Abstract
BackgroundAbout 15 years ago, a diverse group of new recreational psychotropic substances began to emerge, which were marketed for example as “legal highs,” “research chemicals,” or “designer drugs.” These substances were later subsumed under the label “Novel Psychoactive Substances” (NPS). Important NPS classes are cathinones, synthetic cannabimimetics, phenethylamines, and herbal drugs. The health care system for psychotropic substance use disorders (SUDs) traditionally focused on a few substances, such as alcohol, heroin, cocaine, amphetamines, or cannabis. Users of illicit substances often engage in polydrug use. However little is known about the prevalence of NPS use within the group of “classical” illicit substance users.ObjectiveWe investigated lifetime and recent use of NPS and other drugs in patients who underwent in-patient detoxification treatment from illicit drugs in Germany.MethodsIn a multicenter study with eight participating facilities, patients admitted to treatment underwent a standardized interview at admission, concerning their past and current substance use. The interview comprised classical substances of abuse, NPS, and rarely used substances such as LSD. In addition, participating sites had the opportunity to analyze their patients’ routine drug screenings by means of gas chromatography/mass spectrometry (GC/MS), which permitted detection of NPS.ResultsInterviews from 295 patients could be analyzed. Most patients were opiate dependent and multiple substance users. About 32% reported use of synthetic cannabimimetics during lifetime, but usually only a few times. An important reason for their use was that NPS were not detected by drug testing in prisons or drug treatment facilities. Cathinones, herbal drugs or other NPS had rarely been used during lifetime. NPS use during the last 30 days before admission was nearly zero. This was confirmed by urine analysis results. In contrast, lifetime and current use of opiates, alcohol, cocaine, benzodiazepines, and cannabis was high. In addition, 18% reported of regular unprescribed pregabalin use during lifetime, and 20% had recently used pregabalin.ConclusionPatients admitted to drug detoxification treatment showed multiple substance use, but this did not include NPS use. The diversion of legal medications such as pregabalin in this group is a serious concern.
Highlights
The health care system for substance related disorders has traditionally been concerned with a limited number of psychoactive drugs, for example alcohol, opiates, cocaine, cannabis, and amphetamines, and to a much lesser degree with hallucinogenic drugs such as LSD, psilocybin, and others [1]
In the present multicenter study, we examined lifetime and recent Novel Psychoactive Substances (NPS) use in patients admitted to in-patient drug detoxification treatment for illicit drugs
The interview was standardized with regard to questions and answering formats, and specific questions about NPS use were included
Summary
The health care system for substance related disorders has traditionally been concerned with a limited number of psychoactive drugs, for example alcohol, opiates, cocaine, cannabis, and amphetamines, and to a much lesser degree with hallucinogenic drugs such as LSD, psilocybin, and others [1]. About 15 years ago, the market for psychotropic substances saw the advent of a range of diverse substances, designed as legal alternatives to legally controlled drugs [2] These substances first gained prominence under labels such as “legal highs,” “herbal highs,” “research chemicals,” or “spice.” The term Novel Psychoactive Substances (NPS) which is used to describe these substances is not descriptive of their intrinsic properties. About 15 years ago, a diverse group of new recreational psychotropic substances began to emerge, which were marketed for example as “legal highs,” “research chemicals,” or “designer drugs.”. These substances were later subsumed under the label “Novel Psychoactive Substances” (NPS). Little is known about the prevalence of NPS use within the group of “classical” illicit substance users
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