New psychoactive substances and their neurological implications

Abstract

Introduction: The use of psychoactive substances (PAS) represents a serious public health problem both in Colombia and worldwide. In recent years, there has been an accelerated growth in the PAS market, linked to the presence of new substances with increasingly potent and unpredictable effects. An interdisciplinary approach was carried out with the objective of identifying mechanisms of action, effects that these substances have on the Central Nervous System (CNS), compromised neurotransmission pathways, and associated neuropsychiatric alterations. Materials and methods: A narrative review was carried out based on the 6 groups of new PAS reported by the United Nations Office on Drugs and Crime (UNODC). Results: As of June 2025, 123 new substances have been detected, belonging to the following groups: stimulants, synthetic opioid receptor agonists, synthetic cannabinoid receptor agonists, dissociatives, classic hallucinogens, and sedatives/hypnotics. Discussion: Alterations in neural networks related to reward, emotional regulation, memory, learning, and executive control have been reported, favoring the emergence of behavioral disorders and impairment in different spheres of human interaction. Conclusion: Molecular detection of new substances continues to be a challenge, as they are combined with opiates or other substances to potentiate their effects, hence clinical signs of intoxication, withdrawal and behavioral changes are critical to provide timely and effective treatment.