Reducing drug deaths from novel psychoactive substances relies on foreign legislation, but here’s how it can be tackled closer to home

Guest editorial by Ric Treble and Caroline Copeland, authors of a new Frontiers in Pharmacology article on drug legislation

Frontiers

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by Ric Treble and Caroline Copeland

The illicit drug trade is international, and different countries have developed different strategies intended to minimize its negative effects, most commonly through controls on, or prohibition of, specified substances. But which approaches to banning substances are actually most effective in reducing harm? 

The advent of NPS, and the range of subsequent legislative controls introduced by different countries, has created a natural experiment. Using data from the UK’s National Programme on Substance Abuse Mortality (NPSUM), our study examines how different national and international control strategies have translated into real-world outcomes within England, Wales, and Northern Ireland by examining NPS deaths.

Internationally, there has been a high degree of consistency in drug control. The United Nations (UN) annually reviews and updates the lists of substances (and precursors) named in its drugs conventions, based on recommendations from the World Health Organization’s expert committee. All signatory nations of the conventions are then required to incorporate these controls into their national laws. However, this process of problem identification, data compilation, formulation of recommendations, and achieving international consensus followed by national legislation, is inevitably slow. In contrast, the appearance and spread of NPS within drug markets can be incredibly rapid, so there can be significant delays between local identification of issues arising from novel substances and the international introduction of new controls.

Beyond international laws

In response, some nations have therefore chosen to act sooner, introducing their own national controls in response to local concerns, in advance of, or in addition to, those required by the UN. This means that there is an international patchwork of legislation regarding emerging drug threats, with different substances being controlled in different countries at different times. Whilst challenging for policymakers, this variation provides a valuable opportunity to assess the impact of the application of different nations’ controls on particular substances.

In the UK, there have been very few examples of the illicit synthesis of NPS and the vast majority of such substances are imported instead, often facilitated by internet trading and ‘fast parcel’ delivery services. To address the rapid appearance of NPS, the UK’s Misuse of Drugs Act (1971) has been supplemented by other measures, such as the introduction of Temporary Class Drugs Orders (2011) and the much broader Psychoactive Substances Act (2016). These measures effectively prevented open sale of NPS via ‘head shops’ and UK-based websites. However, NPS remained accessible to both individuals and distributors via internet trading and traditional drug distribution networks. 

The power of foreign legislation

Over the period studied, the major sources of NPS in the UK were chemical supply companies based in China. In response to both local and international concerns, China introduced a series of national controls over and above those required by UN scheduling, initially on specifically named substances and, more recently, on whole families of NPS by means of ‘generic’ controls. 

When we compared trends in NPS detections within the NPSUM’s mortality data with the timing of the UN’s international control requirements and the UK’s and China’s national legislations respectively, a clear pattern emerged: controls implemented in the producing countries were associated with larger reductions in NPS detections in deaths than controls introduced solely within the consuming country.

Action at home

National legislation within consumer countries is, of course, still essential. It enables national law-enforcement activity, including restricting the import and trafficking supply chain and the implementation of possession offences. However, national legislation and enforcement alone cannot eliminate drug use or its associated harms. For this reason, they must be complemented by wide-ranging harm-reduction strategies. However, legislative controls can also drive unintended consequences. Targeted bans on specific substances often stimulate the development of novel NPS, including the production of new, as yet uncontrolled, variants of substances controlled by name. This pattern has been particularly evident in the case of synthetic cannabinoids, where successive generations of legislation-avoiding substances have continued to appear, prompting the development of ever broader generic controls.

However, even generic controls have limits. Where entire families of drugs are prohibited, new drug families which produce similar effects may emerge instead. This dynamic is currently being seen in the case of highly potent synthetic opioids, a particularly concerning cause of drug-related deaths. Broad controls on fentanyl and their pre-cursors have been followed by the appearance of nitazenes and, as controls on nitazenes are being introduced, a new group of potent opioids, the orphines, has begun to appear. These cycles of control and innovation are therefore likely to continue.

Early legislative action by consumer countries remains necessary to limit the distribution and harms of newly emerging NPS. The findings of our study also demonstrate the particular effectiveness of prompt action to restrict production within source countries to prevent international distribution. If, as a result of Chinese legislative actions, production of NPS for the illicit drug trade becomes more geographically diverse, action to identify new sources of production and to encourage and support supplier nations to restrict production as soon as practicable will be required. This will present particular challenges if the substances being produced and exported are not perceived to present a threat within the producing country.

However, supply-side interventions alone cannot provide a lasting solution: as long as there is sustained demand for psychoactive substances, there will be strong incentives for suppliers to adapt, innovate, and profit. Reducing drug harms will therefore require not only responsive legislation and international co-operation, but also investment in education, prevention, and treatment to address the drivers of demand.

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Journal

Frontiers in Pharmacology

DOI

10.3389/fphar.2025.1708335 

Method of Research

Observational study

Subject of Research

Not applicable

Article Title

Legislating novel psychoactive substances: Lessons from 15 years of UK mortality data (2007-2022)

Article Publication Date

29-Jan-2026

 

Research clarifies record-late monsoon onset, aiding northern Australian communities

Institute of Atmospheric Physics, Chinese Academy of Sciences

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image: 

A monsoon burst over Darwin.

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Credit: Chris Garth

Every year, Australia experiences a summer monsoon characterized by the reversal of winds, heavy rainfall and flooding. In 2024-2025 however, the Australian summer monsoon (ASM) was the latest on record since measurements began in 1957.

The monsoon's timely arrival is critical for Northern Australia. It dictates water security for communities, drives pasture growth for the vital cattle industry and signals the end of the high bushfire risk period.

The start of the ASM is defined by the change in prevailing dry southeasterly trade winds that occur most of the year to moist northwesterly winds that dominate during the wet season. These winds are measured above the city of Darwin, which is located in the northernmost part of Australia, and is often the first place in Australia to experience the onset of monsoonal conditions each season, usually around Christmas and the New Year.

Despite favorable large-scale climate conditions that would usually support an earlier onset, such as a La Niña-like state in the Pacific Ocean, record ocean warmth and strong ocean convection in December, the ASM onset occurred on 7 February 2025, more than five weeks later than usual and more than two weeks later than the previous record set in 1972-1973.

To better understand the reasons for the delayed ASM in the summer of 2024-2025, an international research group led by scientists from the University of Southern Queensland investigated monsoon criteria and local weather conditions that may have affected the onset of the ASM.

The team published their study on January 29 in Advances in Atmospheric Sciences as part of a special issue organized by the WMO's World Climate Research Programme monsoon panel.

“We… wanted to determine whether this record-late onset was a genuine feature of the broader monsoon system or a result of the local wind conditions at Darwin. To understand this further, we compared numerous monsoon onset definitions across northern Australia and investigated the atmospheric processes that occurred before and during the onset period,” said Tim Cowan, Associate Professor in the Centre for Applied Climate Sciences at the University of Southern Queensland in Toowoomba, Australia and first author of the research paper.

To determine if the late ASM was due to a true delay in the monsoon season or isolated conditions in Darwin, the research team applied multiple ASM- and rainy season (RS)-onset definitions and analyzed the atmospheric and oceanic conditions during the pre-monsoon and onset periods in Darwin and the surrounding area.

Importantly, the researchers observed that the conditions in Darwin during the summer of 2024-2025 did not necessarily reflect other parts of Australia. “The record-late ASM onset in 2024/25 was not entirely representative of the broader monsoon conditions across all of northern Australia but only specific to local wind conditions over Darwin. Other onset definitions showed much earlier onsets than the official ASM wind definition for Darwin, especially those that describe the onset of rainfall,” said Rajashree Naha, research fellow at the Centre for Applied Climate Sciences at the University of Southern Queensland in Toowoomba and co-author of the research paper.

The data suggests that local weather variability over Darwin prevented the upper-level winds from switching to easterlies, despite the presence of strong westerlies in December.

The team hopes their research will benefit weather communication with the general public. “Often people (and the media) confuse the official monsoon onset, based on local winds, with the onset of the first monsoonal rains. The release of our new study provides a great opportunity to improve the messaging around the monsoon arrival and what these impacts are on local communities,” said Cowan.

Ultimately, the research team emphasizes their work isn't just about wind definitions. It's about ensuring that communities who depend on the monsoon receive clear, actionable information. The team hopes the new study could help improve preparedness across the north Australia.

As the 2025-2026 wet season unfolds, communities and forecasters are once again watching Darwin's winds closely—a reminder of how critical clear and accurate monsoon onset information is for northern Australia each and every year.

Hanh Nguyen, Sugata Narsey, Matthew C. Wheeler and Chris Lucas from the Bureau of Meteorology in Melbourne, Australia; Hanna Heidemann from the University of Melbourne School of Geography, Earth and Atmospheric Sciences in Parkville, Australia and the Centre for Applied Climate Sciences at the University of Southern Queensland, in Toowoomba, Australia; Corey Robinson from the School of Earth, Atmosphere and Environment at Monash University in Clayton, Australia and the Australian Research Council Centre of Excellence for 21st Century Weather in Clayton, Australia; Andrew G. Marshall from the Centre for Applied Climate Sciences at the University of Southern Queensland in Toowoomba, Australia and the Bureau of Meteorology in Hobart, Australia; and Lin Wang from the Center for Monsoon System Research at the Institute of Atmospheric Physics (IAP) in the Chinese Academy of Sciences (CAS) in Beijing, China also contributed to this research.

This work was supported by Meat & Livestock Australia, the Queensland Government through the Drought and Climate Adaptation Program, and the University of Southern Queensland through the Northern Australia Climate Program (NACP).

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Journal

Advances in Atmospheric Sciences

DOI

10.1007/s00376-025-5352-2 

Article Title

Why Was the Official Australian Monsoon Onset Unusually Late in 2024/25?

Article Publication Date

29-Jan-2026

 

New Boston University study identifies CTE as cause of dementia

Researchers found those with advanced CTE had four times increased odds for having dementia

Boston University School of Medicine

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Boston–The largest study of its kind from the Boston University CTE Center reveals that chronic traumatic encephalopathy (CTE) should be recognized as a new cause of dementia.

The research, published online today in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, studied 614 brain donors that had been exposed to repetitive head impacts, primarily contact sport athletes. By isolating 366 brain donors that had CTE alone, meaning they had CTE in the absence of any other progressive brain disease, compared to 248 donors without CTE, researchers found those with the most advanced form of CTE had a four times increased odds for having dementia. The four times odds are similar to the strength of the relationship between dementia and advanced Alzheimer’s disease pathology, which is the leading cause of dementia.

“This study provides evidence of a robust association between CTE and dementia as well as cognitive symptoms, supporting our suspicions of CTE being a possible cause of dementia,” said corresponding and senior author Michael Alosco, PhD, associate professor neurology at Boston University Chobanian & Avedisian School of Medicine and co-director of clinical research at the BU CTE Center. “Establishing that cognitive symptoms and dementia are outcomes of CTE moves us closer to being able to accurately detect and diagnose CTE during life, which is urgently needed.”

Dementia is a clinical syndrome that refers to impairments in thinking and memory in addition to trouble with performing tasks of daily living like driving and managing finances. Alzheimer’s disease is the leading cause but there are several other progressive brain diseases listed as causes of dementia that are collectively referred to as Alzheimer’s disease related dementias (ADRD). With this new study, the authors argue that CTE should now also be formally considered an ADRD.

The study also reveals that dementia due to CTE is often misdiagnosed during life as Alzheimer’s disease, or not diagnosed at all. Among those who received a dementia diagnosis during life from a healthcare provider, 40 percent were told they had Alzheimer’s disease despite showing no evidence of Alzheimer’s disease at autopsy. An additional 38% were told the causes of their loved one’s dementia was “unknown” or could not be specified.

In addition, this study addressed the controversial viewpoint expressed by some clinicians and researchers that CTE has no clinical symptoms. As recently as 2022, clinicians and researchers affiliated with the Concussion in Sport Group meeting, which was underwritten by international professional sports organizations, claimed, “It is not known whether CTE causes specific neurological or psychiatric problems.”

“There is a viewpoint out there that CTE is a benign brain disease; this is the opposite of the experience of most patients and families,” said Alosco. “Evidence from this study shows CTE has a significant impact on people’s lives, and now we need to accelerate efforts to distinguish CTE from Alzheimer’s disease and other causes of dementia during life.”

As expected, the study did not find associations with dementia or cognition for low-stage CTE.

The authors note that prospective studies with objective assessments and age-matched controls are needed to validate their findings.

The study was supported by the National Institute of Neurological Disorders and Stroke, National Institute on Aging, Department of Veterans Affairs, and the Nick and Lynn Buoniconti Foundation.

About the BU CTE Center

The BU CTE Center is an independent academic research center at the Boston University Avedisian & Chobanian School of Medicine. It conducts pathological, clinical and molecular research on CTE and other long-term consequences of repetitive brain trauma in athletes and military personnel. For people considering brain donation, click here. To support its research, click here. 

 

 

 

 

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Journal

Alzheimer’s & Dementia

DOI

10.1002/alz.71032 

Method of Research

Data/statistical analysis

Subject of Research

Human tissue samples

Article Title

CTE neuropathology alone is associated with dementia and cognitive symptoms

Article Publication Date

27-Jan-2026

 

Nitrate in drinking water linked to increased dementia risk while nitrate from vegetables is linked to a lower risk, researchers find  

Edith Cowan University

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New research from Edith Cowan University (ECU) and the Danish Cancer Research Institute (DCRI) investigated the association between the intake of nitrate and nitrite from a wide range of different sources, and the associated risk of dementia. 

Dementia is a complex disease shaped by both genetics and lifestyle, and Post-Doctoral Research Fellow at ECU’s Nutrition & Health Innovation Research Institute (NHIRI) and the DCRI, Dr Nicola Bondonno said dietary factors could also be important.  

The research, which investigated the association between source-specific nitrate and nitrite intake and incident and early-onset dementia, followed more than 54,000 Danish adults for up to 27 years and found that the source of nitrate was of critical importance in a diet. 

The researchers found that people who ate more nitrate from vegetables had a lower risk of developing dementia, while those who consumed more nitrate and nitrite from animal foods, processed meats, and drinking water, had a higher risk of dementia. 

ECU Associate Professor Catherine Bondonno said that nitrate intake from vegetables has been linked with a lower risk of dementia, which is thought to be a result of the conversion of nitrate to nitric oxide in the body. 

“When we eat nitrate-rich vegetables, we are also eating vitamins and antioxidants which are thought to help nitrate form the beneficial compound, nitric oxide, while blocking it from forming N-nitrosamines which are carcinogenic and potentially damaging to the brain. 

“Unlike vegetables, animal-based foods don't contain these antioxidants. In addition, meat also contains compounds such as heme iron which may actually increase the formation of N-nitrosamines. We think this is why nitrate from different sources has opposite effects on brain health, but we need laboratory studies to confirm exactly what's happening,” she said.  

This is the first time that nitrate from drinking water has been linked to higher risks of dementia. The study found that participants exposed to drinking-water nitrate at levels below the current regulatory limits, had a higher rate of dementia, however, Dr Bondonno stressed that this was only one study, and more research was required.  

“Water doesn't contain antioxidants that can block formation of N-nitrosamines. Without these protective compounds, nitrate in drinking water may form N-nitrosamines in the body,” she said.  

In Denmark and the EU, the limit for nitrate in groundwater and drinking water is set at 50 mg/L, but the researchers observed a higher risk for drinking water containing as low as 5 mg of nitrate per litre. 

“Importantly, our results do not mean that people should stop drinking water. The increase in risk at an individual level is very small, and drinking water is much better for your health than sugary drinks like juices and soft drinks. However, our findings do suggest that regulatory agencies should re-examine current limits and better understand how long-term, low-level exposure affects brain health.”  

She simultaneously emphasises that this is an observational study, which cannot establish that nitrate directly causes dementia. The results must therefore be confirmed in other studies, and it cannot be ruled out that other factors in participants' diets or lifestyles contribute to the association. 

Dr Bondonno said the take-home results from the study is fairly simple: people who consume more nitrate from vegetables, equating to around one cup a day of baby spinach, had a lower risk of dementia. 

On the other hand, people who consumed more nitrate from animal-based foods, particularly red and processed meat, had a higher risk.  

“Eating more vegetables and less red meat and processed meat is a sensible approach based on our findings and decades of other research on diet and health,” she added.  

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Journal

Alzheimer s & Dementia

DOI

10.1002/alz.70995 

Article Title

Source-specific nitrate intake and incident dementia in the Danish Diet, Cancer and Health Study