UN Places Deadly Synthetic Drugs Under Global Control Following WHO Review; Coca Leaf Status Maintained

Among them is N-pyrrolidino isotonitazene (isotonitazepyne), a synthetic opioid of extreme potency that has been increasingly detected in counterfeit medicines.

In a decisive move to counter the growing threat of synthetic drugs, the United Nations Commission on Narcotic Drugs (CND) has placed three highly dangerous psychoactive substances under international control, acting on scientific recommendations from the World Health Organization (WHO). The decision, adopted during the 69th session of the CND, underscores mounting global concern over potent synthetic opioids and cannabinoids that are increasingly linked to overdose deaths and severe public health risks.

The newly controlled substances — one synthetic cannabinoid and two powerful synthetic opioids — have no recognised medical use and are associated with a rising number of fatal and non-fatal intoxications worldwide. Their inclusion in international drug control schedules will now require countries to implement strict regulatory measures, including restrictions on production, distribution, and use, in line with global drug control conventions.

Crackdown on High-Risk Synthetic Drugs

The three substances brought under international control represent a new generation of clandestinely manufactured drugs that are often disguised as legitimate pharmaceuticals or mixed into other substances, making them particularly dangerous.

Among them is N-pyrrolidino isotonitazene (isotonitazepyne), a synthetic opioid of extreme potency that has been increasingly detected in counterfeit medicines. Often appearing as coloured tablets or crystalline substances, it has been linked to multiple overdose incidents across regions. Recognizing its high abuse potential and lack of therapeutic value, the CND has placed it under Schedule I of the 1961 Single Convention on Narcotic Drugs, the strictest level of international control.

Similarly, N-desethyl etonitazene, a metabolite of the already potent etonitazene, has also been classified under Schedule I. This substance has surfaced in falsified opioid tablets and is associated with fatal overdoses, often due to its high potency and unpredictable dosing in illicit markets.

Completing the list is MDMB-FUBINACA, a synthetic cannabinoid known for causing severe toxic reactions, including acute poisoning and life-threatening neurological effects. Commonly sold as a white powder, it is frequently sprayed onto herbal mixtures or incorporated into vaping liquids. The substance has now been placed under Schedule II of the 1971 Convention on Psychotropic Substances, reflecting its significant risk to public health.

Public health authorities warn that such synthetic substances are particularly dangerous because they are often produced in unregulated environments, vary widely in strength, and are frequently consumed unknowingly by users who believe they are taking other drugs.

Rising Global Threat from Synthetic Opioids

The decision comes amid a broader surge in synthetic drug use, particularly opioids, which are driving overdose crises in multiple regions. These substances are often far more potent than traditional opioids like heroin, increasing the risk of fatal respiratory depression even at low doses.

Illicit drug markets have increasingly shifted toward synthetic compounds due to their ease of manufacture, lower production costs, and high profit margins. Unlike plant-based drugs, synthetic substances can be produced anywhere, making enforcement more challenging and enabling rapid global spread.

Experts note that many of these compounds are deliberately modified to evade existing legal controls, creating a constant race between regulators and illicit manufacturers.

Coca Leaf Status Remains Unchanged

In addition to controlling new synthetic substances, the Commission also reviewed the status of coca leaf, following a comprehensive scientific assessment by WHO — the first such review in over three decades.

WHO's Expert Committee on Drug Dependence (ECDD) concluded that while traditional uses of coca leaf — such as chewing and consumption as tea — do not appear to pose significant public health risks, the plant remains closely linked to the global cocaine trade.

Given the ease and profitability of converting coca leaf into cocaine, alongside rising coca cultivation and expanding illicit markets, WHO recommended maintaining coca leaf under Schedule I of the 1961 Convention. The CND accepted this recommendation, meaning no change was made to its international control status.

Importantly, the decision preserves the ability of countries to allow culturally protected traditional uses of coca leaf within their national legal frameworks. Indigenous communities in the Andean region, where coca holds deep cultural and historical significance, will continue to be able to use it in traditional practices.

At the same time, WHO has called for further scientific research into coca leaf, including its long-term health effects and any potential therapeutic applications, signaling a more evidence-based approach to future policy considerations.

Science-Driven Global Drug Policy

Under international drug control conventions, WHO plays a unique and critical role as the only body authorized to conduct scientific and public health evaluations of psychoactive substances. Through its Expert Committee on Drug Dependence — an independent panel of global specialists — the organization assesses substances based on pharmacology, toxicity, patterns of use, dependence potential, and therapeutic value.

These assessments form the basis for recommendations to the CND, which serves as the United Nations' central policymaking body on drug control.

"The latest decisions reflect a strong commitment by the international community to ensure that drug policies are grounded in science and focused on protecting public health," experts said, emphasizing the importance of coordinated global action in responding to rapidly evolving drug markets.

A Coordinated Response to Emerging Risks

The inclusion of these substances under international control is expected to strengthen law enforcement cooperation, improve monitoring, and reduce the availability of high-risk drugs in illicit markets. However, experts caution that regulation alone is not sufficient.

They stress the need for a comprehensive response, including prevention, treatment services, harm reduction strategies, and public awareness campaigns to address the growing impact of synthetic drugs.

As drug markets continue to evolve, the WHO and its partners are expected to intensify surveillance and accelerate scientific reviews to keep pace with emerging threats.

The decisions taken at the 69th session of the CND, held from 9 to 13 March 2026, mark another step in the global effort to safeguard public health against the dangers of synthetic drugs while balancing cultural and scientific considerations in international policy.