Trend Reports

NPS Opioids in the United States

Q1 2024

This report provides up-to-date information regarding the status of NPS opioid prevalence and positivity in the United States. Novel psychoactive substances (NPS), including NPS opioids, continue to pose great challenges for forensic scientists, clinicians, and public health and safety personnel. NPS opioids have been implicated in an increasing number of emergency room admissions, death investigations, and mass intoxication events, and often appear in combination with other illicit opioids (e.g. fentanyl, heroin). Maintaining a current scope of analysis can be challenging, requiring comprehensive analytical methodologies and reference materials for identification(s).

Our laboratory utilizes novel approaches for the analysis of drugs in toxicology specimens and drug materials using comprehensive non-targeted data acquisition by gas chromatography mass spectrometry (GC-MS) and liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS). The scope of analysis contains more than 1,200 drugs, including a vast majority of NPS and their metabolites. This  approach allows for real-time identification of novel opioids and further data analysis of important trends. Cases and sample types linked to these results originate from recreational drug use, medicolegal death investigations, clinical intoxications, and/or driving under the influence of drugs investigations, among other circumstances. The results in this report represent the total number of NPS identifications at the CFSRE during this quarter, including those from sample-mining, data-mining, routine testing, and esoteric testing.



Select Positivity: Q2 2021 to Q1 2024

NPS Opioids Identified

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