug legislation, others result from substances that were originally developed
by the pharmaceutical industry and for one reason or another were either not
put on the market, or were withdrawn from it. Many of the new substances
that have recently entered the market are the result of the rediscovery of these
pharmacological compounds and their commercial potential when offered on
the drug market.
This picture includes synthetic cathinones that are not really recent.
Mephedrone, for example, was first synthesized in 1929, pmma in 1938, and
3
The European Monitoring Centre for Drugs and Drug Addiction (2016b) has published
an interactive model for simulating the chemical composition of synthetic cannabinoids, which
clearly displays their complexity – Interactive: demystifying the chemistry in http://www.emcdda.
europa.eu/topics/pods/synthetic-cannabinoids#panel2.
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mdpv in 1969 (unodc, 2013). However, they became a major market presence
only in the last decade. Mephedrone and its derivatives thus ended up being
placed on the 1971 Drugs list on 16 April 2010, and on the Portuguese equivalent in 2012, with the implementation of Law n.º 13/2012 of 26 March 2012,
which added mephedrone and tapentadol to the annex of tables of psychoactive substances that are illegal in this country. Despite this, the substances’ high
level of popularity and the ease and speed with which they can be produced
have meant that the new laws have not sufficed to keep them off the market,
with the appearance of new compounds that are analogous to mephedrone,
such as: 4-mec; 4-meppfvp; 4-mppp; and pvp, which is analogous to mdpv
(Zawilska, Andrzejczak, 2015).
Other nps with stimulant psychoactive effects include the compounds 5and 6-apb, which appeared on the recreational drug market in 2010-2011 and
are analogous (compounds with a similar, albeit slightly modified, molecular
structure) to amphetamines, such as benzofuran. We also find aminorex analogs, such as 4,4’- dmar and mdmar. This compound was originally synthesized in pharmaceutical laboratories in the mid-1960s and was registered in
Europe as an appetite suppressor in 1965, but was withdrawn shortly thereafter due to its collateral effects (above all, pulmonary hypertension). Aminorex then reappeared on the recreational drug market a few years later, and
emcdda identified it in 2012 and included it on the nps list in 2014 (emcdda,
2014). Available as powders or pills, many of these substances surfaced with
names that are very similar to those of other, more conventional recreational
designer drugs: “Playboy”, “Mitsubishi”, “Transformers”, and so on. However,
given their characteristics, they can appear in the form of ecstasy tablets.
Their most common forms of use are oral ingestion and inhalation (emcdda,
2014a).
When it comes to hallucinogenic nps, of particular note have been the
appearance of compounds like the second generation of -2c phenethylamines
(nbome), methoxetamine (mxe), diphenidine, and 2-methoxydiphenidine. The
structural base underlying phenethylamine is found in various nps – namely
catecholamines and 2c-type drugs. Since 2c-b substances have become legally
controlled, various compounds have been reinvented, synthesized, and placed
on the market. This is the case of the phenethylamine substitutes (nbome)
25b-nbome (2c-b-nbome), 25c-nbome (2c-c-nbome), and 25i-nbome (2c-inbome). Current street names include “n-Bomb”, “Smile”, and “cimbi-5”.
Because they mimic the effects of conventional substances, some of them have
been marketed as lsd substitutes – the case of the 25c-nbome and 25i-nbome
compounds (emcdda, 2015; Zawilska, Andrzejczak, 2015). nbome-type substances can be found on the market in the form of pills, capsules, powder,
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
liquid, spray, or packaged in small individual doses (Zawilska, Andrzejczak,
2015).
Within this group it is also important to mention Salvia Divinorum, whose
active agent, salvinorin A, makes it a short-lived hallucinogen (Deluca et al.,
2009; Calado, 2013). This substance can be found for sale as extracts from
Salvia Divinorum leaves fortified with salvinorin A solution.4 Although Salvia
Divinorum is permitted in some countries, it was made illegal in Portugal on
17 April 2013 (Ministerial Order 154/20135). As such, while it is not necessarily a new substance, the way in which it reappeared and has become part of
new patterns of recreational use makes it a clear example of a new psychoactive
substance.
Finally, we have the synthetic opiate-type substances, which include the
compounds ah-7921 and mt-45. The former was synthesized and patented
in 1976 as an opiate painkiller; the latter was also developed in the 1970s, by
a Japanese pharmaceutical company. Other substances have appeared under
the name “doxylam”, and are made from the ah-7921 compound (emcdda,
2014b).
Our proposed generic classification is not necessarily as exhaustive as it
might be if it were driven by purely chemical and pharmacological criteria. But
it does have the benefit of simultaneously offering a general organization and
a response to the pharmacological diversity, the complexity of the compounds,
and the potential lack of knowledge associated with their rapid evolution and
transformation. A situation that is further accentuated by the large number of
substances and their generally widespread availability.
N P S , T H E I N T E R N E T, A N D T H E V I RT UA L DI M E N SION
OF T H E I L L IC I T DRU G M A R K E T
In the last decade the issue of drugs has changed in various ways, challenging
researchers to stay abreast. Many of these changes have been driven by technological innovation, with impacts not only in terms of new forms of communication and interaction and the ways in which substances are sold, but also
on the theoretical and empirical approaches adopted in recent investigation
in this field. The focus on the role the internet is playing in the offer of and
4
The level of concentration of the bath determines the intensity of the effects, and can range
from 5 times more to 60 times more.
5
“(145) Salvia Divinorum (and the respective constituent psychoactive elements salvinorin
a and salvinorin b)”, Plants and respective active constituent elements, Annex to Ministerial
Order 154/2013 of 17 April 2013.
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demand for illicit drugs in general and new psychoactive substances in particular has been one of the main examples of this, but also one of the primary
challenges when it comes to the more traditional dynamics, which are the ones
that have been most often studied in recent years (new substances, trafficking
routes, forms of acquisition, criminal networks) (Pires, Borges, Valente, 2015;
emcdda, 2016).
The internet is democratizing access to information, ensuring that it
remains accessible to all, while also providing new opportunities. In this digital
scenario, substance users, dealers, researchers, and others with an interest in
the subject of drugs all use technology and take advantage of easy access to the
internet and mobile devices. The development of new means of information
and communication has led to the emergence of discussion forums, webpages,
applications, and other instruments in which the topic of drugs is discussed
and substances are either promoted or argued against, and sometimes sold.
The problematic aspects of drugs are essentially linked to illicit markets,
even in scenarios like the Portuguese one, in which use is not criminalized.
Within this context the option for the parties to remain anonymous and avoid
personal contact is both a self-protective strategy and an advantage within the
dynamic of these online markets.
A number of studies have focused on the question of the online market
for new psychoactive substances, based on the i-trend – Internet Tools for
Research in Europe on New Drugs software, which monitors online nps shops.
“i-trend” has highlighted the virtual dimension of the drug phenomenon,
and especially its capacity to adapt and respond to each country’s or reality’s
markets, cultures, and usage habits (emcdda, 2016a). Other studies point to
the advantages of this virtual dimension of the markets in terms of reducing
interpersonal conflicts, inasmuch as interactions take place only online and on
the basis of anonymity, and substances are potentially less likely to be adulterated because there tends to be a direct relationship between users and producers (Pires, Borges, Valente, 2015).
The changes in national, European, and international legislation seem to
have contributed to the move from physical markets, such as smartshops, to
the virtual market, with the latter in both its surface form (more accessible)
and deep-web form (more restricted, can be seen as the web’s “underworld” –
i. e. the part of the internet that cannot be accessed via conventional servers,
but only from another particular type of website, using “hidden servers” and
specific skills). nps appear above all on the deep web, where they are available
from the darknet or “cryptomarkets” (part of the deep web that is accessible
only via specific browsers that protect users and conceal search and use histories; examples include Tor, which is short for “The Onion Router”, a search
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
engine that hides a computer’s ip address – the primary way of identifying
a subject who uses the internet – and thereby protects their privacy) (Pires,
Borges, Valente, 2015; emcdda, 2016). The “dark” benefit is the fact that it is
currently possible to conduct any type of transaction in this way, and that the
location and real identity of the parties are irrelevant. Similarly, it is possible to
share experiences of using a given substance in real time, thereby promoting it.
There are no legal or other constraints in these commercial spaces (Aldridge,
Décary-Hétu, 2014), identities are protected, financial transactions employ
bitcoins or “litecoins”, and communications are encrypted/encoded.
One of the first cryptomarkets to appear (2011) was the “Silk Road” – a
sophisticated and innovative marketplace in which it was possible to acquire
all kinds of substances at a wide range of prices. One of its innovative characteristics was that it required a whole assessment process designed to ensure
customer satisfaction by means of ratings of/by producers, sellers, and end
users. The goal of this feature of the marketplace was to establish relationships
of trust between users and promote demonstrations of quality and reliability
to potential customers (Aldridge, Décary-Hétu, 2014). The Silk Road was shut
down in October 2013, but other platforms, such as Black Market Reloaded,
The Armory, Evolution, and Agora have since appeared. In accordance with
their mercantilist vocation, these types of platform have gradually improved
the ways in which they monitor all the processes inherent in transactions, and
are considered “resilient” markets – i. e. ones with the ability to adapt to new
adversities and obstacles (emcdda, 2016a).
In short, cryptomarkets are a second generation of parallel networks that
differ from the first ones by their main characteristics (Aldridge, Décary-Hétu,
2014; Van Hout, Bingham, 2013):
1) Payments are made using virtual currency (e. g. bitcoins).
2) Subjects are required to accept an anonymous protocol (e. g. Tor, or the
Invisible Internet Project – i2p), thereby ensuring the absence of identifying elements and eliminating probabilities that the hidden servers
will be traced and identified.
3) Incentives to keep transactions confidential, in such a way as to avoid
the capture and sharing of information about illicit dynamics.
4) Use of an online assessment system, whereby the various parties can
give their feedback about a given transaction, product, or delivery, thereby differentiating and highlighting certain quality criteria.
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N P S , N E W U SE S , U SE R S , A N D SIG N I F I C A N C E
Recent studies suggest that nps may be being sold as traditional substances
(e. g. nbome as lsd), and that this increases the number of unintentional and/or
unaware transactions, above all among certain groups, such as recreational and
problematic drug users (Brandt, King, Evans-Brown, 2014; Grund et al., 2016).
In Portugal, both media pieces and scientific studies have shown the existence of a trend toward nps use among minors (Silva, 2012; European Commission, 2011, 2014). However, there are still difficulties in producing knowledge
in the nps field, on the one hand due to its dynamic and rapid evolution, as
described in this article, and on the other to a certain lack of knowledge about
nps displayed by psychoactive-substance users themselves.
These characteristics – the low level of knowledge, and the existence of
some unintentional and unaware use – were also identified during the fieldwork conducted as part of the “nps:Trans” study. These difficulties underscore
the need to deepen both the knowledge and the discussion about data on the
prevalence of nps use, their effects, and representations about them, as gathered from users themselves.
The results of the questionnaire-based survey applied as part of the project between June and October 2016 indicate that 281 Portuguese persons (the
respondents), the majority of whom were male and between 18 and 46 years of
age, had already used at least one nps – see Table 2.
This table presents the data collected on nps use in a Portuguese context
and developed within the framework of the broader European study. The
TABLE 2
NPS used
Frequency of use %
NPS
In the last 12 months,
but not in the last 30 days
In the last 30 days
Mixture of herbs
7.1
4.6
Synthetic cannabinoids
8.2
11.7
Branded stimulants
6.8
3.9
Stimulants/Empathogens/
Nootropics
11.7
4.6
Psychedelics
35.6
28.8
Dissociatives
10.0
3.6
Others
14.2
19.2
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
prevalence of hallucinogenic and stimulant-type substances confirms the
results of other, earlier studies carried out in the same context, namely that
of Pires, Borges and Valente (2015). However, all our fieldwork highlighted
the fact that these are emerging substances with different origins and natures,
and that there is thus little available information about their bioactive properties, including among users. This means that it is not possible to know the
composition of the substances that are used, except from samples taken by the
country’s drug-testing service. In this respect, it is important to emphasize that
users were asked whether they knew exactly what substance they were taking
(e. g. what mixture of herbs, or what synthetic cannabinoid) and if they knew
what the active agent was. The most common response for all the substances
was “no”. Having said this, and despite these difficulties in terms of recognition
or an apparent lack of knowledge, 21.3% of respondents said their preferred
substance was 2cb (a hallucinogen).
These data once again confirm our above arguments on how difficult
it is to achieve a conceptual definition of nps. However, they also reinforce
the idea that to the extent that many of these substances mimic the effects of
conventional ones, they may be being sold and used as though they were the
latter without their users really being aware of it. The drug-testing services
around Europe, including in Portugal, that are present in recreational contexts – above all, festivals – seek precisely to collect and provide information
on the substances in circulation and their degree of purity. Users are invited to
submit their substances for analysis, and are given the results along with relevant information about reducing risks and minimizing harm (Giné, Espinosa,
Vilamala, 2014; Brunt et al., 2017).
Although almost all of the studies that have been conducted to date suggest a relatively low level of prevalence of nps use in recreational contexts, the
tendency for the number of new substances to rise is likely to continue. This
rising trend is having serious implications in terms of both the risks associated
with use and the number of regular users, and is reflected in difficulties in
finding responses that are appropriate to the problems (Brandt, King, Evans-Brown, 2014) (for example, at the level of the substitutional pharmacotherapy
employed in cases of nicotine or heroin addiction, and of other therapeutic
methods applied in cases of addiction to cocaine or amphetamine-type psychostimulants). Another of the related risks concerns certain forms of use, such as
substance injection. We also know that there are nps that are being consumed
as though they were conventional substances, in situations of false labelling
(when the substance does not correspond to what it is supposed to be, or to
what is written on the packaging) and unintentional nps users (Brandt, King,
Evans-Brown, 2014; emcdda, 2015). This is both a warning and an additional
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SUSANA HENRIQUES, MARIA DAS DORES GUERREIRO AND JOANA PAULA SILVA
challenge for the specialist staff who work in the risk-reduction field. It seems
to us that one cannot dissociate the recent increase in the number of injected-substance users in Portugal from this context.6
Although, as we have already said, drug-users can be induced to consume
nps without their knowledge, and as such the level of prevalence of use may be
being underestimated, the reasons given for using nps do not present substantial differences compared to those given by users of conventional substances.
In the “nps:Trans” project, the reasons respondents gave for their uses are
shown in Table 3.
Among this set of reasons, the ones that stand out are those most directly
linked to hedonism, the search for self-knowledge, and a certain distancing
from reality. An analysis of the phenomenon of new psychoactive substances
in a globalized context should consider a range of mechanisms and forces that
influence it. Some authors, such as Brandt, King, and Evans-Brown (2014) for
example, argue that the use of psychoactive substances at present is likely to be
one of the manifestations of the increasing medicalization of society that runs
right through the debate on and understanding of the concepts of health, performance, fun, and consumption. The nps phenomenon clearly goes beyond
the designer drugs that marked the last decade of the 20th and the first few
years of the 21st centuries, and is now taking on new shapes against the backdrop of an open market, with “legal highs” and “research chemicals”.
Within the context of today’s consumer societies, pleasure is taking on a
market value, and as such, the discussion about nps needs to incorporate two
complementary dimensions. One concerns the improper use of prescription
medicines as an emerging question of global import (Van Hout, 2014). The
other involves dietary supplements, such as products that are widely available
from e-commerce websites, online “pharmacy-food” shops,7 and fitness-related shops. In most cases they are presented as “natural”, in order to exploit
the generalized belief that these are healthy, safe consumer choices. The availability of these products warrants particular attention, because almost none
of their producers and sellers are covered by substance monitoring systems
(Griffiths, Evans-Brown, Sedefov, 2013).
6
In this respect, see e. g. the news item published in Visão magazine on 12 January 2017,
available in Portuguese at http://visao.sapo.pt/actualidade/sociedade/2017-01-29-Os-novos
-casais-ventosos.
7
The equivalent Portuguese term alicamentos (a junction of the words for food – alimentos –
and medicines – medicamentos) refers to products that are presented as medicines (Henriques,
2007).
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
TABLE 3
Reasons for NPS use
Frequency of use %
Motivations *
The majority
of times
Almost always/
/Always
To forget my worries
3.2
1.8
To cheer me up when I’m in a bad mood
4.6
2.5
Alleged legality
1.8
4
To forget bad problems
3.2
2.8
Because I like the feeling
20.6
50.2
Poor quality of other drugs
2.8
1.4
Because they give me a pleasant sensation
20.6
46.6
Because they help me when I’m depressed or nervous
3.6
5.0
To get to know myself better
10.0
14.6
Because it’s fun
18.5
45.9
Because they help me enjoy a party
21.0
29.9
To get high
7.5
22.8
To be sociable
5.0
4.3
Out of habit
3.2
2.5
Because of the price
1.4
1.8
So that people like me
0.7
0.4
Because they make social events more fun
15.7
16.4
Different or new experiences
14.2
32.0
Because they improve parties or celebrations
14.2
19.6
Because they’re undetectable
1.4
1.4
Because I feel more self-confident and sure of myself
5.0
3.6
To be accepted in the group I like
1.8
0.4
To expand my perception
16.4
26.7
Conventional drugs are had to get
2.8
2.5
To not feel excluded
0.4
0.4
Because they help me be more creative and original
8.5
10.0
Out of boredom
1.8
1.1
To understand things in a different way
10.0
18.9
To be more open to experiences
12.5
25.3
To have fun
15.3
47.3
To celebrate a special occasion with friends
14.9
20.6
* It is important to note that these motivations are broken down here in order to permit international comparisons within the broader framework of the “NPS:Trans” European study.
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SUSANA HENRIQUES, MARIA DAS DORES GUERREIRO AND JOANA PAULA SILVA
F I NA L R E M A R K S
The goal of the present article was to contribute to the discussion on a conceptual delimitation of new psychoactive substances, whose opaque nature has
made advances more difficult on various levels: knowledge, policies, and intervention. To this end we began by situating the nps phenomenon in terms of
the relevant public policies; and then presented a proposed nps classification
based on the type of substance and its effects on the central nervous system.
Albeit a general one, this way of organizing these substances is designed to
respond to their pharmacological diversity and the complexity of their components.
In the case of nps, the virtual dimension of the drug market seems to take
on a particular and poorly known dynamic. This dimension is relevant from
the point of view of both the offer of and the demand for nps. With regard
to the former, it is important to understand the routes, the circuits, the flows
of information that are generated, the specific forms of transaction, and the
(re)definition of the roles of the producer vis-à-vis the seller. When it comes
to the latter, it is important to know the profiles of users, the patterns and
prevalences of use, and the characteristics of the interactions and interaction
networks that are established.
The data collected in relation to the Portuguese reality and within the
overall framework of the “nps:Trans” project have enabled us to illustrate the
discussion with empirical information. In particular, the data on the nps that
are in use and the reasons for that use, which were gathered from users in
recreational contexts and virtual environments, result in knowledge that can
potentially impact the definition of strategies for both preventing and reducing
risks and minimizing harm.
In conclusion, there is an indisputable need to increase knowledge about
the nature and usage patterns of nps and the potential risk associated with
the substances, so as to then be able to identify potential areas of intervention
and focal points for the development of preventive strategies (Giovanni et al.,
2015). In this respect, we have pointed to a number of lines of action that
deserve emphasis and are capable of complementing the updates to the substances’ legal status as they gradually come about (Corazza et al., 2012; 2013).
One entails monitoring online activities, which is essential if one is to map
the dissemination of nps. Another involves incorporating technological tools
into specific prevention programs. Finally, the involvement of international
and multidisciplinary partnership networks is especially important in light of
the challenges created by the nps problem, namely in terms of how novel the
substances are and how fast they are expanding.
NEW PSYCHOACTIVE SUBSTANCES: TOWARDS A CONCEPTUAL DELIMITATION
In summary, while all these particularities of nps are common to, and key
factors in, their appearance in certain markets, and although the development
of information and communication technologies is a reality on a global scale,
it is nevertheless necessary to conduct a whole exercise designed to define and
conceptualize nps, because usage cultures and habits appear to vary from one
country, one context, and one user group to another.
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Susana Henriques » Susana_Alexandra_Henriques@iscte-iul.pt » Centro de Investigação e Estudos de
Sociologia (cies-iul), iscte-iul » Edifício iscte, Av. das Forças Armadas — 1649-026 Lisboa, Portugal » https://orcid.org/0000-0002-7506-1401.
Maria das Dores Guerreiro » maria.guerreiro@iscte.pt » Centro de Investigação e Estudos de Sociologia
(cies-iul), iscte-iul » Edifício iscte, Av. das Forças Armadas — 1649-026 Lisboa, Portugal » https://
orcid.org/0000-0002-6990-5604.
Joana Paula Silva » jpaulapbrsilva@gmail.com » Centro de Investigação e Estudos de Sociologia (cies-iul),
iscte-iul » Edifício iscte, Av. das Forças Armadas — 1649-026 Lisboa, Portugal » https://orcid.org/00000001-7938-5094.