Skip to main content Accessibility help
×
Hostname: page-component-5c6d5d7d68-thh2z Total loading time: 0 Render date: 2024-08-18T07:55:12.788Z Has data issue: false hasContentIssue false

Chapter 1 - An Introduction to Club Drugs and Novel Psychoactive Substances

from Part I - Introduction and Background

Published online by Cambridge University Press:  06 October 2022

Dima Abdulrahim
Affiliation:
Programme Manager and Principal Researcher for the NEPTUNE Project, Central and North West London NHS Foundation Trust
Owen Bowden-Jones
Affiliation:
Consultant Addiction Psychiatrist, Central and North West London NHS Foundation Trust
Get access

Summary

This document provides a new edition and an update to the 2015 NEPTUNE guidance on the clinical management of harms resulting from acute intoxication and from the harmful and dependent use of ‘club drugs’ and ‘novel psychoactive substances’ (NPS).

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Lank, P, Pines, E, Mycyk, M. Emergency physicians’ knowledge of cannabinoid designer drugs. West J Emerg Med 2013;14:467470.Google Scholar
Ramos C, , Guirguis A, , Smeeton N, et al. Exploring the baseline knowledge and experience of healthcare professionals in the United Kingdom on novel psychoactive substances. Brain Sci 2020;10:142. https://doi.org/10.3390/brainsci10030142Google Scholar
United Nations Office on Drugs and Crime (UNODC). Early Warning Advisory on New Psychoactive Substances. www.unodc.org/LSS/Page/NPS [last accessed 9 February 2022].Google Scholar
United Nations Office on Drugs and Crime (UNODC). Global SMART Update Understanding the Synthetic Drug Market: The NPS Factor. Volume 19, March. Appears to be missing the yearGoogle Scholar
The EU Action against Drugs and Organised Crime (EU-ACT) funded by the European Commission and implemented by FIIAPP.Google Scholar
World Health Organization (WHO) and United Nations Office on Drugs and Crime (UNODC). International standards for the treatment of drug use disorders: revised edition incorporating results of field-testing. Geneva, 2020. License: CC BY-NC-SA 3.0 IGO.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. Action framework for developing and implementing health and social responses to drug problems. Available from: www.emcdda.europa.eu/printpdf/publications/mini-guides/action-framework-for-developing-and-implementing-health-and-social-responses-to-drug-problems_enGoogle Scholar
The World Health Organization has developed guidance and training materials on poisons centres. For more information see: https://apps.who.int/iris/handle/10665/331635; www.unodc.org/documents/drug-prevention-and-treatment/UNODC-WHO_International_Standards_Treatment_Drug_Use_Disorders_April_2020.pdf. For a directory of poisons centres, see: www.who.int/gho/phe/chemical_safety/poisons_centres/en/.Google Scholar
Lingford-Hughes, AR, Welch, S, Peters, L, Nutt, DJ; British Association for Psychopharmacology, Expert Reviewers Group. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP. J Psychopharmacol 2012;26(7):899952. https://doi.org/10.1177/0269881112444324Google Scholar
See e.g. Santos-Toscano R, , Guirguis A, , Davidson D., How preclinical studies have influenced novel psychoactive substance legislation in the UK and Europe. Br J Clin Pharmacol, Special Issue: New Psychoactive Substances 2020;86(3):452481.Google Scholar
Peacock A, , Bruno R, , Gisev N, et al. New psychoactive substances: challenges for drug surveillance, control, and public health responses. Lancet 2019;394:16681684.Google Scholar
United Nations Office on Drugs and Crime (UNODC). The Challenge of New Psychoactive Substances. Global SMART Programme 2013.Google Scholar
United Nations Office on Drugs and Crime (UNODC). Global SMART Update Understanding the Synthetic Drug Market: The NPS Factor, Volume 19.Google Scholar
United Nations Office on Drugs and Crime (UNODC). World Drug Report 2014.Google Scholar
World Drug Report 2021 (United Nations publication, Sales No. E.21.XI.8).Google Scholar
United Nations Office on Drugs and Crime (UNODC). Early Warning Advisory on New Psychoactive Substances. www.unodc.org/LSS/Announcement?type=NPS [last accessed 21 February 2022].Google Scholar
European Monitoring Centre for Drugs and Drug Addiction (2021), European Drug Report 2021: Trends and Developments, Publications Office of the European Union, LuxembourgGoogle Scholar
Corkery, JM, Guirguis, A, Papanti, DG, Orsolini, L, Schifano, F. Synthetic cathinones: prevalence and motivations for use. In: Zawilska, J (ed.), Synthetic Cathinones: Current Topics in Neurotoxicity, volume 12. Springer, Cham, 2018.Google Scholar
World Drug Report 2021 (United Nations publication, Sales No. E.21.XI.8).Google Scholar
World Drug Report 2020 (United Nations publication, Sales No. E.20.XI.6).Google Scholar
The United Nations Office on Drugs and Crime (UNODC) World Drug Report 2019 (United Nations publication, Sales No. E.19.XI.8). Available at: https://wdr.unodc.org/wdr2019/prelaunch/WDR19_Booklet_1_EXECUTIVE_SUMMARY.pdf [last accessed 15 February 2022].Google Scholar
European Monitoring Centre for Drugs and Drug Addiction and Europol. EU Drug Markets Report: In-Depth Analysis, EMCDDA–Europol Joint publications. Publications Office of the European Union, Luxembourg, 2016.Google Scholar
Reuter, P. Options for Regulating New Psychoactive Drugs: A Review of Recent Experiences. UK Drug Policy Commission (UKDPC), 2011.Google Scholar
McNabb, CB, Russell, BR, Caprioli, D, Nutt, DJ, Gibbons, S, Dalley, JW. Single chemical entity legal highs: assessing the risk for long term harm. Curr Drug Abuse Rev 2012;5(4):304319.Google Scholar
Peters, FT, Martinez-Ramirez, JA. Analytical toxicology of emerging drugs of abuse. Ther Drug Monit 2010;32(5):532539. https://doi.org/10.1097/FTD.0b013e3181f33411Google Scholar
Maurer, HH. Chemistry, pharmacology, and metabolism of emerging drugs of abuse. Ther Drug Monit 2010;32(5):544549. https://doi.org/10.1097/FTD.0b013e3181eea318CrossRefGoogle ScholarPubMed
United Nations Office on Drugs and Crime (UNODC). The Challenge of New Psychoactive Substances. Global SMART Programme 2013.Google Scholar
United Nations Office on Drugs and Crime (UNODC). Early Warning Advisory on New Psychoactive Substances. www.unodc.org/LSS/Page/NPS [last accessed 9 February 2022].Google Scholar
United Nations Office on Drugs and Crime (UNODC). Early Warning Advisory on New Psychoactive Substances. www.unodc.org/LSS/Page/NPS [last accessed 9 February 2022].Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Publications Office of the European Union, Luxembourg, 2019.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2017: Trends and Developments. Publications Office of the European Union, Luxembourg, 2017.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Publications Office of the European Union, Luxembourg, 2019.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2017: Trends and Developments. Publications Office of the European Union, Luxembourg, 2017.Google Scholar
Tanibuchi, Y, Matsumoto, T, Shimane, T, Funada, D. The influence of tightening regulations on patients with new psychoactive substance-related disorders in Japan. Neuropsychopharmacol Rep 2018;38(4):189196. https://doi.org/10.1002/npr2.12035Google Scholar
The United Nations Office on Drugs and Crime (UNODC). World Drug Report 2019 (United Nations publication, Sales No. E.19.XI.8). Available at: https://wdr.unodc.org/wdr2019/prelaunch/WDR19_Booklet_1_EXECUTIVE_SUMMARY.pdfGoogle Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Publications Office of the European Union, Luxembourg, 2019.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. Fentanils and synthetic cannabinoids: driving greater complexity into the drug situation. An update from the EU Early Warning System (June 2018). Publications Office of the European Union, Luxembourg, 2018.Google Scholar
World Drug Report 2019 (United Nations publication, Sales No. E.19.XI.8).Google Scholar
European Monitoring Centre for Drugs and Drug Addiction European Drug Report 2021: Trends and Developments, Publications Office of the European Union, Luxembourg. 2021Google Scholar
Measham, F, Moore, K, Newcombe, R, & Welch, Z. Tweaking, bombing, dabbing and stockpiling: the emergence of mephedrone and the perversity of prohibition. Drugs and Alcohol Today 2010;10(1):1421.Google Scholar
Corazza, O, Simonato, P, Corkery, J, Trincas, G, & Schifano, F.Legal highs’: safe and legal ‘heavens’? A study on the diffusion, knowledge and risk awareness of novel psychoactive drugs among students in the UK. Rivista Di Psichiatria 2014;49(2):8994. https://doi.org/10.1708/1461.16147Google Scholar
Sande, M. Characteristics of the use of 3-MMC and other new psychoactive drugs in Slovenia, and the perceived problems experienced by users. Int J Drug Policy 2016;27:6573. https://doi.org/10.1016/j.drugpo.2015.03.005Google Scholar
Winstock, AR, Lawn, W, Deluca, P, Borschmann, R. Methoxetamine: an early report on the motivations for use, effect profile and prevalence of use in a UK clubbing sample. Drug Alcohol Rev 2016;35(2):212217. https://doi.org/10.1111/dar.12259Google Scholar
Measham, F, Moore, K, Newcombe, R, Welch, Z. Tweaking, bombing, dabbing and stockpiling: the emergence of mephedrone and the perversity of prohibition. Drugs Alcohol Today 2010;10(1):1421. https://doi.org/10.5042/daat.2010.0123Google Scholar
Soussan C, , Andersson M, , Kjellgren A. The diverse reasons for using novel psychoactive substances: a qualitative study of the users’ own perspectives. Int J Drug Policy 2018;52:7178.Google Scholar
Benschop, A, Urbán, R, Kapitány-Fövény, M, et al. Why do people use new psychoactive substances? Development of a new measurement tool in six European countries. J Psychopharmacol 2020;34(6):600611. https://doi.org/10.1177/0269881120904951Google Scholar
Corazza, O, Simonato, P, Corkery, J, Trincas, G, Schifano, F. Legal highs: safe and legal heavens? A study on the diffusion, knowledge and risk awareness of novel psychoactive drugs among students in the UK. Rivista Di Psichiatria 2014;49(2):8994. http://dx.doi.org/10.1708/1461.16147Google Scholar
Johnson, LA, Johnson, RL, Portier, RB. Current legal highs. J Emerg Med 2013;44(6):11081115. http://dx.doi.org/10.1016/j.jemermed.2012.09.147Google Scholar
Measham, F, Moore, K, Newcombe, R, Welch, Z. Tweaking, bombing, dabbing and stockpiling: the emergence of mephedrone and the perversity of prohibition. Drugs Alcohol Today 2010;10(1):1421. http://dx.doi.org/10.5042/daat.2010.0123Google Scholar
Sande, M. Characteristics of the use of 3-MMC and other new psychoactive drugs in Slovenia, and the perceived problems experienced by users. Int J Drug Policy 2016;27:6573. http://dx.doi.org/10.1016/j.drugpo.2015.03.005Google Scholar
Werse, B, Morgenstern, C. How to handle legal highs? Findings from a German online survey and considerations on drug policy issues. Drugs Alcohol Today 2012;12(4):222231. http://dx.doi.org/10.1108/17459261211286636Google Scholar
Winstock, AR, Lawn, W, Deluca, P, Borschmann, R. Methoxetamine: an early report on the motivations for use, effect profile and prevalence of use in a UK clubbing sample. Drug Alcohol Rev 2016;35:212217. https://doi.org/10.1111/darGoogle Scholar
Maxwella S, , Shahmanesh M, , Gafos M. Chemsex behaviours among men who have sex with men: a systematic review of the literature. Int J Drug Policy 2019;63:7489.Google Scholar
Soussan C, , Andersson M, , Kjellgren, A. The diverse reasons for using novel psychoactive substances: a qualitative study of the users’ own perspectives. Int J Drug Policy 2018;52:7178.Google Scholar
Soussan, C, Kjellgren, A. The users of novel psychoactive substances: online survey about their characteristics, attitudes and motivations. Int J Drug Policy 2016;32:7784. http://dx.doi.org/10.1016/j.drugpo.2016.03.007Google Scholar
Bonaccorso S, , Metastasio A, , Ricciardi A, et al. Synthetic cannabinoid use in a case series of patients with psychosis presenting to acute psychiatric settings: clinical presentation and management issues. Brain Sci 2018;8(7):133. https://doi.org/10.3390/brainsci8070133Google Scholar
Mitcheson, L, McCambridge, J, Byrne, A, Hunt, N, Winstock, A. Sexual health risk among dance drug users: cross-sectional comparisons with nationally representative data. Int J Drug Policy 2008;19(4):304310. https://doi.org/10.1016/j.drugpo.2007.02.002Google Scholar
Sutherland, R, Peacock, A, Whittaker, E, et al. New psychoactive substance use among regular psychostimulant users in Australia, 2010–2015. Drug Alcohol Depend 2016;161:110118.Google Scholar
Singh AK. Alcohol, interaction with cocaine, methamphetamine, opioids, nicotine, cannabis, and γ-hydroxybutyric acid. Biomedicines 2019;7:16. https://doi.org/10.3390/biomedicines7010016CrossRefGoogle Scholar
Sutherland, R, Peacock, A, Whittaker, E, et al. New psychoactive substance use among regular psychostimulant users in Australia, 2010–2015. Drug Alcohol Depend 2016;161:110118.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Publications Office of the European Union, Luxembourg, 2019.Google Scholar
Measham, F, Moore, K. Repertoires of distinction: exploring patterns of weekend poly-drug use within local leisure scenes across the English night-time economy. Criminal Justice 2009;9(4):437464.Google Scholar
Hoare, R, Flatley, J. Drug Misuse Declared: Findings from the 2007/2008 British Crime Survey (Home Office Statistical Bulletin 13/10). Home Office, 2008.Google Scholar
Vento, AE, Martinotti, G, Cinosi, E, et al. Substance use in the club scene of Rome: a pilot study. Biomed Res Int 2014;2014:617546. https://doi.org/10.1155/2014/617546CrossRefGoogle Scholar
Fernández-Calderóna F, , Cleland CM, , Palamar JJ., Polysubstance use profiles among electronic dance music party attendees in New York City and their relation to use of new psychoactive substances. Addict Behav 2018;78:8593. https://doi.org/10.1016/j.addbeh.2017.11.004Google Scholar
Fernández-Calderón, F, Lozano, OM, Vidal, C, et al. Polysubstance use patterns in underground rave attenders: a cluster analysis. J Drug Educ 2011;41:183202. http://dx.doi.org/10.2190/DE.41.2.dGoogle Scholar
Palamar, JJ, Griffin-Tomas, M, Ompad, DC. Illicit drug use among rave attendees in a nationally representative sample of US high school seniors. Drug Alcohol Depend 2015a;152:2431. http://dx.doi.org/10.1016/j.drugalcdep.2015.05.002Google Scholar
Palamar, JJ, Acosta, P, Ompad, DC, Cleland, CM. Self-reported ecstasy/MDMA/“Molly” use in a sample of nightclub and dance festival attendees in New York City. Subst Use Misuse 2016;52(1):8291. http://dx.doi.org/10.1080/10826084.2016.1219373Google Scholar
Palamar, JJ, Acosta, P, Sherman, S, Ompad, DC, Cleland, CM. Self-reported use of novel psychoactive substances among attendees of electronic dance music venues. Am J Drug Alcohol Abuse 2016;42:624632. http://dx.doi.org/10.1080/00952990.2016.1181179Google Scholar
Palamar, JJ, Barratt, MJ, Ferris, JA, Winstock, AR. Correlates of new psychoactive substance use among a self-selected sample of nightclub attendees in the United States. Am J Addict 2016c;25:400407. http://dx.doi.org/10.1111/ajad.12403Google Scholar
Measham, F, Moore, K. Repertoires of distinction: exploring patterns of weekend poly-drug use within local leisure scenes across the English night-time economy. Criminal Justice 2009;9(4):437464.Google Scholar
Home Office and Office for National Statistics. Drug Misuse: Findings from the 2017/2018 Crime Survey for England and Wales Statistical Bulletin 14/18 July 2018.Google Scholar
Schuler, MS, Stein BD, Collins RL. Differences in substance use disparities across age groups in a national cross-sectional survey of lesbian, gay, and bisexual adults. LGBT Health 2019;6(1):6876.Google Scholar
Newcomb, ME, Birkett, M, Corliss, HL, Mustanski B. Sexual orientation, gender, and racial differences in illicit drug use in a sample of US high school students. Am J Public Health 2014;104:304310.Google Scholar
Corliss, HL, Rosario, M, Wypij, D, et al. Sexual orientation and drug use in a longitudinal cohort study of US adolescents. Addict Behav 2010;35:517521.Google Scholar
Mereish, EH, Goldbach, JT, Burgess, C, DiBello AM. Sexual orientation, minority stress, social norms, and substance use among racially diverse adolescents. Drug Alcohol Depend 2017;178:4956.CrossRefGoogle ScholarPubMed
Seil, KS, Desai, MM, Smith MV. Sexual orientation, adult connectedness, substance use, and mental health outcomes among adolescents: findings from the 2009 New York City Youth Risk Behavior Survey. Am J Public Health 2014;104:19501956.Google Scholar
Goldbach, JT, Tanner-Smith, EE, Bagwell, M, Dunlap S. Minority stress and substance use in sexual minority adolescents: a meta-analysis. Prev Sci 2014;15:350363.Google Scholar
Marshal, MP, Dermody, SS, Shultz, ML, et al. Mental health and substance use disparities among urban adolescent lesbian and bisexual girls. J Am Psychiatr Nurses Assoc 2013;19:271279.Google Scholar
Halkitis, PN, Palamar, JJ. GHB use among gay and bisexual men. Addict Behav 2006;31(11):21352139.Google Scholar
Bourne A, Reid D, Hickson F, et al. Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex Transm Infect 2015;91:564–568.Google Scholar
Abdulrahim, D, Whiteley, C, Moncrieff, M, Club Drug, Bowden-Jones O Use among Lesbian, Gay, Bisexual and Trans (LGBT) People. Novel Psychoactive Treatment UK Network (NEPTUNE). London, 2016.Google Scholar
Kirby, T, Thornber-Dunwell, M. High-risk drug practices tighten grip on London gay scene. Lancet 2013;381(9861):101102.Google Scholar
Ahmed, AK, Weatherburn P, Reid D, et al. Social norms related to combining drugs and sex (‘chemsex’) among gay men in South London. Int J Drug Policy 2016;38:2935.Google Scholar
Evers, YJ, Hoebe, CJPA, Dukers-Muijrers, NHTM, et al. Sexual, addiction and mental health care needs among men who have sex with men practicing chemsex: a cross-sectional study in the Netherlands. Prev Med Rep 2020;18:101074.Google Scholar
Frankis, J, Flowers, P, McDaid, L, Bourne, A. Low levels of chemsex amongst men who have sex with men, but high levels of risk among men who engage in chemsex: analysis of a cross-sectional online survey across four countries. Sex Health 2018;15(2): 144150. https://doi.org/10.1071/SH17159Google Scholar
Giorgetti, R, Tagliabracci A, , Schifano F, et al. When ‘chems’ meet sex: a rising phenomenon called ‘chemsex’. Curr Neuropharmacol 2017;15(5):762770.Google Scholar
Graf N, Dichtl A, Deimel D, Sander D, Stöver H. Chemsex among men who have sex with men in Germany: motives, consequences and the response of the support system. Sex Health 2018;15(2):151–156. https://doi.org/10.1071/SH17142Google Scholar
Hammoud MA, Bourne A, Maher L, et al. Intensive sex partying with gamma-hydroxybutyrate: factors associated with using gamma-hydroxybutyrate for chemsex among Australian gay and bisexual men – results from the Flux Study. Sex Health 2018;15(2):123–134. https://doi.org/10.1071/SH17146Google Scholar
Hegazi A., Lee MJ, Whittaker W, et al. Chemsex and the city: sexualised substance use in gay bisexual and other men who have sex with men attending sexual health clinics. Int J STD AIDS 2017;28(4):423.Google Scholar
Hibbert MP, Brett CE, Porcellato LA, Hope VD. Psychosocial and sexual characteristics associated with sexualised drug use and chemsex among men who have sex with men (MSM) in the UK. Sex Transm Infect (online). Available at: https://sti.bmj.com/content/sextrans/early/2019/04/12/sextrans-2018-053933.full.pdf [last accessed 15 February 2022].Google Scholar
Hockenhull J, Murphy KG, Paterson S. An observed rise in g-hydroxybutyrate-associated deaths in London: evidence to suggest a possible link with concomitant rise in chemsex. Forensic Sci Int 2017;270:93–97.Google Scholar
O’Reilly, M. Chemsex case study: is it time to recommend routine screening of sexualised drug use in men who have sex with men? Sex Health 2018;15(2):167169. https://doi.org/10.1071/SH17156Google Scholar
Pollard, A, Nadarzynski, T, Llewellyn, C. Syndemics of stigma, minority-stress, maladaptive coping, risk environments and littoral spaces among men who have sex with men using chemsex. Cult Health Sex 2018;20:411427.Google Scholar
Pufall, EL, Kall M, Shahmanesh M, et al. Sexualized drug use (‘chemsex’) and high-risk sexual behaviours in HIV positive men who have sex with men. HIV Med 2018;19(4):261270.Google Scholar
Stevens, O, Forrest, JI. Thinking upstream: the roles of international health and drug policies in public health responses to chemsex. Sex Health 2018;15(2):108115. https://doi.org/10.1071/SH17153Google Scholar
Ruane D., Field experiments: psychonauts’ efforts to reduce the harm of old and new drugs at music festivals. Drugs Educ Prevent Policy 2018;25(4):337344. https://doi.org/10.1080/09687637.2017.1418836Google Scholar
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). EMCDDA–Europol 2012 Annual Report on the Implementation of Council Decision 2005/387/JHA. Publications Office of the European Union, Luxemburg, 2012.Google Scholar
Schifano, F, Deluca, P, Baldacchino, A, et al. Drugs on the web; the Psychonaut 2002 EU project. Prog Neuropsychopharmacol Biol Psychiatry 2006;30(4):640646.Google Scholar
Schifano F. Analyzing the open/deep web to better understand the new/novel psychoactive substances (NPS) scenarios: suggestions from CASSANDRA and NPS Finder Research Projects. Brain Sci 2020;10:146. https://doi.org/10.3390/brainsci10030146Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2017: Trends and Developments. Publications Office of the European Union, Luxembourg, 2017.Google Scholar
Corazza, O, Schifano, F, Farre, M, et al. Designer drugs on the internet: a phenomenon out-of-control? The emergence of hallucinogenic drug Bromo-Dragonfly. Curr Clin Pharmacol 2011;6(2):125129.Google Scholar
Corazza, O, Schifano, F, Simonato, P, et al. Phenomenon of new drugs on the internet: the case of ketamine derivative methoxetamine. Hum Psychopharmacol Clin Exp 2012;27(2):145149.Google Scholar
Corazza, O, Valeriani, G, Bersani, FS, et al. “Spice, , ” “Kryptonite,” “Black Mamba”: an overview of brand names and marketing strategies of novel psychoactive substances on the web. J Psychoactive Drugs 2014;46(4):287294.Google Scholar
Orsolini L, Papanti D, Corkery J, Schifano F. An insight into the deep web; why it matters for addiction psychiatry? Hum Psychopharmacol Clin Exp 2017;32:e2573. https://doi.org/10.1002/hup.2573Google Scholar
European Monitoring Centre for Drugs and Drug Addiction and Europol. Drugs and the Darknet: Perspectives for Enforcement, Research and Policy. EMCDDA–Europol Joint publications. Publications Office of the European Union, Luxembourg, 2017.Google Scholar
Orsolini L, Papanti D, Corkery J, Schifano F. An insight into the deep web; why it matters for addiction psychiatry? Hum Psychopharmacol Clin Exp 2017;32:e2573. https://doi.org/10.1002/hup.2573Google Scholar
van der Gouwe D, Brunt TM, van Laar M, van der Pol P. Purity, adulteration and price of drugs bought on-line versus off-line in the Netherlands (online). https://doi.org/10.1111/add.13720Google Scholar
In Focus: Trafficking over the Darknet – World Drug Report 2020. www.unodc.org/documents/Focus/WDR20_Booklet_4_Darknet_web.pdf [last accessed 9 February 2022].Google Scholar
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). EMCDDA–Europol 2012 Annual Report on the Implementation of Council Decision 2005/387/JHA. Publications Office of the European Union, Luxembourg, 2012.Google Scholar
Hout, Van MC. Nod and wave: an Internet study of the codeine intoxication phenomenon. Int J Drug Policy 2015;26:6777.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Recent Changes in Europe’s Cocaine Market. Results from an EMCDDA Trendspotter Study. Publications Office of the European Union, Luxembourg, 2018.Google Scholar
Schifano, F. Novel psychoactive substances (NPS): clinical and pharmacological issues. Drugs Alcohol Today 2015;15(1):2127.Google Scholar
Schifano, F, Orsolini, L, Duccio Papanti, G, Corkery, JM. Novel psychoactive substances of interest for psychiatry. World Psychiatry 2015;14(1):15–26.Google Scholar
van Amsterdam, J, Nutt, D, Phillips, L, van den Brink, W. European rating of drug harms. J Psychopharmacology 2015;29(6):655660https://doi.org/10.1177/0269881115581980Google Scholar
Gable, RS. Acute toxic effects of club drugs. J Psychoactive Drugs 2004;36(3):303313.Google Scholar
Gable, RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction 2004;99(6):686696.Google Scholar
Luethia D, , Kolaczynskaa KE, , Doccia L, , Krähenbühla S, , Hoenerb MC, , Liechti ME., Pharmacological profile of mephedrone analogs and related new psychoactive substances. Neuropharmacology 2018;134(Part A):412.Google Scholar
Centre for Public Health, Faculty of Health and Applied Social Science, Liverpool John Moore’s University, on behalf of the Department of Health and National Treatment Agency for Substance Misuse. A Summary of the Health Harms of Drugs. Department of Health, 2011.Google Scholar
Elliott S, , Sedefov R, , Evans‐Brown M. Assessing the toxicological significance of new psychoactive substances in fatalities. Drug Test Anal 2018;10:120126.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report: Trends and Developments. Published 2016. Available at: https://dx.doi.org/10.2810/Google Scholar
Evans‐Brown, M, Sedefov, R. New psychoactive substances: driving greater complexity into the drug problem. Addiction 2017;112:36.Google Scholar
Gable, RS. Acute toxic effects of club drugs. J Psychoactive Drugs 2004;36(3):303313.Google Scholar
King LA, , Corkery JM., An index of fatal toxicity for new psychoactive substances. J Psychopharmacol 2018; 32(7):793801.Google Scholar
National Records of Scotland Drug-related Deaths in Scotland in 2019. Published on 15 December 2020.Google Scholar
Nutt, D, King, LA, Saulsbury, W, Blakemore, C. Development of a rational scale to assess the harm of drugs of potential misuse. Lancet 2007;369(9566):10471053.Google Scholar
Gable, RS. Comparison of acute lethal toxicity of commonly abused psychoactive substances. Addiction 2004;99(6):686696.Google Scholar
Centre for Public Health, Faculty of Health and Applied Social Science, Liverpool John Moore’s University, on behalf of the Department of Health and National Treatment Agency for Substance Misuse. A Summary of the Health Harms of Drugs. Department of Health, 2011.Google Scholar
Corazza, O, Schifano, F, Farre, M, et al. Designer drugs on the Internet: a phenomenon out-of-control? The emergence of hallucinogenic drug Bromo-Dragonfly. Curr Clin Pharmacol 2011;6(2):125129.Google Scholar
Costa, G, De Luca, MA, Piras, G, Marongiu, J, Fattore, L, Simola, N. Neuronal and peripheral damages induced by synthetic psychoactive substances: an update of recent findings from human and animal studies. Neural Regen Res 2020;15(5):802816. https://doi.org/10.4103/1673-5374.268895Google Scholar
United Nations Office on Drugs and Crime (UNODC). Current NPS Threats, Volume I. Published March 2019. Available at: www.unodc.org/pdf/opioids-crisis/Current_NPS_Threats_-_Volume_I.pdf [last accessed 9 February 2022].Google Scholar
United Nations Office on Drugs and Crime (UNODC). Current NPS Threats, Volume I. Published March 2019. www.unodc.org/pdf/opioids-crisis/Current_NPS_Threats_-_Volume_I.pdf [last accessed 9 February 2022].Google Scholar
Guirguis A, , Girotto S, , Berti B, , Stair JL, . Identification of new psychoactive substances (NPS) using handheld Raman Spectroscopy employing both 785 and 1064 nm laser sources. Forensic Sci Int, published online 4 February 2017. https://doi.org/10.1016/j.forsciint.2017.01.027Google Scholar
Addison M, , Stockdale K, , McGovern R, et al. Exploring the intersections between novel psychoactive substances (NPS) and other substance use in a police custody suite setting in the north east of England. Drugs Educ Prevent Policy 2018;25(4):313319. https://doi.org/10.1080/09687637.2017.1378620Google Scholar
Brandt, SD, Sumnall, HR, Measham, F, Cole, J. Analyses of second-generation ‘legal highs’ in the UK: initial findings. Drug Test Anal 2010;2(8):377382. https://doi.org/10.1002/dta.155Google Scholar
Brandt, SD, Sumnall, HR, Measham, F, Cole, J. Second generation mephedrone. The confusing case of NRG-1. BMJ 2010;341:c3564. https://doi.org/10.1136/bmj.c3564Google Scholar
Davies, S, Wood, DM, Smith, G, et al. Purchasing ‘legal highs’ on the Internet: is there consistency in what you get? QJM 2010;103(7):489493. https://doi.org/10.1093/q jmed/hcq056.Google Scholar
Ramsey, J, Dargan, PI, Smyllie, M, et al. Buying ‘legal’ recreational drugs does not mean that you are not breaking the law. QJM 2010;103(10):777783. https://doi.org/10.1093/qjmed/hcq132Google Scholar
Ayres, TC, Bond, JW. A chemical analysis examining the pharmacology of novel psychoactive substances freely available over the Internet and their impact on public (ill)health. Legal highs or illegal highs? BMJ Open 2012;2(4):e000977. https://doi.org/10.1136/bmjopen-2012-000977. 2012Google Scholar
Baron, M, Elie, M, Elie, L. An analysis of legal highs: do they contain what it says on the tin? Drug Test Anal 2011;3(9):576581. https://doi.org/10.1002/dta.274Google Scholar
World Drug Report 2016.Google Scholar
Home Office Annual Report on the Home Office Forensic Early Warning System (FEWS) 2016/17. A system to identify New Psychoactive Substances (NPS) in the UK November 2018. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/757040/FEWS_Annual_Report_2016-17_STH.pdfGoogle Scholar
See for example: Baron, M, Elie, M, Elie, L. An analysis of legal highs: do they contain what it says on the tin? Drug Test Anal 2011;3(9):576581. https://doi.org/10.1002/dta.274Google Scholar
James, DA, Potts, S, Thomas, SHL, et al. Clinical features associated with recreational use of ‘Ivory Wave’ preparations containing desoxypipradrol. Clin Toxicol 2011;49:201.Google Scholar
Kalasinsky, KS, Hugel, J, Kish, SJ. Use of MDA (the ‘love drug’) and methamphetamine in Toronto by unsuspecting users of ecstasy (MDMA). J Forensic Sci 2004;49(5):11061112.Google Scholar
Parrott, AC. Is ecstasy MDMA? A review of the proportion of ecstasy tablets containing MDMA, their dosage levels, and the changing perceptions of purity. Psychopharmacology 2004;173:234241.Google Scholar
Cole, JC, Bailey, M, Sumnall, HR, Wagstaff, GF, King, LA. The content of ecstasy tablets: implications for the study of their long-term effects. Addiction 2002;97:15311536.Google Scholar
Tanner-Smith, EE. Pharmacological content of tablets sold as ‘ecstasy’: results from an online testing service. Drug Alcohol Depend 2006;83(3):247254.Google Scholar
Baron, M, Elie, M, Elie, L. An analysis of legal highs: do they contain what it says on the tin? Drug Test Anal 2011;3(9):576581. https://doi.org/10.1002/dta.274Google Scholar
Brunt, TM, Atkinson, AM, Nefau, T, et al. Online test purchased new psychoactive substances in five different European countries: a snapshot study of chemical composition and price. Int J Drug Policy 2017;44:105114. https://doi.org/10.1016/j.drugpo.2017.03.006Google Scholar
Brunt, TM, Atkinson, AM, Nefau, T, et al. Online test purchased new psychoactive substances in five different European countries: a snapshot study of chemical composition and price. Int J Drug Policy 2017;44:105114.Google Scholar
Brunt, TM, Atkinson, AM, Nefau, T, et al. Online test purchased new psychoactive substances in five different European countries: a snapshot study of chemical composition and price. Int J Drug Policy 2017;44:105114.Google Scholar
Kalasinsky, KS, Hugel, J, Kish, SJ. Use of MDA (the ‘love drug’) and methamphetamine in Toronto by unsuspecting users of ecstasy (MDMA). J Forensic Sci 2004;49(5):11061112.Google Scholar
Parrott, AC. Is ecstasy MDMA? A review of the proportion of ecstasy tablets containing MDMA, their dosage levels, and the changing perceptions of purity. Psychopharmacology 2004;173:234241.Google Scholar
Cole, JC, Bailey, M, Sumnall, HR, Wagstaff, GF, King, LA. The content of ecstasy tablets: implications for the study of their long-term effects. Addiction 2002;97:15311536.Google Scholar
Tanner-Smith, EE. Pharmacological content of tablets sold as ‘ecstasy’: results from an online testing service. Drug Alcohol Depend 2006;83(3):247254.Google Scholar
Ciccarone, D, Ondocsin, J, Mars, SG. Heroin uncertainties: exploring users’ perceptions of fentanyl-adulterated and -substituted ‘heroin’. Int J Drug Policy 2017;46:146155.Google Scholar
Unick, GJ, Ciccarone, D. US regional and demographic differences in prescription opioid and heroin-related overdose hospitalizations. Int J Drug Policy 2017;46:112119. https://doi.org/10.1016/j.drugpo.2017.06.003Google Scholar
Tomassoni, AJ. Multiple fentanyl overdoses—New Haven, Connecticut, June 23, 2016. Morb Mort Wkly Rep 2017;66:107111.Google Scholar
Fairbairn, N, Coffin, PO, Walley, AY. Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: challenges and innovations responding to a dynamic epidemic. Int J Drug Policy 2017;46:172179. https://doi.org/10.1016/j.drugpo.2017.06.005Google Scholar
Krause, D, Plörer, D, Koller, G, et al. High concomitant misuse of fentanyl in subjects on opioid maintenance treatment. Subst Use Misuse 2017;52(5):639645.Google Scholar
Cicero, TJ, Ellis, MS, Kasper, ZA. Increases in self-reported fentanyl use among a population entering drug treatment: the need for systematic surveillance of illicitly manufactured opioids. Drug Alcohol Depend 2017;177:101103. https://doi.org/10.1016/j.drugalcdep.2017.04.004Google Scholar
Ciccarone, D, Ondocsin, J, Mars, SG. . Heroin uncertainties: exploring users’ perceptions of fentanyl-adulterated and -substituted ‘heroin’. Int J Drug Policy 2017;46:146155.Google Scholar
Caudevilla-Gálligo, F, Riba, J, Ventura, M, et al. 4-bromo-2,5-dimethoxyphenethylamine (2C-B): presence in the recreational drug market in Spain, pattern of use and subjective effects. J Psychopharmacol 2012;26(7):10261035. https://doi.org/10.1177/0269881111431752Google Scholar
Liakoni E, Yates C, Dines, AM, et al. Acute recreational drug toxicity. Medicine 2018;97(5):e9784. https://doi.org/10.1097/MD.0000000000009784Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Publications Office of the European Union, Luxembourg, 2019.Google Scholar
Wood DM, , De La Rue L, , Hosin AA, et al. Dargan poor identification of emergency department acute recreational drug toxicity presentations using routine hospital coding systems: the experience in Denmark, Switzerland and the UK. J Med Toxicol 2019;15:112120. https://doi.org/10.1007/s13181-018-0687-zGoogle Scholar
Wood, DM, Conran, P, Dargan, PI. ICD- 10 coding: poor identification of recreational drug presentations to a large emergency department. Emerg Med 2011;28:387389.Google Scholar
Shah, AD, Wood, DM, Dargan, PI. Survey of ICD-10 coding of hospital admissions in the UK due to recreational drug toxicity. QJM 2011;104:779784.CrossRefGoogle ScholarPubMed
Wood DM, , De La Rue L, , Hosin AA, et al. Dargan poor identification of emergency department acute recreational drug toxicity presentations using routine hospital coding systems: the experience in Denmark, Switzerland and the UK. J Med Toxicol 2019;15:112120. https://doi.org/10.1007/s13181-018-0687-zGoogle Scholar
Poznyak V, Reed GM, Medina-Mora ME. Aligning the ICD-11 classification of disorders due to substance use with global service needs. Epidemiol Psychiatr Sci (online). https://doi.org/10.1017/S2045796017000622Google Scholar
International Classification of Diseases for Mortality and Morbidity Statistics, 11th edn., v2019-04 6C47. Disorders due to use of synthetic cathinones. Available at: https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1605818663 [last accessed 15 February 2022].Google Scholar
International Classification of Diseases for Mortality and Morbidity Statistics, 11th edn., v2019-04 6C42. Disorders due to use of synthetic cannabinoids. Available at: https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/804833492 [last accessed 15 February 2022].Google Scholar
International Classification of Diseases for Mortality and Morbidity Statistics, 11th ed., v2019-04 6C4C. Disorders due to use of MDMA or related drugs, including MDA. Available at: https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1218193465[lastaccessed15February2022].Google Scholar
Wood DM, , De La Rue L, , Hosin AA, et al. Dargan poor identification of emergency department acute recreational drug toxicity presentations using routine hospital coding systems: the experience in Denmark, Switzerland and the UK. J Med 673 Col:311Toxicol 2019;15:112120. https://doi.org/10.1007/s13181-018-0687-zGoogle Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Publications Office of the European Union, Luxembourg, 2019.Google Scholar
Wood, DM, Heyerdahl, F, Yates, CB, et al. The European Drug Emergencies Network (Euro-DEN). Clin Toxicol 2014;52(4):239241. https://doi.org/10.3109/15563650.2014.898771Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. Drug-related hospital emergency presentations in Europe: update from the Euro-DEN Plus expert network, technical report. Publications Office of the European Union, Luxembourg, 2020.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Publications Office of the European Union, Luxembourg, 2019.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction. European Drug Report 2019: Trends and Developments. Publications Office of the European Union, Luxembourg, 2019.Google Scholar
Hunter, LJ, Dargan, PI, Benzie, A, White, JA, Wood, DM. Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM. Postgrad Med J 2014;90(1061):133138. https://doi.org/10.1136/postgradmedj-2012-131428Google Scholar
Scottish Government. The Sexual Health and Blood Borne Virus Framework 2011–2015.Google Scholar
Department of Health. A Framework for Sexual Health Improvement in England. Published 2013.Google Scholar
Royal College of Physicians. Alcohol and Sex: A Cocktail for Poor Sexual Health (Report of the Alcohol and Sexual Health Working Party). Published 2011.Google Scholar
British HIV Association. Standards of Care for People Living with HIV in 2013. Available at: www.bhiva.org/file/WSheCFExXGBRK/BHIVAStandardsA4.pdf [last accessed 15 February 2022].Google Scholar
Hunter, LJ, Dargan, PI, Benzie, A, White, JA, Wood, DM. Recreational drug use in men who have sex with men (MSM) attending UK sexual health services is significantly higher than in non-MSM. Postgrad Med J 2014;90(1061):133138. https://doi.org/10.1136/postgradmedj-2012-131428Google Scholar
Bowden-Jones O. Joining up sexual health and drug services to better meet client needs. Background paper commissioned by the EMCDDA for Health and social responses to drug problems: a European guide. Available at: www.emcdda.europa.eu/system/files/attachments/6239/EuropeanResponsesGuide2017_BackgroundPaper-Sexual-health-and-drug-use.pdf [last accessed 15 February 2022].Google Scholar
National Institute for Health and Care Excellence. Alcohol-Use Disorders: Preventing Harmful Drinking (PH24). Published 2010.Google Scholar
British Association of Sexual Health and HIV. Standards for the management of sexually transmitted infections (STIs). Published 2019. Available at: www.bashh.org/about-bashh/publications/standards-for-the-management-of-stis/ [last accessed 15 February 2022].Google Scholar
British Association of Sexual Health and HIV. Standards for the management of sexually transmitted infections (STIs). Published 2019. Available at: www.bashh.org/about-bashh/publications/standards-for-the-management-of-stis/ [last accessed 15 February 2022].Google Scholar
Department of Health and Social Care, Public Health England. Integrated Sexual Health Services. A suggested national service specification. Published August 2018. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/731140/integrated-sexual-health-services-specification.pdf [last accessed 15 February 2022].Google Scholar
World Health Organization. International Standards for the Treatment of Drug Use Disorders. Revised edition incorporating results of field-testing. 31 March 2020. Available from: www.who.int/publications/i/item/international-standards-for-the-treatment-of-drug-use-disordersGoogle Scholar
United Nations Office for Drugs and Crime, World Health Organization. Principles of Drug Dependence Treatment. Published March 2008. Available at: www.unodc.org/documents/drug-treatment/UNODC-WHO-Principles-of-Drug-Dependence-Treatment-March08.pdf [last accessed 15 February 2022].Google Scholar
Panagopoulos, I, Ricciardelli, LA. Harm reduction and decision making among recreational ecstasy users. Int J Drug Policy 2005;16:5464.Google Scholar
Fernández-Calderón, F, Lozano-Rojas, Ó, Rojas-Tejada, A, et al. Harm reduction behaviors among young polysubstance users at raves. Subst Abuse 2014;35:4550.Google Scholar
Greenspan, NR, Aguinaldo, JP, Husbands, W, et al. “It’s not rocket science, what I do”: self-directed harm reduction strategies among drug using ethno-racially diverse gay and bisexual men. Int J Drug Policy 2011;22:5662.Google Scholar
Cruz, OS. Non problematic illegal drug use: drug use management strategies in a Portuguese sample. J Drug Issues 2015;45:133150.Google Scholar
Fernández-Calderón F, , Díaz-Batanero C, , Barratt MJ, , Palamar JJ. Harm reduction strategies related to dosing and their relation to harms among festival attendees who use multiple drugs. Drug Alcohol Rev 2019;38:5767. https://doi.org/10.1111/dar.12868Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×