4. NPS Discovery: An Open Access Early Warning System for the United States

The lack of a centralized broad surveillance model for new drugs in the US, led to the establishment in 2018 of NPS Discovery at the non-profit CFSRE. NPS Discovery is a model that collects data from multiple intelligence channels that guide its application of analytical tools to the identification of novel substances, and a tiered approach to rapid dissemination of information to multiple stakeholder types.

The NPS Discovery model follows a five-step process, beginning with intelligence gathering from social media data, publications, conference proceedings, scheduling actions, illicit drug vendor websites, online drug user forums, and seized drug and toxicology data. Once the list of possible new substances is filtered and ranked, we begin surveilling for these drugs. As drugs are identified in surveillance, we step up monitoring to begin to document the proliferation of the drugs. After this notification, the response phase focuses on collecting case histories in drug related deaths, metabolomics studies, and collaborations with academic partners on toxicity studies. Finally, we analyze the data collected for forecasting potential future drugs.

Since 2018, NPS Discovery has issued identifications for 116 novel drugs and precursors. It has an email distribution of over 1000 recipients, and secondary distribution of data, trends and public health alerts.

Findings from the NPS Discovery model have been used to educate clinicians, emergency room physicians, forensic toxicology and drug chemistry analysts, and provide harm reduction information to people who use drugs. The cases reported are also cited in decisions regarding scheduling of NPS.