New psychoactive substances in Eurasia: a qualitative study of people who use drugs and harm reduction services in six countries

Abstract

Background This study examines the use of new psychoactive substances (NPS) and the harm reduction response in six Eurasian countries: Belarus, Moldova, Serbia, Kazakhstan, Kyrgyzstan, and Georgia. The aim is to identify current patterns of NPS use and related harms in each country through recording the perspectives and lived experience of people who use drugs and people who provide harm reduction services in order to inform the harm reduction response. Methodology The study involved desk-based research and semi-structured interviews/focus groups with 124 people who use drugs and 55 health and harm reduction service providers across the six countries. Results People who use drugs in all countries were aware of NPS, primarily synthetic cathinones and synthetic cannabinoids. NPS users generally reflected two groups: those with no prior history of illicit drug use (typically younger people) and those who used NPS on an occasional or regular basis due to the lack of availability of their preferred drug (primarily opiates). In many cases, these respondents reported they would not use NPS if traditional opiates were available. Common factors for choosing NPS included cost and accessibility. Respondents in most countries described NPS markets that use the DarkNet and social media for communication, secretive methods of payment and hidden collection points. A recurring theme was the role of punitive drug policies in driving NPS use and related harms. Respondents in all countries agreed that current harm reduction services were important but needed to be enhanced and expanded in the context of NPS. Conclusions The study identified patterns and drivers of NPS use, risk behaviours and drug-related harms. It identified gaps in the current harm reduction response, particularly the needs of non-injectors and overdose response, as well as the harmful effects of punitive drug policies. These findings may inform and improve current harm reduction services to meet the needs of people who use NPS.

Synthetic cannabinoids awareness among patients with opioid use disorder in Serbia – A survey based cross-sectional pilot study

“…A study by Elliott et al showed that marijuana and SCs are not commonly used interchangeably by the same individuals, implying either that the substance effects are sufficiently different, or that SCs are used out of a perceived necessity, not preference ( 40 ). In Serbia, NPS were commonly consumed in combination with amphetamines, cocaine, ecstasy, alcohol and cannabis ( 11 ). Reasons for drug combinations were: to prolong or amplify the drug’s effects, to add a new effect and to alleviate drug hangovers ( 11 ).…”

“…In Serbia, NPS were commonly consumed in combination with amphetamines, cocaine, ecstasy, alcohol and cannabis ( 11 ). Reasons for drug combinations were: to prolong or amplify the drug’s effects, to add a new effect and to alleviate drug hangovers ( 11 ). Acute side effects reported strongly support those described in the literature and included dry mouth, trouble thinking clearly, panic attack, palpitations and fear ( 6 , 11 , 13 , 14 ).…”

“…Also, this study confirms that NPS use in Europe is much lower than the use of classical psychoactive drugs ( 10 ). On the other hand, lived experience of people who use NPS as well as people who provide harm reduction services were main sources of information for the study conducted by Kurcevič et al in 6 Euroasian countries, including Serbia ( 11 ).…”

Perceived risk and condomless sex practice with commercial and non-commercial sexual partners of male migrant sex workers in London, UK

“…[48][49][50] Authors describe the use of drugs with clients as a social aspect of their occupation, 51 while improving their performance. 52 Further, some argue that this is a difficult aspect to avoid with clients who are regular drug users. 49 Another interlinked factor was feeling sexually attracted to clients that implied opting for personal pleasure over a professional perspective.…”

New Psychoactive Substances: Awareness and Attitudes of Future Health Care Professionals in Serbia

“…Moreover, just two reliable publications in international peer-reviewed journals are available regarding NPSs in Serbia. The first one pointed out clinical and analytical experience of the Serbian National Poison Control Centre with synthetic cannabinoids [ 8 ], while the second one examined the use of NPSs in light of harm-reduction responses in six Euroasian countries, including Serbia [ 9 ].…”