Michael Evans-Brown is a specialist in early warning, risk assessment, and responses to emerging drug-related public health threats. He is programme manager for risk assessment and risk communication at the EMCDDA in the team responsible for the European Union Early Warning System and risk assessment of new psychoactive substances (NPS). Before this, Mike researched human enhancement drugs and co-ordinated the United Kingdom’s early warning system on NPS. He tweets @mevansbrown

25 years of early warning and response in Europe: Where are we with new psychoactive substances?
Abstract
One of the unintended effects of globalisation is that new and recurring public health threats can emerge and spread faster than ever before. Infectious diseases, such as COVID-19, and the growing market in fake medicines, are just two examples. Drug markets have not been immune to these global changes either, with a large increase in the number, type, and availability of new psychoactive substances (NPS) on the market in the last 15 years. This market has become resilient and highly dynamic making it difficult to disrupt — in part because of its strong links with the illicit drug markets. Major new challenges have also emerged: an upward trend in highly potent NPS appearing — especially synthetic cannabinoids, opioids, and benzodiazepines — which pose a greater risk of life-threatening poisoning; while globalised markets have also increased the risk of ‘MACD’ events — misselling, adulteration, contamination, or dilution of drugs with highly potent, toxic, or otherwise dangerous substances. For 25 years, the European Union Early Warning system on NPS has allowed Europe to rapidly detect, assess, and respond to public health threats caused by NPS. Based on this work and other real world cases studies, this presentation traces the development of the NPS phenomenon; discuss the current situation in Europe; highlights emerging threats and challenges; and discusses what we may see next and how we need to adapt to strengthen health protection in a globalised world.