WHO Places New Psychoactive Substances Under Control

The United Nations Commission on Narcotic Drugs (CND) accepted recommendations from the World Health Organization (WHO) to place five new psychoactive substances and one medicine under international control. This decision aims to address the rising public health risks associated with these substances, which have been identified as causing harm and having no recognised therapeutic use.

WHO’s Role and Recommendations

The WHO’s Expert Committee on Drug Dependence (ECDD) evaluates psychoactive substances for their health risks and benefits. The committee assesses substances circulating in global markets. If evidence suggests that their use poses a threat to public health, the ECDD recommends international control. This process has been crucial in protecting vulnerable populations, especially youth.

Substances Under Control

• Four synthetic opioids were placed in Schedule I of the Single Convention on Narcotic Drugs (1961). These include:

1. 1. N-Pyrrolidino protonitazene – A synthetic opioid identified in counterfeit pharmaceutical tablets. It can be administered through various routes and is associated with health risks, including death.
   2. N-Pyrrolidino metonitazene – Another synthetic opioid linked to severe health risks. It is primarily administered by injection and has no known therapeutic use.
   3. Etonitazepipne – This substance is a crystalline solid and poses similar risks as the previous opioids. Its use can lead to substantial harm and death.
   4. N-Desethyl isotonitazene – Identified in falsified pharmaceuticals, this opioid has been associated with multiple deaths and hospital admissions in various regions.

• Additionally, Hexahydrocannabinol (HHC) was placed in Schedule II of the Convention on Psychotropic Substances (1971). HHC is a semi-synthetic cannabinoid found in various products. Its use has raised public health concerns, warranting international control. Carisoprodol, a muscle relaxant, was placed in Schedule IV. It is available as a pharmaceutical product but has been linked to nonmedical use, posing health risks.

Global Implications

The CND’s decision reflects a growing awareness of the dangers posed by new psychoactive substances. These substances are often clandestinely manufactured and lack medical applications. The WHO has been advising on drug policy for over 70 years. Its role is vital in ensuring that psychoactive substances are available for legitimate medical purposes while protecting populations from harmful substances. Emerging synthetic opioids, such as fentanyl and nitazenes, continue to pose challenges. Member States have expressed interest in further scientific reviews of these substances to enhance public health safety.

Questions for UPSC:

1. Examine the role of the World Health Organization in regulating psychoactive substances.
2. Discuss the health risks associated with synthetic opioids and their impact on global public health.
3. What are the implications of international control on the manufacture and distribution of psychoactive substances? How can countries implement these controls effectively?
4. Critically discuss the challenges posed by emerging synthetic opioids in the context of drug policy and public health.

Answer Hints:

1. Examine the role of the World Health Organization in regulating psychoactive substances.

1. The WHO’s Expert Committee on Drug Dependence (ECDD) evaluates health risks and benefits of psychoactive substances.
2. Recommendations from the ECDD lead to international control of substances deemed harmful.
3. WHO provides scientific reviews to inform drug policy decisions for the UN Commission on Narcotic Drugs.
4. The organization has been active in protecting vulnerable populations, especially youth, from harmful substances.
5. WHO’s ongoing mission includes ensuring psychoactive substances are available for legitimate medical use while minimizing risks.

2. Discuss the health risks associated with synthetic opioids and their impact on global public health.

1. Synthetic opioids, such as protonitazene and metonitazene, are linked to severe health risks, including overdose and death.
2. These substances are often clandestinely manufactured and lack recognized therapeutic uses.
3. Their presence in counterfeit pharmaceuticals exacerbates public health crises, leading to increased hospital admissions.
4. Emerging synthetic opioids contribute to the opioid epidemic, affecting communities worldwide.
5. The rise in synthetic opioids poses challenges for healthcare systems and drug policy enforcement globally.

3. What are the implications of international control on the manufacture and distribution of psychoactive substances? How can countries implement these controls effectively?

1. International control aims to limit the availability of harmful substances, reducing public health risks.
2. It requires countries to align their national laws with international treaties, enhancing regulatory frameworks.
3. Effective implementation includes monitoring production and distribution channels to prevent illicit trade.
4. Countries must engage in public health campaigns to educate communities about the risks of controlled substances.
5. Collaboration between nations is essential for sharing intelligence and best practices in enforcement.

4. Critically discuss the challenges posed by emerging synthetic opioids in the context of drug policy and public health.

1. Emerging synthetic opioids are often more potent and dangerous than traditional opioids, complicating treatment and prevention efforts.
2. The rapid evolution of these substances outpaces regulatory frameworks, making timely responses difficult.
3. Public health systems face increased strain due to rising overdose deaths and healthcare costs associated with synthetic opioid use.
4. Stigma surrounding drug use can hinder effective public health responses and support for affected individuals.
5. International cooperation is crucial, as synthetic opioids are often trafficked across borders, necessitating coordinated drug policy efforts.