New psychoactive substances continue to put people at serious risk across the Netherlands. Poisoning reports have climbed by 90 per cent every year for more than a decade. That is the stark finding of new research from the Dutch National Poisons Information Centre. It was discussed on the Society for the Study of Addiction’s Addiction Audio podcast.

PhD researcher and toxicologist Annette Nugteren van Lonkhuyzen led the analysis. She examined 14 years of poisoning data from the centre’s round the clock advice line for medical professionals. Her findings show how quickly novel psychoactive substances have moved from a niche concern to a mainstream public health problem.

What Are New Psychoactive Substances?

New psychoactive substances are often shortened to NPS. They are drugs designed to mimic well known recreational substances while sitting outside existing drug laws. As soon as one compound is banned, a chemically tweaked version often appears to take its place.

The Netherlands changed its approach in July last year. Instead of banning individual substances one at a time, lawmakers outlawed entire groups of novel psychoactive substances in one go. This covered synthetic cathinones, phenethylamines, fentanyl derivatives and synthetic cannabinoids. Even so, plenty of new psychoactive substances still fall outside these four categories and remain legal to buy.

Fourteen Years of Rising Harm

Between 2012 and 2025, the Dutch Poisons Information Centre logged 4,289 cases involving new psychoactive substances. The scale of the increase is striking. Annual cases rose from just 32 in 2012 to 829 in 2025. That is an average annual rise of 90 per cent.

The centre first noticed a handful of unusual consultations around 2010. That trickle soon became a flood of previously unseen compounds. Given the severity of some health incidents, the centre decided to intensify its monitoring. The aim was to flag emerging threats to doctors and policymakers as early as possible.

Which Substances Are Causing the Most Harm?

More than 80 per cent of all poisonings involved just three classes of new psychoactive substances. These were cathinones, designer benzodiazepines and phenethylamines. Cathinones formed the single largest group overall. 3MMC and 4MMC were responsible for the bulk of recent cases.

The substances driving the numbers have shifted repeatedly since 2012. Designer benzodiazepines dominated in the earliest years. Phenethylamines took over between 2013 and 2018. Cathinones have led since 2019. Bromazolam is now the most common benzodiazepine involved. 2CB has overtaken 4 fluoroamphetamine as the leading phenethylamine.

One notable absence from the data is synthetic cannabinoids. These made up fewer than five per cent of Dutch cases, despite being a major issue in neighbouring countries. New synthetic opioids also remained rare in this dataset. Researchers caution this could change quickly, given how volatile the market for novel psychoactive substances tends to be.

Banning a Substance Does Not Always Stop the Harm

The study’s most sobering lesson may be this. Legal bans do not guarantee a drop in poisonings. Authorities banned 4 fluoroamphetamine in 2017, yet poisoning reports had already started falling beforehand. This was likely driven by media coverage of deaths and severe health effects rather than the law itself.

3MMC tells a very different story. Despite a ban in 2021, poisonings involving it have continued to climb. Many products still sold and bought as 3MMC no longer contain that substance at all. Buyers often receive closely related compounds such as 2MMC or 3CMC instead. The name 3MMC has effectively become a generic street term rather than an accurate description of what is inside the packet.

This is precisely what makes new psychoactive substances so dangerous. Users frequently have no reliable way of knowing what they are actually taking. This holds true regardless of what a seller claims or a product is labelled as. A substance bought under a familiar name one month may be a completely different, untested compound the next.

An Unpredictable and Poorly Understood Market

Reporting to the Dutch Poisons Information Centre is voluntary. It relies on what patients and medical staff describe over the phone. The true scale of harm from new psychoactive substances is almost certainly higher than official figures suggest. Laboratories rarely confirm cases. The centre itself does not run a lab, so researchers depend on other institutes to verify what caused a poisoning.

Other monitoring methods tell a patchy story too. Forensic seizures fell between 2017 and 2020 before rising again. Hospital emergency department visits peaked back in 2014 and 2015. This pattern may reflect growing awareness among doctors as much as any real change in use. Researchers say this inconsistency between data sources shows how hard it is to build a complete picture of the risks posed by novel psychoactive substances.

Why the Findings Matter

The research underlines why poison centre data has real value. It can spot emerging drug threats early, long before other monitoring systems catch up. For families, educators and health professionals, the message is a sobering one. New psychoactive substances are not a safer or more controlled alternative to established drugs. They are largely unregulated and frequently mislabelled. They are capable of causing severe harm even from a single dose.

New compounds keep appearing faster than laws can be written to cover them. Researchers argue that early identification, public awareness and prevention focused education remain essential. These tools help protect people from a drug market that shows no sign of slowing down.

Source: dbrecoveryresources