The nature of the drug phenomenon is changing rapidly, and recent years have seen a marked increase in the use of stimulants and dissociative substances. Geopolitical changes, the emergence of new trafficking routes, and other supply-related factors add further complexity. The dangers posed by polydrug use and the emergence of new synthetic drugs means that we will need to develop more timely sources of information, linked to risk communication systems, and more responsive harm reduction strategies, particularly in recreational settings. While we need to continue to respond effectively to the current situation, much of our focus must be on developing preparedness and anticipatory capacity in this constantly evolving field.