New Psychoactive Substances (NPS) – a Challenge for the Addiction Treatment Services

Scherbaum, Norbert; Schifano, Fabrizio; Bonnet, Udo

doi:10.1055/s-0043-102059

Cited by 33 publications

(28 citation statements)

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“…These mainly include synthetic stimulants, depressants, hallucinogens, and cannabinoids (EMCDDA, 2017;Nelson, Bryant, & Aks, 2014), but some plant-based drugs may also be classified as NPS (Schifano, Orsolini, Duccio Papanti, & Corkery, 2015). In cases where sales information or labels exist, these may be inaccurate or misleading due to intended mislabeling or adulteration of common drugs with NPS (Oliver et al, 2019;Palamar et al 2017;Scherbaum, Schifano, & Bonnet, 2017;UNODC, 2016) or the chemical name may be difficult to remember. Hence, even when reporting to the best of their knowledge, users may still do so incorrectly.…”

Section: Introductionmentioning

confidence: 99%

Drug Use by Music Festival Attendees: A Novel Triangulation Approach Using Self-Reported Data and Test Results of Oral Fluid and Pooled Urine Samples

Gjerde

Gjersing

Baz-Lomba

et al. 2019

Substance Use & Misuse

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Background: Self-reported data are commonly used when investigating illicit substance use. However, self-reports have well-known limitations such as limited recall and socially desirable responding. Mislabeling or adulteration of drugs on the illicit market may also cause incorrect reporting. Objectives: We aimed to examine what could be gained in terms of illicit drug use findings among music festival attendees when including biological sample test results in the assessment. Methods: We included 651 attendees at three music festivals in Norway from June to August 2016. Self-reported drug use was recorded using questionnaires, and samples of oral fluid were analyzed to detect use of illicit drugs. In addition, we analyzed samples of pooled urine from portable toilets at each festival. Results: All methods identified cannabis, MDMA, and cocaine as the most commonly used drugs. Overall, 6.6% of respondents reported use of illicit substances during the previous 48 hours. Oral fluid testing identified a larger number of drug users as 12.6% tested positive for illicit drugs. In oral fluid testing, we identified ketamine and three new psychoactive substances (NPS) that had not been reported on the questionnaire. In pooled urine testing, we identified amphetamine and three additional NPS that were neither reported used nor found in oral fluid samples. Conclusions/Importance: Drug testing of biological samples proved to be an important supplement to self-reports as a larger number of illicit substances could be detected.

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Section: Introductionmentioning

confidence: 99%

Drug Use by Music Festival Attendees: A Novel Triangulation Approach Using Self-Reported Data and Test Results of Oral Fluid and Pooled Urine Samples

Gjerde

Gjersing

Baz-Lomba

et al. 2019

Substance Use & Misuse

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“…This ever-changing drug scenario represents a challenge for accident and emergency units; healthcare services [ 19 ]; public health; psychiatry; and drug-control policies [ 23 ]. Indeed, in case of some drug intoxication presentations, drug detection for some of those medications that are central to the “pharming” phenomenon (e.g., loperamide; antidepressants; antipsychotics; cough and cold preparations; anti-histamines, etc.)…”

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confidence: 99%

What about “Pharming”? Issues Regarding the Misuse of Prescription and Over-the-Counter Drugs

Chiappini

Schifano

2020

Brain Sciences

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Recently, a range of prescription and over-the-counter (OTC) drugs have emerged as being used recreationally, either on their own or in combination with other substances, both licit and illicit, including new psychoactive substances (NPS). Among them, the misuse of prescription drugs involves not only traditionally recorded substances, such as benzodiazepines and opioid pain relievers, but also gabapentinoids (e.g., pregabalin and gabapentin); some antidepressants, e.g., bupropion and venlafaxine; some second-generation antipsychotics, e.g., quetiapine and olanzapine. Moreover, the use of some OTC for recreational purposes appears on the increase, especially in vulnerable categories such as young people/youths, including the use of high dosages of the antidiarrheal loperamide; first-generation antihistamines, e.g., promethazine, cyclizine, and diphenhydramine; cough and cold preparations containing dextromethorphan and/or codeine. In this context, the role of the Internet has rapidly increased, playing a significant role both in the diffusion of emerging trends of drug misuse among users and experimenters, and the marketing, sale, and distribution of drugs through online pharmacies. This phenomenon within the context of a rapidly modifying drug scenario is a globally recognized health problem, determining severe adverse consequences, including fatalities, and represents a challenge for clinicians in general, psychiatrists, public health, and drug-control policies.

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“…Cochrane reviews show that the evidence for successful PSIs for substance use disorders, including polydrug use, focuses on motivational interviewing, cognitive-behavioural therapy, contingency management and community reinforcement approaches. 199,200 Furthermore, individuals with higher severity and secondary use who have complex comorbidities will benefit from a combination of psychological treatment modalities that include relapse-prevention models as part of the treatment plan. 152 Solomon et al 201 advise that, in the absence of research evidence to support the use of PSIs for NPS use, they should not be offered as a standalone therapy but should be used as an adjunct therapy alongside appropriate drug therapy as well as family, peer, community and psychiatric support.…”

Section: Harm Reductionmentioning

confidence: 99%

Evidence for public health on novel psychoactive substance use: a mixed-methods study

et al. 2019

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Background Novel psychoactive substances (NPSs) contribute to the public health impact of substance misuse. This report provides research evidence addressing 11 research questions related to NPSs, covering types, patterns and settings of use; supply sources; and implications for policy and practice. Methods The study used a conceptually linked three-phase mixed-methods design with a shared conceptual framework based on multiple-context risk and protective factors. Phase 1 was a quantitative phase involving secondary data analysis of the longitudinal Belfast Youth Development Study (BYDS), a latent class analysis using the 2039 BYDS participants. Phase 2 was an extensive qualitative analysis via narrative interviews with participants, sampled from BYDS, drug/alcohol services and prisons, to explore NPS use trajectories. Phase 3 was the final quantitative phase; generalisability of the shared risk factor part of the model was tested using the manual three-step approach to examine risk factors associated with latent class membership. The quantitative and qualitative analyses were integrated, thus allowing emerging findings to be further explored. Results The data suggest that NPSs have a place within a range of polydrug use trajectories. Models showed no distinctive NPS class, with no clear evidence of differential risks for NPS use compared with the use of other substances. From the qualitative analysis, a taxonomy of groups was derived that explored how and where NPSs featured in a range of trajectories. This taxonomy was used to structure the analysis of factors linked to use within a risk and protective framework. Drivers for use were considered alongside knowledge, perceptions and experience of harms. Suggestions about how interventions could best respond to the various patterns of use – with special consideration of synthetic cannabinoids (SCs), including how they relate to the use of heroin and the potential for NPSs to operate as a ‘snare’ to more problem use – were also presented. Limitations The study was conducted during 2016/17; generalisability beyond this sample and time point is limited. The level of missing data for some of the BYDS analysis was a limitation, as was the fact that the BYDS data were collected in 2011, so in a different context from the data collected during the narrative interviews. The Psychoactive Substances Act 2016 (Great Britain. Psychoactive Substances Act 2016. London: The Stationery Office; 2016) came into force during qualitative fieldwork and, although not particularly influential in this study, may be influential in future work. It is acknowledged that many of the data related to SCs and mephedrone. Although drug use was measured by self-report, the strength of rapport within interviews, reflective diaries and methodological acceptability checks helped to mitigate self-report bias. Conclusions NPSs continue to present significant challenges for legislation and monitoring, researching and developing interventions. Understanding of usage patterns remains poor, with most information based on populations and settings where problems have already occurred. This research contributes to the evidence base by providing much needed further empirical data on the lived experiences of NPS users across a range of settings. In the light of these data, implications for policy and practice are discussed. Future work Future research must generate improved epidemiological data on the extent, patterns and motivations for use longitudinally. The uniqueness of the information concerning SC use points to a specific set of findings not evidenced in other literature (e.g. intensity of SC withdrawal). Future research should focus on the symbiotic link between SC and heroin use. Funding The National Institute for Health Research Public Health Research programme.

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New Psychoactive Substances (NPS) – a Challenge for the Addiction Treatment Services

Cited by 33 publications

References 50 publications

Drug Use by Music Festival Attendees: A Novel Triangulation Approach Using Self-Reported Data and Test Results of Oral Fluid and Pooled Urine Samples

Drug Use by Music Festival Attendees: A Novel Triangulation Approach Using Self-Reported Data and Test Results of Oral Fluid and Pooled Urine Samples

What about “Pharming”? Issues Regarding the Misuse of Prescription and Over-the-Counter Drugs

Evidence for public health on novel psychoactive substance use: a mixed-methods study

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