Monitoring of new psychoactive substances in France: update of addictovigilance data

Abstract New psychoactive substances (NPS) represent a growing public health challenge in Europe. Their rapid emergence, chemical diversity and unpredictable toxicity complicate prevention, clinical management and regulatory responses. This study provides an updated overview of NPS-related harms in France using national addictovigilance data. Data were extracted from three complementary surveillance systems: (i) the NotS program of spontaneous reports of NPS-related adverse events (2009–24), (ii) the OPPIDUM survey conducted among users attending addiction care centers (2016–24), and (iii) the DRAMES registry of toxicologically confirmed drug-related deaths (2012–23). Substances were classified by chemical family and clinical effects were coded using MedDRA terminology. In addition to descriptive analyses, regression models were used to assess temporal trends. A total of 3468 NotS involving at least one NPS were recorded, increasing from 5 cases in 2009 to 726 in 2024. Synthetic cathinones and synthetic cannabinoids accounted for nearly 90% of notifications. Trend analyses confirmed a significant increase in NPS notifications and reported use over time. In OPPIDUM, the proportion of NPS users increased from 0.3% in 2016 to 1.7% in 2024. In DRAMES, 136 NPS-related deaths were identified between 2012 and 2023, with no significant overall increase in mortality during the study period. Synthetic cathinones and synthetic cannabinoids dominate the French NPS landscape. The integration of multiple addictovigilance data sources provides a robust framework for early signal detection and supports public health decision-making.