2024-12-01-世界卫生组织-Annex_1._47th_WHO_ECDD_summary_assessments_and_recommendations_10页_221kb

Annex 1: 47th WHO ECDD Summary Assessments and Recommendations

Date: 14–18 October 2024

Overview: The report details the assessment and recommendations by the WHO Expert Committee on Drug Dependence (ECDD) for four substances.

1. Synthetic Opioids

• N-Pyrrolidino Protonitazene (Substance Identification: Protonitazepyne)

  • Assessment: Full μ-opioid receptor agonist with high potency (> morphine and fentanyl). No known therapeutic use, illicit production, abuse potential via multiple routes, associated with overdose deaths. Recommendation: Add to Schedule I of the 1961 Single Convention.

• N-Pyrrolidino Metonitazene (Substance Identification: Metonitazepyne)

  • Assessment: Full μ-opioid receptor agonist (potency varies); linked to fatalities, no therapeutic use. Similar profile to N-Pyrrolidino Protonitazene. Recommendation: Add to Schedule I.

• Etonitazepipne (Substance Identification: N-Piperidinyl Etonitazene)

  • Assessment: Full μ-opioid receptor agonist (higher than morphine in some models), abused leading to fatal intoxications, no therapeutic use. Recommendation: Add to Schedule I.

• N-Desethyl Isotonitazene (Substance Identification: Norisotonitazene)

  • Assessment: Potent μ-opioid receptor agonist, significant public health burden (overdoses, hospitalizations), metabolite of isotonitazene. Recommendation: Add to Schedule I.

Area: Schedule I Additions (Single Convention)

2. Hexahydrocannabinol (HHC)

• Assessment: Agonist at CB1 receptors, psychoactive effects similar to Δ⁹-THC. Semi-synthetic, synthetic source. Associated with intoxication cases, no recognized therapeutic use. Recommendation: Add to Schedule II of the 1971 Convention.

Area: Schedule II Additions (Psychotropic Convention)

3. Carisoprodol

• Assessment: Muscle relaxant linked to abuse, dependence, CNS depression, fatalities. Previously saw sporadic non-medical use but recent data shows significant increase. Therapeutic use withdrawn in some areas due to risks. Recommendation: Add to Schedule IV.

Area: Schedule IV Additions (Psychotropic Convention)

4. N-Ethylheptedrone (Substance Identification: N-Ethyl-3-phenylpropanamide)

• Assessment: Synthetic cathinone analogue linked to public health threat via abuse potential. Increase in seizures noted. Abuse liability evidenced, however, classification under international control not recommended based on insufficiency of data; shifted recommendation to surveillance only.

Area: Substances to be kept under surveillance

Key Conclusions: All assessed synthetic opioids are potent and pose significant abuse and public health risks, warranting their addition to the schedules of international drug control conventions. Hexahydrocannabinol meets similar criteria for international control. Carisoprodol was cleared previously but new data necessitates stricter placement. N-Ethylheptedrone represents an ongoing surveillance need due to abuse potential but insufficient evidence for international control.