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. 2020 Mar;86(3):505-516.
doi: 10.1111/bcp.14123. Epub 2020 Jan 9.

Impact of the UK Psychoactive Substances Act on awareness, use, experiences and knowledge of potential associated health risks of novel psychoactive substances

Elena Deligianni  1 , Omari J Daniel  1 , John M Corkery  1 , Fabrizio Schifano  1 , Lisa A Lione  1
Affiliations

Impact of the UK Psychoactive Substances Act on awareness, use, experiences and knowledge of potential associated health risks of novel psychoactive substances

Elena Deligianni et al. Br J Clin Pharmacol. 2020 Mar.

Abstract

Aims: The risk of potential harms prompted the UK government to introduce the Psychoactive Substances Act in 2016. The aim of the present study was to evaluate the impact and effectiveness of this new legislation on patterns of novel psychoactive substance (NPS) awareness, use, experiences and risk awareness in a self-selected sample of UK consumers to inform education and policy.

Methods: The Bristol Online Survey was advertised on the Bluelight drug forum and social media Facebook pages and University email between 7 January and 7 February 2015 (168 responses) and 9 March to 18 September 2017 (726 responses). UK country of residence responses were extracted for analysis (SPSS).

Results: In a predominantly university-educated, young (< 25 years) self-selecting sample, 1 year after introduction of the legislation, NPS use (in males, under 18s, those educated to school/college level, P < .001) has increased, whilst health risk awareness has not changed and remains poor. Users are switching to sourcing NPSs via street dealers (49%) and the darknet (31%) and showing an increase in preference for the herbal NPS Salvia divinorum (P < .05). The main reasons for NPS use remain the influence of friends (69%) in a social setting and to get high (76%) usually in combination with alcohol, cannabis or ecstasy.

Conclusion: Regulation alone, so far, has not impacted on health risk awareness, NPS drug demand and culture in our UK survey sample. Alongside regulation, NPS health promotion education (particularly in schools, colleges) is needed that addresses resilience and both the risks and beneficial effects of NPS.

Keywords: Psychoactive Substances Act 2016; novel psychoactive substances; online survey; policy; psychoactive effects; recreational use.

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Conflict of interest statement

No conflicts of interest are declared here that may have influenced the interpretation of present data. Please note the following: F.S. is an editor of this special issue of Brain Science, was a full member of the UK Advisory Council on the Use of Drugs (ACMD) and a member of the ACMD's NPS and Technical Committees; J.C. is also a co‐opted member of the NPS and Technical Committees. The views expressed here are solely those of the authors and do not necessarily reflect those of the Home Office or the ACMD.

Figures

Figure 1
Figure 1
Source of novel psychoactive substance (NPS; A), setting of NPS use (B) and NPS information (C) in 2017 UK survey respondents. Data are expressed as % frequency responses of the 134 UK 2017 users. Absolute n number of responses denoted on histobar. Other sources of information on NPS (C) included friends, PubMed, ScienceDirect, medical case reports or simply trying them
Figure 2
Figure 2
Types of novel psychoactive substance (NPS) used by 2015 and 2017 UK survey respondents. Data is expressed as absolute number of responses (on histobar) and % of user responses. Significant population proportional change *P < .05 (z‐test). The total number of responses is higher in 2017 users (354 responses, 3–4 NPS per user) compared with 2015 users (19 responses, 1–2 NPS per user). Other NPS reported included stimulants, hallucinogens, dissociatives, sedatives and opioids. 2017 other included kratom, 'shrooms, 5‐MeO‐dimethyltryptamine, dimethyltryptamine, etizolam, pyrazolam, mescaline, butyr‐fentanyl, furanyl‐fentanyl, diclazepam, ephenidine, clonazolam, diclazepam, methiopropamine, thiopropamine and entheogens. 2015 other included kratom, α‐methyl‐tryptamine, methylphenidate
Figure 3
Figure 3
Preference for other substances used in combination with novel psychoactive substance in UK 2017 and 2015 respondents. Data is expressed as absolute number of responses (on histobar) and % of user responses. Significant population proportional change *P < .05 (z‐test). Polydrug use is similar in both survey samples (2017, 441 total responses, 3–4 drug per user; 2015, 54 total responses, 3–4 drug per user)
Figure 4
Figure 4
Subjective effects of novel psychoactive substance use. Data is expressed as absolute number of responses (on histobar) and % of user responses. Similar trends in subjective effects of novel psychoactive substance use in both survey samples (P > .05, z‐test)
Figure 5
Figure 5
(A) User perception of health risks associated with novel psychoactive substance (NPS) use and (B) 2017 user risk awareness by age. Data expressed as absolute number of responses (on histobar) and % of user respondents. There is a decreased trend (P > .05) in health risk perception in 2017 survey sample compared with 2015 sample. There is no age group effect on risk awareness of the 2017 NPS users (P > .05)
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