ECAD had a very informative conference on the novel psychoactive substances on the Baltic and European scale last week. The conference is the last one of the Baltic Spice Alert Project and it was preceded by a study visit to the Swedish Police and Maria Ungdom health and prevention unit, run by the Stockholm County Council and the City of Stockholm.


The reports presented by the Swedish Public Health Agency and the Swedish Council for information on Alcohol and other drugs underscored important concerns with the problematic forms of NPS use, mixing the new substances with other drugs, including prescription drugs. Harms discussed are related to the certain risk groups of users.

A few speakers mentioned the differences in defining NPS-related fatalities. This factor often let NPS merge with other narcotic substances in drug-related fatalities in the statistical picture or not to be taken into account at all. To sum the discusstion we had, there is a general risk to lose the novel psychoactive substances in a wider drug context. This is a practical issue that leaves room for improvement in the international measurement data for drug fatalities.

Synthetic cannabinoids represent the biggest group of these substances. From a health perspective, many synthetic cannabinoids are considerably more toxic, upsetting the drug misuse statistics of the Baltic region with mass poisonings and even fatalities in the last couple of years.
The presentation of Latvian and Estonian colleagues below have a good overview of the local problematic issues. It seems the cannabinoids have not yet lost their actuality among the Baltic youth and synthetic opioids (like Tramadol) and fentanyl-varieties are catching up in popularity, saturating the already saturated drug market in the Baltic Sea region. Some of these varieties are extremely potent (carfentanyl) and are causing serious trouble in other European countries too. For example, carfentanyl entered the UK market some time ago. In general, the NPS use have overgrown cocaine use in Scotland and Northern Ireland. The number of users is growing steadily also in the UK.

When reflecting on the high numbers of drug-related deaths in Sweden, the conference concluded that one could not accurately measure drug-related fatalities and be sure one had the correct comparable numbers even within one geographical area.


Swedish Public Health Agency`s perspective and work related to the NPS (PDF)
Sara Wall, Analyst, Unit for Drug Prevention, Public  Health Agency of Sweden

Parties to die for: NPS-related health risks among youth (PDF)
Rita Santacroce, MD, Psychiatrist and researcher, PhD student at the Department of Neuroscience, University “G. d´Annunzio”, Chieti, Italy 

Synthetic opioids and NPS (PDF)
Håkan Leifman, Director, CAN, Swedish Council for information on Alcohol and other drugs

City of Stockholm prevention work—general overview (PDF)
Therese Holmkvist, Project Manager, Administration of Social Affairs, City of Stockholm

The world of NPS and overdose (PDF)
John Corkery, BA Hons, MSs, MPhil, Drug Epidemiologist & Senior Lecturer in Clinical Pharmacy Practice, Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research, University of Hertfordshire, UK

Drug-related deaths and synthetic opioids and cannabinoids as seen by the Stockholm Police (PDF)
Lennart Karlsson, Superintendent, Stockholm Regional Police, Sweden

NPS in Latvia— challenges and responses : the Police perspective (PDF)
Angelina Gribova, Senior Inspector, Criminal Police, Latvia

NPS and high numbers of use among Estonian youth (PDF)
Anna Markina, researcher,
University of Tartu, Estonia

Estonian Police work with new synthetic substances (PDF)
Margo Kivila, leading Investigator, Drug and Organized Crime Division, Estonian Police and Border Guard Board

Synthetic opioids and Swedish Substance Maintenance Programme (LARO) (PDF)
Kerstin Käll, Chief Physician, leading LARO specialist in Östergötland, Linköping, Sweden