Acting on recommendations from the World Health Organization (WHO) following the 48th meeting of the WHO Expert Committee on Drug Dependence (ECDD), the United Nations Commission on Narcotic Drugs (CND) placed three harmful new psychoactive substances – one synthetic cannabinoid and two potent synthetic opioids, with no recognized medical use – under international control. As a result, countries are required to apply control measures to these substances in accordance with the international drug control conventions.
Strengthened control of high‑risk synthetic substances
The three harmful substances placed under international control are:
- N-pyrrolidino isotonitazene, also referred to as isotonitazepyne, is a potent synthetic opioid associated with fatal and non‑fatal overdoses. It has been described as a crystalline solid and has been detected in falsified pharmaceutical products, appearing as coloured tablets. The CND accepted the recommendation to include it in Schedule I of the 1961 Convention.
- N-desethyl etonitazene is a metabolite of etonitazene and a highly potent synthetic opioid linked to overdose deaths. It has been described as a crystalline solid, and a yellow or beige powder, and has appeared in falsified pharmaceutical opioid tablets. This substance was also placed into Schedule I of the 1961 Convention.
- MDMB‑FUBINACA is a potent synthetic cannabinoid, typically appearing as a white powder, and has been associated with severe adverse effects and multiple cases of poisoning. It has been found sprayed onto herbal products and sold in e-liquids for vaping. The CND endorsed the recommendation to add it to Schedule II of the 1971 Convention on Psychotropic Substances.
These scheduling decisions strengthen the global response to emerging synthetic substances that are clandestinely manufactured and associated with serious health risks, including fatalities, and for which no recognized medical use has been identified.
Current international control framework for coca leaf confirmed
The Commission also considered the WHO recommendation regarding coca leaf. Following a comprehensive scientific review, WHO had recommended maintaining coca leaf under Schedule I of the Single Convention on Narcotic Drugs. As it did not propose any change to the current international control status of coca leaf, no vote by the Commission was required.
WHO’s critical review of coca leaf, conducted for the first time in more than 30 years, brought updated scientific, cultural and public health evidence to the international arena. The ECDD acknowledged that traditional coca chewing and coca tea consumption do not appear to pose significant public health risks and that coca leaf holds important cultural meaning and traditional value for Indigenous Peoples across the Andean region.
At the same time, the Committee raised serious concerns about the rapidly expanding global cocaine market, increasing coca cultivation and the well‑documented ease and profitability of converting coca leaf into cocaine.
In this context, the ECDD concluded – and the CND confirmed – that retaining coca leaf in Schedule I of the 1961 Convention remains necessary to reduce the risks associated with illicit cocaine production, while still allowing countries to maintain culturally protected traditional uses within national legal frameworks. Legitimate medical, scientific and traditional uses of coca leaf, permitted under national legislation, remain unaffected.
WHO has encouraged further scientific research on coca leaf, including its long-term health effects and potential therapeutic properties.
WHO’s role in international drug control
Under the international drug control conventions, WHO is the only body mandated to conduct scientific and public health assessments of psychoactive substances. Through the ECDD, an independent scientific advisory body of international experts, the Organization evaluates available evidence on pharmacology, toxicology, epidemiology, dependence potential and therapeutic value of substances circulating globally, before making scheduling recommendations. These recommendations advise the CND, the United Nations’ policy-making body on international drug control, on whether international control measures are warranted to protect public health.
The decisions reflect WHO and the international community’s shared commitment to protecting public health, responding to evolving drug markets and ensuring that global policies remain firmly rooted in scientific assessment.
The WHO ECDD recommendations were endorsed by Member States at the 69th session of the CND, held from 9 to 13 March 2026.