New Psychoactive Substances and suicidality: a systematic review of the current literature.

Background and Objectives: Over the past twenty years a large number of New Psychoactive Substances (NPS) has entered and modified the recreational drug scene. Their intake has been associated with health-related risks, and especially so for vulnerable populations such as people with severe mental illness, who might be at higher risk of suicidality or self- injurious behaviour.
This paper aims at providing an overview of NPS abuse and effects on mental health and suicidality issues, performing a literature review of the current related knowledge, thereby identifying substances that more than others are linked to suicidal behaviours.
Materials and Methods: A comprehensive and updated overview of the literature regarding suicidality and NPS categories has been provided. An electronic search was performed, including all papers published up to March 2021, using the following keywords "NPS" OR "new psychoactive substances" OR "novel psychoactive substances" OR "synthetic cannabinoids" OR "phenethylamines" OR "synthetic cathinones" OR “tryptamines” OR “piperazines” OR “new synthetic opioids” OR “designer benzodiazepines”) AND ("suicide" OR "suicidality") NOT review NOT animal on the PubMed, Cochrane Library, and Web of Science online databases.
Results: Suicidality and self-injurious behaviour appear to be frequently associated with some NPS such as cathinones, synthetic cannabinoids, and new synthetic opioids. Results are organised according to substances recorded.
Conclusion: The growing use of NPS has become a significant clinical issue, posing increasing concern and challenges for clinicians working in both mental health and emergency departments. Thus, considering the associations between NPS and suicidality or self-injurious behaviours, areas where suicide-prevention efforts and strategies might be focused are the early detection, monitoring and restriction of NPS.