New psychoactive substances in Belgium: current status

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New psychoactive substances in Belgium: current status P. Blanckaert Coordinator Belgian Early Warning System on Drugs Rue Juliette Wytsmanstraat 14 1050 Brussels Belgium T +32 2 642 54 08 F +32 2 642 54 10 email: peter.blanckaert@wiv-isp.be http://bewsd.wiv-isp.be

NPS in Belgium: definition Derivatives of known psychoactive drugs, specifically designed to evade current legislation Not a new phenomenon (USA 1970 s) Used terms/definitions: Analogs Designer drugs Herbal ecstacy / smart drugs Legal highs, research chemicals New Psychoactive Substances (not included in UN Narcotics treaty 1971)

NPS in Belgium Every year ~100 NPS detected in Belgium Rapidly increasing until 2015 ~90% of substances only detected by customs laboratory big transit role for Belgium as «distribution country» Monitoring by BEWSD Estimated use in Belgium seems low, but Influence of high quality of «classic» illicit drugs? Little motivation for widespread NPS use?

NPS in Belgium: harm? Pre-2015 era Most notable: 2012-2013: at least 6 deaths 4-MA! Occasionally: PMA or PMMA EWS alerts mostly for highly dosed MDMA tablets

NPS in Belgium: harm? 2015-2016 2015: 1 death after consumption ocfentanil 2016: Several fatal fentanyl overdose cases (patches+powder) At least 2 deaths after consumption of U-47700

NPS in Belgium: harm? First half of 2017 March 2017: 1 death, injection of U-47700 May 2017: 1 death, sniffing of acrylfentanyl May 2017: 1 death, injection of ocfentanil June 2017: 1 suicide by carfentanil (+ fentanyl) June 2017: 1 death, consumption of 3-MeO-PCP July 2017: 1 death, combo 3-MeO-PCP and U-47700 substances acquired online mislabelled NPS bags found in some cases!

Current drug legislation in Belgium General principle: list of scheduled substances International legislation: United Nations Convention on Narcotic Drugs, 1961 United Nations Convention on Psychotropic Substances, 1971 National legislation: Royal Decree regulating some psychotropic substances, 1998 (framework legislation 1921) 7

Current drug legislation in Belgium Updates: 1999: 4-methyl-thio-amphetamine (4-MTA) 2002: PMA and PMMA 2004: piperazines, TMA, 2C-E 2006: mcpp, Salvinorine 2010: mephedrone 2011: several synthetic cannabinoids e.g. JWH-018 2013: 4-MA, fluoro-amphetamine, 5-IT, 2015: ~100 most frequently encountered NPS added Disadvantage: nominative list quickly outdated 8

Current drug legislation in Belgium Royal Decree 2014: preparatory actions Increasing cannabis growshop nuisance/problems Also aimed at control of novel precursors (APAAN, BMK-glycidate) First time future generic legislation is mentioned 9

Future drug legislation in Belgium Generic definitions of several drug classes definition based on chemical structure Included classes: Amphetamine derivatives (e.g. 4-FA) Cathinones (e.g. pentylone) Synthetic cannabinoids (e.g. AB-FUBINACA) Tryptamines (e.g. 5-MeO-DMT) Piperazines (e.g. mcpp) Fentanyl derivatives 10

NPS in Belgium: generic legislation Fentanyl derivatives

Generic legislation: examples Synthetic cannabinoids

Generic legislation: examples Amphetamine derivatives (phenethylamines) R 4 R 3 R 1 N R 2 R 4 Cathinones O R 1 N R 3 R 2

Generic legislation: examples Piperazine derivatives Tryptamines R 2 R 3 N R 4 N R 6 R 1 R 5 R 3 R 4 N R 1 R 2 R 3 R 2 N N R 1 NH R 4 R 6 R5

NPS in Belgium: generic legislation General principle: Definition of chemical basic structure Definition of chemical analogs using R-groups Inclusion of chemical drawings into legislation itself Advantage: Potentially hundreds of future NPS already controlled Drastically decreased need for update of legislation Disadvantage: Unclear for justice departments which substances allowed What about future NPS with different structures?