Novel Psychoactive Substances and ChemSex

"In recent years, the development of new substances, collectively referred to as New Psychoactive Substances (NPS), has surged (28). This term encompasses a broad range of synthetic and plant-derived psychoactive substances that have gained prominence since 2008 (27). NPS include newly designed synthetic drugs, plant-based compounds or their extracts, previously existing substances that have recently entered the market, and certain pharmaceuticals or medications. The number of identified NPS has risen dramatically, growing from 236 in 2012 (29) to 930 in 2023 (30). A specific category of NPS, known as cathinones (e.g., mephedrone (4-MMC), metaphedrone (3-MMC), and others), is commonly used in sexual contexts (2).

"To capture the diverse effects of newly developed substances, a new categorization was deemed necessary. Building on the work of Leonard (31), Adley and colleagues (27) developed the Drugs Wheel, a taxonomy that includes both established drugs and NPS. The primary goal of the Drugs Wheel is to offer a comprehensive framework, integrating information on the effects of individual drugs, their actions on receptor pathways, and harm reduction strategies for each of its seven categories (27).

"This Drugs Wheel, created in collaboration with stakeholders and end-users (27), organizes substances into seven categories: stimulants, empathogens, psychedelics, dissociatives, depressants, opioids, and cannabinoids. With the approval of the original developers, Schrooten and colleagues adapted this taxonomy into the Pharmacosex Wheel, published in Dutch (32). Figure 1 below presents a translation of this Pharmacosex Wheel (32) and provides an overview of the sexual effects of individual drugs, including their impact on sexual desire, arousal, and orgasm, within each of the seven categories outlined in the Drugs Wheel (27)."