Chavant François, Boucher Alexandra, Le Boisselier Reynald, Deheul Sylvie, Debruyne Danièle
Centre d'Addictovigilance de Poitiers, CHU, Poitiers, France.
Centre d'Addictovigilance de Lyon, CHU, Lyon, France.
Therapie. 2015 Mar-Apr;70(2):167-89. doi: 10.2515/therapie/2015001. Epub 2015 Apr 9.
New substances, also known as "designer drugs" or "legal highs" are increasingly available to drug users. Two hundred and fifteen hitherto unlisted substances have been notified by European Union member states since 2005. These synthetic drugs, which have been developed to side-step the legislation on drugs, are analogues or derivatives of existing drugs and medications. The availability of these "legal highs", sold on Internet under various denominations such as bath salt, plant fertilizer, chemical not intended for human use, or spice, is unlimited. The effects felt by users vary, and the substances may be stimulant, entactogenic, hallucinogenic, psychedelic or dissociative. The pharmacological targets also vary, and may be either the increase of extracellular levels of neurotransmitters via different mechanisms (reuptake inhibition, stimulation of intracellular release) or else fixation on specific receptors. Several chemical classes, themselves divided into sub-classes, are involved: phenethylamines, tryptamines, piperazines, cathinones, cannabinoids etc. The toxicity of the main members of these categories is increasingly well known, the most deleterious being behavioural effects, physical manifestations, and cardiovascular consequences. However, small variations in their chemical structure can generate effects that are quantitatively different, thus enhancing their toxicity or addictive potential, and much remains to be achieved in terms of knowledge about these new drugs. These substances are indeed present on the French territory, as shown by data provided by the Observatoire Français des Drogues et Toxicomanies, and notifications by the French Addictovigilance network. Screening in clinical toxicology laboratories is not widespread, since these molecules are not detected by the standard screening tests, so that there is probably an under-estimation of the use of these new drugs. The legislation on these substances changes regularly, with more and more countries classifying them as "narcotics" or illegal psychotropic drugs so as to restrict their use, applying a generic classification when possible.
新物质，也被称为“策划药”或“合法兴奋剂”，越来越容易被吸毒者获取。自2005年以来，欧盟成员国已通报了215种此前未列入清单的物质。这些合成药物是为规避毒品立法而研发的，是现有毒品和药物的类似物或衍生物。这些“合法兴奋剂”在互联网上以各种名称出售，如浴盐、植物肥料、非供人类使用的化学品或香料，其供应不受限制。使用者感受到的效果各不相同，这些物质可能具有兴奋、致幻、迷幻或分离作用。其药理靶点也各不相同，可能是通过不同机制（再摄取抑制、刺激细胞内释放）提高神经递质的细胞外水平，或者是作用于特定受体。涉及几个化学类别，每个类别又分为子类：苯乙胺类、色胺类、哌嗪类、卡西酮类、大麻素类等。这些类别的主要成员的毒性越来越为人所知，最有害的是行为影响、身体表现和心血管后果。然而，其化学结构的微小变化可能会产生数量上不同的效果，从而增强其毒性或成瘾潜力，在这些新药的知识方面仍有许多有待完成的工作。法国毒品和毒瘾观察站提供的数据以及法国药物警戒网络的通报表明，这些物质确实存在于法国境内。临床毒理学实验室的筛查并不普遍，因为这些分子无法通过标准筛查测试检测出来，因此可能低估了这些新药的使用情况。关于这些物质的立法经常变化，越来越多的国家将它们归类为“麻醉品”或非法精神药物，以便限制其使用，并尽可能采用通用分类。
