NPS comes of age: a UK overview.

Summary • All the available official data indicates that in general terms, albeit with some recent blips and changing patterns of use, non-medical drug use in the UK has been in decline since the start of this century. • However, from around 2006, there has been a growing interest in, and availability of, a new generation of drugs collectively known as Novel Psychoactive Substances (NPS) or more colloquially, 'legal highs' and less frequently 'research chemicals.' • The arrival of NPS has been something of a ‘game-changer’ in that traditional models of drug diffusion and supply (e.g. for heroin or cocaine) have been joined by the internet as a new route of wholesale and retail supply, distribution and information exchange. • From 2006 until 2016, many of these substances have been legally available on the high street, both from 'head shops' and a range of other retail outlets such as petrol stations and fast food outlets. However, the Psychoactive Substances Act which came into effect on 26th May 2016, bans the manufacture, sale and distribution of any and all psychoactive substances accompanied by a list of exemptions including tobacco and alcohol. • The citing of NPS patterns and prevalence of use in official datasets remains patchy, not least because those groups most affected are least likely to be identified by official surveys like the Crime Survey for England and Wales. But from what exists plus a growing body of anecdotal evidence and unofficial reporting – a picture is emerging of NPS use in the UK in 2016. • That picture is not dissimilar to the emergence of crack cocaine in the UK: much sensational media reporting and dire predictions for the future, but ultimately finding a level in the drug scene with regular use primarily concentrated among those with existing serious drug problems and other vulnerable groups. • The main group of drugs are the synthetic cannabinoid receptor agonists (SCRAs) which are currently presenting serious problems in prisons and young offender institutions, among the homeless and existing service users. • Still thought of as an NPS, mephedrone is the other main source of problems across a range of user cohorts, from young people, to those on the ‘chem sex’ party scene, through to traditional service clients. • Relatively few people are coming forward to treatment services in the community citing an NPS as their primary drug problem in 2016. Workers see more of the problem out in the community with clients who are not accessing treatment, for example homeless and rough sleepers. • While NPS have been mentioned in a number of fatalities, very few deaths appear to have been as a direct result of taking an NPS in isolation. • The issue of providing up to date and credible information in such a new and rapidly developing scenario is problematic – and there is a danger of over-reacting to the situation. For drugs workers, the key message is to ‘deal with the problem in front of you’ rather than being overly concerned about the substance that is alleged to have been taken. Useful clinical guidance has been published under the auspices of Project Neptune with more targeted care bundles to come