Lucy in the Sky with Diamonds: Keeping up with New Psychoactive Substances | 20

For this episode we will take a slightly different trip - one that takes us into the rapidly changing world of new psychoactive drugs. From synthetic cannabinoids and novel stimulants, to designer benzodiazepines and emerging psychedelics, the landscape is constantly evolving. New molecules appear faster than we can sometimes characterise them, creating major challenges for clinicians, toxicologists, laboratories and regulators. So, how can we detect these entities when we may not even know what we are looking for? And what can pharmacology and toxicology tell us about their clinical effects and their risks? In this episode, we are joined by Souleiman El Balkhi and Richard Kevin, who walk us through what it takes to make sense of the vast NPS terrain.

In this episode we'll hear about:

• Keeping up with chemists engineering roughly 400–500 new psychoactive substances a year (about eight drugs a week!)

• Why synthetic cannabinoids and other NPS can be markedly more toxic than the prototype drugs they mimic

• Moving beyond immunoassays toward high-resolution mass spectrometry and cellular bioassay screens to catch substances without reference standards

• Why a single blood concentration rarely settles whether a dose was recreational or lethal

• Whether banning each new substance protects patients, or simply fuels the next, more potent generation

About our guests:

• Dr Souleiman El Balkhi is a Toxicologist and Head of the Analytical and Environmental Toxicology Unit at Limoges University Hospital, and a researcher at INSERM UMR 1248 "Pharmacology & Transplantation," University of Limoges. His research focuses on hepatic biomarkers alongside environmental and forensic toxicology.

• Dr Richard Kevin is a Senior Hospital Scientist at St Vincent's Hospital Sydney and Conjoint Senior Lecturer in the School of Clinical Medicine at the University of New South Wales. His doctoral research characterised synthetic cannabinoids, and he now works on drug-checking trials across Australia.

Eight Drugs a Week is supported by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT). The personal views of the hosts and guests do not necessarily reflect the position of the Association.