Novel Psychoactive Substances: At the epicenter of an unrelenting drug epidemic

Known as designer or synthetic drugs, NPS are designed to mimic the effect of controlled substances and/or illicit drugs, are routinely chemically altered to enhance drug effects, and can evade tracking by law enforcement.^2,3

NPS have been implicated in overdose and mass-poisoning events,¹ and there has been a dramatic increase in NPS detection in the US,⁴ posing a growing public health threat to our communities.

Traditional testing may miss Novel Psychoactive Substances

NPS may supplement traditional drugs of abuse and can be more potent and harder to detect.^1,2 As new compounds continually appear on the drug market, detecting them via presumptive immunoassay or point-of-care testing is challenging because they:

Two NPS of concern: xylazine and fentanyl

Two NPS classes—other illicit additives (xylazine) and fentanyl analogs (acetyl fentanyl)—are frequently found in specimens and contribute to the nation’s misuse crisis.6 As part of the process of bringing the NPS panel to market, we conducted a national NPS surveillance study, retesting nearly 4,000 specimens.⁶

• Xylazine was found in nearly 1 in 12 specimens (8.1%) tested, making it the most prevalant single NPS
• One-third (32.7%) of fentanyl-positive specimens were also positive for xylazine
• Nearly all (97.7%) specimens positive for xylazine were also positive for fentanyl

Since the list of NPS rapidly evolves, Quest has updated the substances tested with this panel, without changing test codes and requiring EHR updates.

Most recent updates to the NPS panel include

• 26 analytes added to the 6 different NPS classes
• Removal of parent drugs in Synthetic Cannabinoid Class
• Individual class order codes available

– (13793) Designer Benzodiazepinesa

– (13794) Designer Fentanyl Analogs

– (13795) Designer Opioids

– (13796) Designer Stimulants

– (13797) Synthetic Cannabinoids

– (13798) Other illicit additives

_{^a Note that there has been a CPT® code change for Designer Benzodiazepines.}