Every year from 7000 to 8000 people die only in the European Union as a result of narcotic substance intoxications. In Poland there are from 100 000 to 120 000 people addicted to narcotics, however these data refer only to people who officially admit it. The Chief Sanitary Inspectorate presents quite disturbing data in which it is possible to notice that at the turn of 2014 and 2015 the number of designer drug intoxications increased from 6.29 per 100 000 inhabitants in 2014 to 18.92 cases per 100 000 persons in 2015 (1). This is nearly a threefold increase of such cases recorded by the Chief Sanitary Inspectorate. The WHO has considered acute intoxications the fourth leading cause of death in the world (2). The data demonstrate the great size of the problem which stimulants have become nowadays as people have started considering them a good escape from everyday stress related to work, school and family life.

Increased demand for various types of narcotic substances as well as the development of pharmaceutical technology make stimulants so popular.

One of the main routes of drug trafficking to western Europe is the “Balkan Trail” which starts in Afghanistan and the neighboring countries and goes to Poland through Turkey and the Balkan countries. This trail is mainly used for trafficking opioids which are responsible for 41% of all drug addictions in the countries of the European Union.

There is over a million registered people aged 15-64 who regularly take opioids and, what is interesting, ca. 4% of all the deaths of the inhabitants of Europe aged 15-39 are caused by the abuse of this drug (3).

According to the Polish law narcotic substances are substances of synthetic or natural origin affecting the central nervous system, the list of which has been published in annexes to the Act on counteracting drug addiction (4).

Despite of the constant extending of the list of narcotic substances every month new substances emerge; they are most often derivatives of the chemical substances present hitherto. The annexes to the act on counteracting drug addiction include several hundred psychoactive agents. Table 1 presents the latest changes to the list of narcotic substances included in the act on counteracting drug addiction dated 1^st July 2015.

Since 2010 a medical and social problem of growing significance are chemical substances called “designer drugs”. “Designer drugs” are products containing psychoactive substances which haven’t been included in the list of controlled substances annexed to the act on counteracting drug addiction. The sales of these substances has significantly increased in the last years thanks to distribution taking place via online shops. Changes to the above mentioned act have extended the list of controlled substances by another 114 substances which have previously been considered as “designer drugs” (4).

A very popular division of narcotic substances is the classification which has been presented by the WHO (5):

I. opium group,

II. alcohol and barbiturates, barbiturate-like substances group,

III. amphetamine, amphetamine-like stimulant drugs group,

IV. cocaine group,

V. cannabis group,

VI. hallucinogen group,

VII. khat group,

VIII. volatile solvents group.

The opium group includes ca. 20 substances which are divided into two types: phenanthrene alkaloids and isoquinoline alkaloids. The most popular substances in this group are: heroin, methadone, morphine, buprenorphine, tramadol, fentanyl as well as hydromorphone which is not available in Polish drug stores (6). The substance from this group most often applied by Medical Rescue Teams in Poland is morphine which is present in the following medications: Morphini sulfas WZF, MST Continus, Sevredol, Vendal, Doltard oraz M-Eslon (7). Morphine (MF) is a phenanthrene alkaloid constituting one tenth of opium. It is an agonist of opioid receptors, strongly acting on μ receptors, significantly less strongly on δ and κ. The primary effects of morphine are the analgesic, antitussive and anti-diarrheal effect. It is applied as a medicine of choice in patients with severe and very severe pain (8).

The next group are alcohols and barbiturates. The derivatives of barbituric acid have got a sedative, soporific, anxiolytic, anticonvulsant and amnestic effect. Their mechanism of action consists in activating the chlorine channel by binding to the GABAa receptor and blocking the conductance of the sodium and calcium channels. Due to the fact that these substances are strongly addictive, they exhibit high toxicity, they disrupt sleeping phases and they negatively affect the patients’ behavior, currently they’re applied only in anesthesiology and in the treatment of epilepsy. These medications include: phenobarbital, benzobarbital, methylphenobarbital (7-10).