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In an unprecedented show of unity, more than 47 million health professionals, patients, advocates, representatives from civil society organizations, and individuals worldwide have signed a resounding call for urgent action to reduce air pollution and to protect people’s health from its devastating impacts.

Following recommendations by the World Health Organization (WHO), the United Nations Commission on Narcotic Drugs (CND) has decided to place five new psychoactive substances and one medicine under international control.

The recommendations were developed by WHO Expert Committee on Drug Dependence--ECDD, which consists of global experts analyzing health risks and benefits of psychoactive substances circulating on global markets and alerting to include them under international control if evidence found that their use can cause harm for population health in countries.

“These substances have been brought to WHO’s attention for being clandestinely manufactured, posing serious risk to public health and society without any recognized therapeutic use,” said Dr Deus Mubangizi, WHO Director for Health Product Policy and Standards. “We are pleased that the Commission (on Narcotic Drugs) has accepted the full set of WHO recommendations and added these substances to relevant schedules in the 1961 or 1971 Conventions. We hope countries and communities will increase vigilance and take necessary actions to protect vulnerable groups particularly youth from these substances.”

Four substances placed in Schedule I of the Single Convention on Narcotic Drugs (1961), as amended by the 1972 Protocol are:

N-Pyrrolidino protonitazene, also referred to as protonitazepyne, is a synthetic opioid.  It has been described as a beige powder or a white colourless or crystalline solid, and has been identified in falsified pharmaceutical opioid tablets. It is reported to be administered by various routes, including smoking, snorting and by injection. It can cause substantial harm, including death. It has no known therapeutic use.

N-Pyrrolidino metonitazene, also referred to as metonitazepyne, is a synthetic opioid. It has been described as a beige powder and is reported to be administered by injection. There is evidence that its use causes substantial harm, including death. It has no known therapeutic use.

Etonitazepipne, also referred to as N-piperidinyl etonitazene, is a synthetic opioid.  It has been described as a crystalline solid and a yellowish-white or yellow powder. There is evidence that use of this substance causes substantial harm, including death. It has no known therapeutic use.

N-Desethyl isotonitazene, also referred to as norisotonitazene, is a synthetic opioid that has been described as a crystalline solid. It has been identified in falsified pharmaceuticals. Multiple deaths and hospital admissions have been reported in at least two regions. There is evidence that its use causes substantial harm, including death. It has no known therapeutic use.

Substance placed in Schedule II of the Convention on Psychotropic Substances (1971):

Hexahydrocannabinol, also known as HHC, is a semi-synthetic cannabinoid described as a colourless viscous oil or resin. Products such as THC cannabis flowers and resins infused or sprayed with the substance, e-liquids and cartridges for electronic cigarettes, edible products such as gummies and marshmallows, tinctures resembling dietary supplements and distillate oils can include HHC. There is sufficient evidence that HHC is used in ways to constitute a public health and social problem, warranting placement under international control.

Substance placed in Schedule IV of the Convention on Psychotropic Substances (1971):

Carisoprodol is a centrally acting skeletal muscle relaxant sold as a single-ingredient preparation and in combination products. Carisoprodol is available as a pharmaceutical product in tablet form, has been detected in falsified pharmaceuticals and is also found as a white powder. There is increasing evidence that nonmedical use of carisoprodol in a number of countries constitutes a significant risk to public health.

WHO has been convening the ECDD as a scientific advisory body for over 70 years with the mission to protect populations from harmful substances and to ensure that psychoactive substances are available where needed for medical and scientific purposes. The ECDD conducts scientific reviews at the request of the UN Commission on Narcotic Drugs and is the only treaty-mandated body to provide health recommendations to the Commission to inform decisions in drug policy.

With the ongoing emergence of more harmful substances, including clandestinely manufactured synthetic opioids with no medical use such as fentanyl and nitazenes, Member States expressed interest in more scientific reviews of these substances by WHO in the coming period. Above-mentioned decisions were announced at the 68th regular session of the Commission on Narcotic Drugs, taking place in Vienna, Austria, on 10-14 March 2025. 

The European Centre for Disease Prevention and Control (ECDC) has published findings from its 2024 survey assessing public health workforce capacity in infectious disease prevention and control across European Union and European Economic Area (EU/EEA) countries.