When most people think about workplace substance use, cannabis and alcohol tend to dominate the conversation. Yet, a rapidly growing market of New Psychoactive Substances (NPS)—synthetic compounds formulated to mimic or enhance the effects of established drugs—has emerged since the early 2000s. According to reports, over 1,100 different NPS had been notified to global monitoring agencies by late 2021. This unprecedented rise poses serious concerns for both public health and workplace safety, highlighting the urgent need to develop modern approaches to impairment screening. 

What are new psychoactive substances? 

NPS, sometimes referred to as “designer drugs,” are chemical compounds engineered to imitate or intensify the psychoactive effects of substances like cannabis, cocaine, opioids, or hallucinogens. Common examples include: 

• Synthetic cannabinoids (often sold under names like “Spice” or “K2”) 

• Synthetic cathinones (“bath salts”) 

• Novel opioids (including various fentanyl analogues) 

• Phenethylamines (the “2C” family of hallucinogens) 

Unlike cannabis and alcohol, which have been extensively researched and regulated, many NPS lack long-term studies. This knowledge gap is especially problematic because manufacturers often tweak chemical structures to bypass existing drug laws, constantly introducing new variants onto the market. The ease and speed with which these substances evolve create a moving target for both regulators and employers seeking to uphold a drug-free workplace. 

Are NPS more or less dangerous than cannabis and alcohol? 

It’s important to stress that all psychoactive substances—even legal ones like alcohol—carry inherent risks. Nevertheless, NPS can present heightened dangers due to factors such as: 

1. Rapid proliferation & high toxicity 

• Unprecedented growth: by December 2021, more than a thousand NPS had been reported worldwide, increasing faster than research or legislation can keep pace. 

• Potent formulations: synthetic cannabinoid receptor agonists and novel opioids (e.g., certain fentanyl analogues) can be far more powerful than natural cannabis or prescribed opioids, raising the risk of overdose and severe side effects. 

2. Unpredictability & limited research 

• Unknown mechanisms: while cannabis and alcohol have been studied for decades, many NPS are poorly understood. Even small molecular modifications can dramatically alter potency and risk profiles. 

• Sparse data: few robust clinical trials exist to determine the long-term impacts of each new variant. Users often have no idea what they’re consuming. 

3. Severe health consequences 

• Acute rangers: Recent data from the European Drug Emergencies Network indicate that up to 9% of all drug-related emergencies involve NPS, including incidents of extreme agitation, cardiac issues, and even fatalities. 

• Long-term risks: reports also cite links between NPS use and the spread of diseases such as HIV and hepatitis C, underscoring how little is known about these emerging substances over time. 

4. Higher usage among young people 

• While overall NPS use in the general population may be relatively low, 1 in 10 young people in certain regions have experimented with NPS. This highlights the gap between public awareness and actual market penetration. 

Taken together, the rapid evolution, high potency, and knowledge gaps associated with NPS often make them more dangerous in day-to-day practice than cannabis or alcohol—especially when it comes to detection and prevention. 

How widespread is NPS use? 

Although alcohol and cannabis remain the most commonly used substances overall, the fast-paced emergence of NPS is reshaping global drug trends: 

• Changing marketplace: online platforms make it easy to purchase new or “legal” alternatives, and these can quickly replace older substances once they’re banned. 

• Unwitting consumers: in some cases, people may not even realize they are consuming NPS. Adulterated or mislabeled products can be sold as more familiar drugs, creating a hidden layer of risk. 

• Disproportionate impact on youth: younger demographics often experiment with “legal highs,” which can appear less risky or easier to access than conventional illicit drugs. Self-report data on NPS usage among young people may also understate the scale of the issue. 

Why should employers be concerned? 

• Detection challenges: most standard test panels target well-known substances like THC or opioids. Many NPS simply do not appear on these tests—meaning employees could easily go undetected if you’re relying on outdated methods. 

• Immediate workplace threats: the unpredictable potency of NPS can lead to sudden impairment, erratic behavior, or even severe medical emergencies on the job. This risk is especially critical in safety-sensitive industries, like construction or transportation. 

• Shifting legal landscape: governments struggle to keep up with the NPS market. Employers must regularly update workplace policies and detection tools to remain both compliant and effective. 

• Public health & liability: documented links between NPS use and acute psychological distress (including psychosis) or severe health complications underscore the legal and ethical responsibilities organizations bear. Proactive screening and support can reduce liability and promote employee wellbeing. 

Charting a safer path forward 

New psychoactive substances are no longer fringe anomalies; they are a rapidly growing phenomenon with serious implications for public health, drug policies, and workplace environments. Although cannabis and alcohol remain the focus of many workplace policies, the accelerated evolution and high toxicity of NPS demand equally adaptable and proactive strategies. 

By expanding testing methods, implementing real-time impairment tools, and educating employees on the potential hazards of these lesser-known substances, organizations can stay ahead of the curve. Equally crucial is promoting a culture that supports—not penalizes—those who seek help for substance use. 

In the end, acknowledging that impairment extends beyond familiar drugs like cannabis and alcohol is vital for ensuring a truly safe, healthy, and productive workplace. Employers who proactively adapt their policies and practices to the reality of NPS will be better equipped to protect both their workforce and the bottom line.