In the last few years, a wide range of new psychoactive substances (NPS) have been produced and marketed to
elude the controlled substance lists. These molecules enter the traditional illegal and web market with poor knowledge
about their toxicity, mechanism of action, metabolism, abuse potential so that they are directly tested by the consumers.
This perspective highlights the main issues connected with NPS: the celerity they enter and leave the market once included
in the banning laws to be substituted by new legal analogues; the unavailability of analytical screening tests and
certified standards to perform toxicological analyses; the time lag between NPS identification and inclusion in the controlled
substances lists. Finally, the authors take a snapshot of the commitment of the Italian Early Warning System in
highlighting the recent seizures of NPS as well as the distribution of NPS related intoxication and deaths as an example of
what is happening in the European countries and internationally.