Intoxications with novel psychoactive substances constitute a significant part of ambulance calls and are the main reason for poisoning deaths in Estonia. The abuse of designer drugs such as phentanyl derivates, synthetic cannabinoids and cathinones has emerged in the 21st century. Lower doses of opioids cause changes in breathing rhythm and larger doses decrease tidal volume. The most common adverse effects of the usage of cannabinoids are tachycardia, anxiety and nausea, but some cases of respiratory arrests have also been described. The effects of narcotic bath salts are similar to the effects of amphetamine, with the associated higher cardiovascular risk. Another major group of adverse effects are neurological disorders. The most common respiratory abnormality is dyspnea but respiratory distress or respiratory arrest may also occur.