BACKGROUND: There has been an increase in the number of serious poisonings and deaths after the use of new psychoactive substances (NPS). These are usually bought online: sometimes legally, often illegally or "in the grey area".
OBJECTIVES: Characteristics of different NPS. Legal status concerning the New Psychoactive Substances Act (NpSG). Risk assessment of several substance groups, possible complications of acute poisonings, therapeutic recommendations.
MATERIALS AND METHODS: Literature search and evaluation of own case data.
DISCUSSION of official statistics, literature and expert recommendations.
RESULTS: There has been an increase in the number of poisonings with NPS and associated deaths: in Germany in 2016 there were 98 deaths compared to 39 deaths in 2015. Serious acute poisonings require intensive care therapy. Therapy is usually symptomatic. Referring to the drugs discussed in this article an antidote is only available for the synthetic opioid: naloxone.
CONCLUSIONS: With the NpSG being in force since the end of 2016, the number of severe intoxications with NPS will probably (not immediately) decrease. It remains to be seen if the increasing number of fatalities will decrease again. Consultation with a poison centre is recommended in cases of suspected intoxication with NPS. Diagnosis and therapy can then be discussed. Toxicological screening may be false negative because many synthetic drugs are not detected in standard analysis. The NPS often require a special analysis.