Once thought to be largely a western problem, new psychoactive substances - so-called "legal highs" - are now a global issue being fuelled by the internet, according to a report to be released soon by the UN Office on Drugs and Crime.
The world's drug culture is constantly evolving, but it is not becoming any safer. Those taking drugs today are just as likely to be unwittingly supplied a new psychoactive substance (known as "NPS") as ecstasy. In this new environment, the seemingly legal is competing with the outright illegal - but the health risks remain.
Today, we are staring at a new drug horizon where those willing to take these substances have become the participants in a lottery that puts lives at risk. Users are potentially one tweaked molecule away from death.
Sold with names such as Spice and K2, these drugs, or drugs similar to them, have killed and injured young people across the world. Wrongly described as "legal highs", these substances simply exploit existing legal loopholes.
Such substances also exist in a wide variety. For example, there are over 60 different types of synthetic cannabinoids, which mimic cannabis.
These drugs have emerged in the UAE, as well as Bahrain, Jordan, Lebanon, Oman and Saudi Arabia. Dubai Customs has reported trafficking in the synthetic cannabinoid known as Spice.
The UNODC report, The challenge of new psychoactive substances, examined 80 countries and received information from 142 drug analysis laboratories in 54 countries.
It found that there are now around 250 types of NPS that are not under international control and about which we know very little. For the first time, this figure is greater than the 234 drugs scheduled under international drug conventions. The gap continues to widen.
By simply changing a part of a molecule, the people producing these chemicals can stay ahead of those attempting to regulate the drugs. For this reason, the number of new substances is potentially limitless. Healthcare professionals are facing a situation where an NPS can cause death and injury before they fully understand its effect.
What was once a regional problem has become a global threat. This creates daunting challenges for health services in fragile countries without the resources to respond to specialised health issues.
While avoiding moral panic, we need to respond decisively. Most importantly, we need to ensure that political understanding and commitment is locked into a coordinated health and law-enforcement response. Decision-makers, community leaders, police and health officials need to speak with a single voice, based on a sound understanding of the situation.
Research and analysis is also pivotal. Many countries are carrying out isolated studies, but the real situation is largely uncharted territory. We need a wider understanding of the spread of these substances and more information on their composition and potentially harmful effects. Countries also need to strengthen their forensic science capabilities.
Treatments for the effects of these drugs remain in their infancy. Although more users are presenting at hospitals and clinics, a gap in medical knowledge remains. We do not know if present use is creating future addiction. To help further study, more analysis and greater information sharing are needed.
We must also build a bridge to young people through greater raising of awareness. This means engaging young people in a dialogue, not talking down to them. We can't risk losing them to ignorance and misunderstanding.
Innovative approaches should be applied. For example, New Zealand has enacted creative legislation that places the onus of proving the substance is safe on the seller.
There is also a need to come up with fresh strategies to deal with the internet. Respondents from all regions cited the internet as a source for these substances, and online shops numbers increased from 170 in 2010 to 690 in 2012.
This month, UNODC will publish a complete list of substances to make everyone aware of the challenge.
We need to start working closely together at the international level and we need to do so now.
Yury Fedotov is executive director of the United Nations Office on Drugs and Crime, based in Vienna. A version of this article appeared recently in the German-language Neue Zuercher Zeitung