Novel Psychoactive Substances Users Research Articles

Narrative Means to Recovery Ends. Novel Psychoactive Substance Users in Early Recovery

The relationship between trauma and subsequent substance use has been extensively studied. Substance dependence and its consequences are a source of further traumatization. This explorative qualitative study is an analysis of the recovery narratives of persons with polydrug dependence, using mainly novel psychoactive substances (NPSs). NPS use, with its unpredictability and major health risks poses a challenge to treatment systems, but only few studies are available on NPS users’ recovery processes. In this longitudinal study, authors explore processes of identity reconstruction in the emotionally valent episodes of 10 respondents’ life interviews. The interviews had been conducted with 77 patients at the beginning of their residential treatment and were repeated a year later with those in recovery and available for the study, altogether 10 persons. Narrative Oriented Inquiry was used as a framework, focusing on the key themes and changes in the narrative mode. Our results support the findings on previous and subsequent NPS use-related traumatization. In this perspective, NPS use corresponds to revictimization. Contrary to available but sporadic evidence suggesting a marked difference between the recovery processes of users of classical substances and NPS users, the respondents in this study could utilize the traditional cultural stock of recovery stories during their treatment. Changes involved more reflective and responsible attitudes and the broadening of a healing social network. Contents describing care/self-care and the emergence of hopeful attitudes were also identified. Further research, involving larger samples and cross-cultural comparisons, could deepen our understandings of NPS users’ recovery processes.

Self-medication with Novel Psychoactive Substances (NPS): a Systematic Review

AbstractCurrently, novel psychoactive substance (NPS) use presents a challenging issue for authorities. To effectively tackle the use of NPS, a deeper understanding of the motivations of those who use NPS is required. Evidence suggests that a subset of NPS users declare their use as ‘self-medicating’; however, there is a paucity of research in this area. The aim of this review is to provide an overview and synthesis of the research concerning self-medication with novel psychoactive substances (NPS). Seven databases (EMBASE, MEDLINE, APA PsychInfo, Global Health, PubMed, Scopus, and Google Scholar) were searched using a search strategy compromising 600 + NPS terms, yielding 3563 articles, 24 of which met the search criteria. Two independent reviewers screened the articles and appraised the quality of the included studies. The results were synthesised using a narrative synthesis approach. We identified 22 NPS being used for self-medication. We found that (1) self-medication with NPS occurs mainly for anxiety, depression, and ADHD; (2) links between cluster headaches, the use of psychedelic NPS, and anxiety and novel benzodiazepines were evident; (3) novel benzodiazepine use by young individuals represents particular concern. There is a need for greater knowledge within healthcare professions concerning self-medication practices with NPS. Primary qualitative research is needed to address the underlying motivations behind this phenomenon.

Acute neurological consequences of novel psychoactive substance use: a retrospective review in a large UK hospital

Novel psychoactive substances (NPS) are a growing public health concern. We aimed to identify the acute neurological consequences of NPS. We performed a retrospective case-note review of patients who presented to the emergency department after taking NPS. We identified 237 admissions from 190 patients, mostly young men. There were high rates of psychiatric comorbidity (43%), unemployment (39%), homelessness (24%) and incarceration (17%). Most reported use of synthetic cannabinoids (SC; 91%). Some took synthetic cathinones (SCath; 7%) or nitrous oxide (NOS; 2%). SC caused impaired consciousness (61%) and seizures (16%). SCath users presented with psychiatric disturbance or seizures (55%). Most patients were managed conservatively (67%) and a small proportion (14%) were referred to drug or psychology services. NPS users represent a vulnerable group in society. Certain clinical features may suggest the type of NPS used. Most patients require supportive management and onward referral to drug addiction services is recommended.

Correction: Lifetime prevalence of novel psychoactive substances use among adults in the USA: Sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007–2014

[This corrects the article DOI: 10.1371/journal.pone.0241056.].

"Hot" and "Cold" Cognition in Users of Club Drugs/Novel Psychoactive Substances.

Novel psychoactive substances (NPS) are popular “club/party” drugs that first attracted attention in the UK in 2009 and remained legal until the 2016 Psychoactive Substances Act criminalized their distribution. Unlike “traditional” illicit drugs, very little is known about the influence of their analogs on neuropsychological functioning. We characterized the cognitive and emotional profile of NPS/polydrug users using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and EMOTICOM test battery in adult male (aged 20–49 years) recreational users without psychiatric comorbidities (n = 27; “psychonauts”), service users attending a UK specialist “Club Drug” Clinic for problematic use (n = 20) and healthy control volunteers without significant drug-taking histories (n = 35). Tasks were selected to distinguish “hot” cognitive processes that are highly influenced by emotion from “cold” cognitive processes that are largely independent of emotional influence. Both user groups reported significantly higher sensation-seeking traits compared with non-users. Recreational NPS users demonstrated more risk-taking behavior compared with controls and treatment-seeking NPS users showed poorer learning, episodic memory and response inhibition compared with the other two groups. These effects persisted, when controlling for age, intelligence, alcohol and cannabis use severity, nicotine dependence, trait anxiety, depression, childhood adversity, impulsivity, and sensation seeking. Overall, recreational NPS users showed elevated “hot” (emotion-laden) cognition in the absence of “cold” (non-emotional) cognitive deficits, whereas “cold” cognitive dysfunction was pronounced in individuals seeking treatment for problematic NPS use. High trait impulsivity and poor self-control may confer additional risk to NPS/polydrug use severity and separate those seeking treatment from those using NPS recreationally.

Lifetime prevalence of novel psychoactive substances use among adults in the USA: Sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007-2014.

IntroductionAs Novel psychoactive substances (NPS) are conceived to mimic the effects of common illicit drugs, they represent a serious public health challenge due to the spike in intoxications and fatalities that have been linked to their use. This study aims to provide epidemiological data on NPS use in the USA, determining lifetime prevalence of use and defining demographic, socioeconomic, drug use patterns and mental health correlates.MethodsThis study uses secondary data from the US National Survey on Drug Use and Health (NSDUH), which is a large cross-sectional population-based survey carried out annually in the USA. We analysed data from 2007–14 (N = 307,935) using bivariate descriptive analysis and binary logistic regression to calculate prevalence and determine factors underlying NPS consumption. Adjusted odds ratios (OR) with 95% CI’s were calculated for a set of selected independent variables.Results and discussionOur analysis NSDUH from 2007–14 highlights an increase in NPS use among adults, especially among white young men aged 18 to 25. Although the level of education of NPS users was relatively higher as compared to non-users, NPS users seemed to have a less wealthy situation. However, socioeconomic vulnerability appeared to be less important than mental health issues as a correlate to NPS use. NPS users seem to have followed a pattern of polysubstance use throughout their life, which involves both traditional illicit drugs and classic synthetic drugs. As NPS use seemed to be more prevalent among people having mental health issues, the rise in their use may have a negative impact on population mental health outcomes.ConclusionFurther comparative research on trends in NPS use and potential public health responses would be instrumental for developing appropriate health interventions, including drug checking, education for users and training for healthcare professionals working both within emergency wards and in/outpatient addiction and mental health services.

Virtual ‘Experiential Expert’ Communities of Practice in Sharing Evidence-Based Prevention of Novel Psychoactive Substance (NPS) Use: the Portuguese Experience

We present findings from a unique virtual community of practice piloted to support a programme of prevention evidence and knowledge sharing among professional prevention practitioners as ‘experiential experts’ around tackling novel psychoactive substances (NPS) use in Portugal. A mixed-methods approach that combined quantitative analysis of interactions and qualitative content analysis of debates about NPS, NPS users, patterns of use and best practices in prevention of this type of drug use was conducted. Results show low and irregular interactions between members of this virtual community, but very rich discussions around sharing of experiences and problematizing practices. We discuss the layers of interaction between members, and the shared learning around policy and practice implications. Such virtual and collaborative work practices are not yet integrated within the drug prevention field where instead individualistic approaches tend to prevail and preclude the sharing of alternative solutions that shape different experiences. Our virtual community of NPS prevention experts provides a flagship for ongoing collaboration between research, generation of evidence informing policy and practice, professional training, support and shared learning. It underscores the need for an innovative and multi-disciplinary approach to sharing perspectives in tackling emerging and harmful drug trends.

Synthetic cannabinoid and synthetic cathinone use in Hungary: A literature review

Purpose In the past decade, novel psychoactive substances (NPSs) gained a significant role on the contemporary drug scene. Synthetic cathinones and synthetic cannabinoids are the most common NPSs both in Hungary and worldwide. This study aims to provide a literature review on the Hungarian characteristics related to the use of these NPSs. Materials and methods Available literature regarding synthetic cathinone and cannabinoid use in Hungary was overviewed and structured into (a) epidemiological studies, (b) studies on the subjective and somatic effects, and (c) studies on toxicity and adverse consequences. Published papers between 2007 and 2017 were identified using PubMed and MATARKA search engines. Results One hundred twenty-six papers were identified and after exclusion, 54 papers remained for in-depth analysis. Most of the reviewed studies were providing epidemiological information regarding the NPSs of our interest. Hungarian prevalence rates were not higher than the European averages. Identified risks of these NPSs consisted of drug-induced psychosis, further severe psychiatric symptoms, and fatal overdose. Injecting of cathinones was also a commonly reported phenomenon, mostly among clients of needle-exchange programs. Conclusion Based on the reviewed body of research, necessary information is available to plan effective prevention and intervention programs and establishes specific therapeutic guidelines for the treatment of NPS users.

Selective attentional bias for novel psychoactive substance (NPS) and expectancy-related stimuli among nonproblematic NPS users and never NPS users

ABSTRACTBackground: Novel psychoactive substance (NPS) use has emerged as a new trend in the recreational drug market with increasing prevalence and availability rates. Little evidence has focussed on psychologically based cognitive/motivational processes that may increase the likelihood of continuing NPS use leading to habitual behavior patterns/dependence. One such process, highlighted in studies examining a plethora of addictive behaviors, concerns users’ preferential attention (attentional bias) to concern-related stimuli. Methods: The current study assessed whether current NPS users compared to never NPS users showed differential attentional processing of (i) NPS-related words, (ii) NPS positive expectancy words, and (iii) NPS negative expectancy words in a modified Stroop task. Results: For NPS users, only negative expectancies captured increased attention—the semantic nature of the word interfered with the secondary task of color-naming the ink within the Stroop task. In addition, the magnitude of this attentional bias was significantly different from zero (the point of no registered interference). Finally, we found no association between attentional biases for all word types and severity of problems associated with NPS use in NPS users. Conclusions: Among nonproblematic NPS users, expectancy-based cognitions may be characterized by highly accessible negative NPS expectancies that are salient for attentional capture and preoccupation.

The diverse reasons for using Novel Psychoactive Substances - A qualitative study of the users' own perspectives

BackgroundThe increasing number of legally ambiguous and precarious Novel Psychoactive Substances (NPS) constitutes a challenge for policy makers and public health. Scientific and more in-depth knowledge about the motivations for using NPS is scarce and often consist of predetermined, non-systematic, or poorly described reasons deduced from top-down approaches. Therefore, the aim of the present study was to explore and characterize the users’ self-reported reasons for NPS use inductively and more comprehensively. MethodsThe self-reported reasons of a self-selected sample of 613 international NPS users were collected via an online survey promoted at the international drug discussion forum bluelight.org and later analyzed qualitatively using inductive thematic analysis. ResultsThe analysis showed that the participants used NPS because these compounds reportedly: 1) enabled safer and more convenient drug use, 2) satisfied a curiosity and interest about the effects, 3) facilitated a novel and exciting adventure, 4) promoted self-exploration and personal growth, 5) functioned as coping agents, 6) enhanced abilities and performance, 7) fostered social bonding and belonging, and 8) acted as a means for recreation and pleasure. The consumption of NPS was also driven by 9) problematic and unintentional use. ConclusionThe present study contributed to a more comprehensive understanding of the users’ own and self-reported reasons for using NPS, which needs to be acknowledged not only in order to minimize drug related harm and drug user alienation but also to improve prevention efforts and reduce the potentially counter-intuitive effects of strictly prohibitive policies.

Health and Social Problems Associated with Recent Novel Psychoactive Substance (NPS) Use Amongst Marginalised, Nightlife and Online Users in Six European Countries

Continued diversification and use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland (n = 3023). Some respondents were unable to categorise NPS they had used. Use of ‘herbal blends’ and ‘synthetic cannabinoids obtained pure’ was most reported in Germany, Poland and Hungary, and use of ‘branded stimulants’ and ‘stimulants/empathogens/nootropics obtained pure’ was most reported in the Netherlands. Increased heart rate and palpitation, dizziness, anxiety, horror trips and headaches were most commonly reported acute side effects. Marginalised users reported substantially more acute side effects, more mid- and long-term mental and physical problems, and more social problems. Development of country-specific NPS awareness raising initiatives, health and social service needs assessments, and targeted responses are warranted.

Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions

ObjectivesAssess the impact of selective prohibition and seizure of novel psychoactive substances (NPS) supply on NPS use prevalence within psychiatric admissions and evaluate demographic characteristics of current NPS users.DesignA 6-month...

The "Endless Trip" among the NPS Users: Psychopathology and Psychopharmacology in the Hallucinogen-Persisting Perception Disorder. A Systematic Review.

Hallucinogen-persisting perception disorder (HPPD) is a syndrome characterized by prolonged or reoccurring perceptual symptoms, reminiscent of acute hallucinogen effects. HPPD was associated with a broader range of LSD (lysergic acid diethylamide)-like substances, cannabis, methylenedioxymethamphetamine (MDMA), psilocybin, mescaline, and psychostimulants. The recent emergence of novel psychoactive substances (NPS) posed a critical concern regarding the new onset of psychiatric symptoms/syndromes, including cases of HPPD. Symptomatology mainly comprises visual disorders (i.e., geometric pseudo-hallucinations, haloes, flashes of colors/lights, motion-perception deficits, afterimages, micropsia, more acute awareness of floaters, etc.), even though depressive symptoms and thought disorders may be comorbidly present. Although HPPD was first described in 1954, it was just established as a fully syndrome in 2000, with the revised fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). HPPD neural substrates, risk factors, and aetiopathogenesys still largely remain unknown and under investigation, and many questions about its pharmacological targets remain unanswered too. A critical mini review on psychopathological bases, etiological hypothesis, and psychopharmacological approaches toward HPPD, including the association with some novel substances, are provided here, by means of a literature search on PubMed/Medline, Google Scholar, and Scopus databases without time restrictions, by using a specific set of keywords. Pharmacological and clinical issues are considered, and practical psychopharmacological recommendations and clinical guidelines are suggested.

Exploring the intersections between novel psychoactive substances (NPS) and other substance use in a police custody suite setting in the north east of England

Aims: Novel psychoactive substances (NPS), a range of plant-based/synthetic substances that mimic effects of other illicit substances (e.g. cannabis), are now illegal in the United Kingdom (May 2016) to produce/supply. Negative behavioural consequences of NPS use mean that users frequently transgress the law are arrested and detained in police custody suites. Evidence shows a link between traditional substance use and offending behaviour, with significant police time spent on alcohol-related incidents. We explore the intersections between NPS and other substances with police staff and users in custody; specifically the similarities and differences in treatment, management and policing of these substances.Methods: A qualitative study using semistructured interviews and thematic analysis. We recruited 15 police staff (4 women/11 men) and 25 NPS users (9 women/16 men).Results: Police staff perceived NPS users to be extremely volatile in custody and reported feeling less knowledgeable about how to manage and respond to their needs compared to other substance users (e.g. alcohol, heroin). Users rarely took NPS in isolation and often compared them to other illicit substances, balancing effects versus costs.Conclusion: NPS use has a striking effect on custody work, primarily because of unpredictable user behaviour, adding further pressure to already overstretched police staff.

Knowledge and (Ab)Use in Connection with Novel Psychoactive Substances: A Cross-Sectional Analysis of Psychedelic Users Existing on Online Platforms

BACKGROUND: The prevalence of use and misuse of novel psychoactive substances (NPS) has been escalating at an exponential rate in the past two decades. Studies on NPS are highly concentrated in relevance to the developed world, while few have been undertaken in the developing countries.MATERIALS & METHODS: This study is observational and cross-sectional in nature; it relies on a web-based survey distributed to a population of (ab)users of psychedelics and NPS; this community was accessible via dedicated online platforms psychedelics users located on the Facebook social communication medium. The aim of the study is to estimate the level of knowledge and the extent of (mis)use in connection with psychoactive substances, including the novel ones (NPS).RESULTS: The number of participants who responded to the survey reached 458 responders. The level of knowledge and (ab)use was relatively high. The majority of participating individuals were Caucasians males from the developed world including the US, the UK, India, and western European countries. The primary religious affiliation was either agnosticism or atheism. Approximately, 26% were diagnosed with the neuropsychiatric condition.CONCLUSION: The NPS phenomenon is still a major concern primarily in the developed world. Additional studies are required in virtual and non-virtual populations. The targeted populations should include; students, medical professionals, academics, patients with psychiatric and neurological abnormalities, convicts and criminals, and even terrorists.

Examination of Synthetic Cannabinoid and Cathinone Use among a Drug-Using Offender Sample, 2013–2015

ABSTRACTUse of novel psychoactive substances (NPS) such as synthetic cannabinoids (e.g., “Spice,” “Serenity”) and cathinones (e.g., “bath salts”) has proliferated in recent years; however, there is a gap in research examining prevalence among offender samples. This study examined demographics, drug use, mental health characteristics, and criminal histories of NPS users compared to non-NPS users within an offender sample entering drug treatment. Using logistic regression analysis, combined 2013–2015 assessment data were examined (N = 8,791). NPS users offended more often (x̄ = 10.3), were more likely to have experienced homelessness (12.2%), and to have lived in a metro area (59.0%). NPS users reported significantly more past-year drug use, including substances not readily detected by standard urine analysis (e.g., hallucinogens, alcohol, and inhalants). Individuals with higher anxiety symptom counts (OR = 1.07; p < .001) and those who reported drinking to intoxication (OR = 1.30; p < .001) had an increased likelihood of NPS use. Older individuals (OR = 0.95; p < .001) and those who began using drugs at an older age (OR = 0.95; p < .001) were less likely to report NPS use. NPS use may be a marker of more severe using patterns in an offender sample. Future investigation should focus on NPS use as a possible method for bypassing drug testing measures.

An international survey on the awareness, use, preference, and health perception of novel psychoactive substances (NPS).

This survey investigated the level of public awareness, preference, and motivation of novel psychoactive substances (NPS) use as well as knowledge of potential associated health risks. A Bristol Online Survey was advertised through social media and a drug forum "Bluelight" between January 7 and February 7, 2015. Responses were received from 17 countries, mainly from Europe. Most responses (83%) came from university educated students. Two-thirds (65%) of the 168 respondents were aware of NPS. Awareness was significantly increased in those with bisexual or homosexual orientation (p<.05) and those in employment (p<.05). Fourteen percent of the 168 respondents were users of NPS, and use was significantly affected by age and employment (p<.01) but unaffected by level of education (p>.05). Nearly half of the NPS users perceived NPS to carry either a low risk to health (20%) or did not know whether or not they posed a health risk (29%). These survey data indicate that awareness of NPS and, importantly, perception of the potential health risks associated with NPS use is lacking. NPS awareness and use is higher in those in employment but is unaffected by level of education. This highlights the need for targeted drugs education intervention by policy-makers in schools and universities.

The Dynamic Landscape of Novel Psychoactive Substance (NPS) Use in Ireland: Results from an Expert Consultation

In Ireland, legislators encountered a new phenomenon in 2005 onwards with the advent of ‘legal highs’ sold in headshops. Use of ‘legal highs’ containing herbal and synthetic new psychoactive substances (NPS) was not confined to problematic drug users, and included social recreational users. Legislative controls were enacted in 2010, 2011 and 2015. The study aimed to investigate expert perspectives on the NPS situation with regard to changing and emergent trends in use, health and social consequences and service implications. This brief report presents descriptive findings from a national consultation using a structured guide with experts in 2016. Four themes emerged and centred on; ‘Definitions of NPS used within Professional Roles’; ‘Professional Experiences of NPS‘; ‘Types of NPS Users, Sourcing and Consequences of Use’; and ‘Service Response.’ Findings underscored the mental health and addiction related consequences of NPS use, with prevention, clinical and treatment services ill- equipped to deal with the particular characteristics of this form of drug abuse. Enhanced strategies, services and clinical responses are warranted to address the challenges encountered.

The highs and lows of NPS/“Legal High” use: Qualitative views from a UK online survey

Introduction: Novel psychoactive substances (NPS) are rapidly proliferating in the United Kingdom and elsewhere. We lack detailed information on rationales for their use. Methods: Qualitative data from 431 NPS users were collected as part of a 2014 online survey on NPS (n = 468 NPS users, 704 non-NPS users). These 431 users answered some or all of five open-ended questions on favourite NPS and NPS they would not use and rationales for these assessments. Findings: Respondents were asked to identify and describe favourite NPS. The favourite NPS identified (n = 258 respondents) mostly had brand names (148). Favourite NPS was associated with a good buzz/feeling, euphoria, enhancing sociability and relaxation. Ease of availability, cheapness and legality of NPS were cited. Achieving a predictable, safe high was important. Adverse NPS experience, including dependency issues both personally or amongst friends was reported by a majority of the 148 who described NPS that they would definitely not take and why, most of these reported having now ceased NPS use. Negative experiences ran from the mildly unpleasant to the persistent, serious and life threatening. Conclusions: Developing new methods of reaching and working with NPS users need timely knowledge of global and local trends in NPS use and effects. These data are of some assistance in expanding such knowledge.

Injecting ATS/NPS use and drug abjection in Romania

Purpose– The purpose of this paper is to investigate a group of Romanian injecting substance users “migrating” from heroin to novel psychoactive substances (NPS) as a counterpublic seeking to escape the stigma of drug abjection.Design/methodology/approach– The findings are drawn from interview and observational data collected mainly at drug services sites in Bucharest, Romania.Findings– The stimulant powders sold by head shops appealed to experienced drug users because they seemed to emulate a consumerist ethos and cultivate a healthy, rational agent that popular discourses of addiction deem incompatible with drug careers. NPS and head shops were thus initially understood as a possibility of escaping “junk identities”. However, they ultimately sealed injectors as abject bodies that obstructed the collaborative goals of rehabilitation and health restoration. A sense of symbolic distance shaped by notions of moral and bodily hygiene separated heroin and NPS users, as the latter increasingly came to be seen and see themselves as flawed consumers of health and freedom.Practical implications– NPS retail spaces could present valuable opportunities to insert harm-reduction resources and harness counterpublic health strategies.Social implications– Dominant definitions of substance use as unavoidable paths into self-destruction push users towards unknown compounds they can attach more fluid meanings to. This suggests that prohibitionist language still obscures rational dialogue about existing and emerging drugs.Originality/value– The paper traces ATS/NPS in an Eastern European context offering an alternative vantage point to harm-focused perspectives.