Are new psychoactive substances driving sudden unexpected deaths and violence among youth in the European countries?

Sudden unexpected deaths (SUD) and violent behaviours among young people have emerged as urgent public health concerns in Europe, with Italy showing a marked increase in recent years. This study explores the hypothesis that the diffusion of new psychoactive substances (NPS), such as synthetic cathinones (e.g. 3-methylmethcathinone (3-MMC), besides cocaine, may be contributing to these trends. Drawing on European and Italian data, forensic reports, and pharmacological evidence, we conducted exploratory correlation analyses between NPS availability and outcomes including SUD, sexual harassment, and aggression. Significant associations were observed, with strong correlations between synthetic drug entries and both sudden deaths and violence particularly during the COVID-19 pandemic years (e.g. R2 = 0.918, p = 2.63 × 10-⁷). While causality cannot be established, the biological plausibility of cardiovascular and neuropsychiatric toxicity supports further investigation. These findings highlight the need for enhanced surveillance, standardized toxicological protocols, and youth-focused prevention strategies to address the growing risks posed by NPS proliferation.