The European Monitoring Centre for Drugs and Drug Addiction last month published a report, ‘Health Responses to New Psychoactive Substances,’ to provide an over-view of NPS-drug trends in Europe and recommend future drug interventions. This evidence-based approach reflects the adverse effects of NPS drug use and recommends good practise guidelines to ensure treatment providers, health clinics and educators adapt to the new drug environment.

The EMCDDA report is useful to practitioners working across a number of disciplines in delivering a health response to the NPS phenomenon. Angelus has condensed the report into key professional areas to signpost the existing strategies which have been most effective.

The UK has the high client admission for NPS-related problems, more so than anywhere else in Europe. It is EMCDDA’s view that ‘cultural competency’ is essential when improving services, engagement and user uptake. The EMCDDA has observed a strong trend across Europe - professionals who have limited knowledge of NPS and are struggling to manage NPS drug-users. Given the lack of data on ‘under-researched chemicals’ it can be difficult to assess the harms followed by the best approach to manage drug or health problems. To overcome the challenge of ‘cultural incompetency’ the EMCDDA recommend professionals to seek further training to fill in the knowledge gap.

In the UK, the Angelus Foundation has been approached by a variety of organisations who wish their staff to upskill. Angelus supports professional development through staff training enabling staff to understand the cultural issues that influence drug use and helps to conceptualise the diverse groups of NPS users.

South Wales Police and Project Life Line tweet their NPS training sessions delivered to construction workers and health professionals to increase awareness in the workplace.

NPS prevalence in school age population is generally low, regardless of the likelihood of the risk of students drug-taking, EMCDDA argue that all should be educated on the harms. In a Mentor- ADEPIS survey of 288 teachers in the UK, school students received only 1-2 hours of drug education or less per year, with the focus on illicit substances not new and often legal psychoactive substances.

Young people are most at-risk of establishing future behaviours with drugs, so education can act as a ‘myth buster,’ an intervention for some and a deterrent for others. Research on the effects of NPS drug related education is incomplete with little knowledge of the outcomes. In order to prevent these drugs from being normalised, the monitoring centre advice is to run prevention activities to build resilience when improving interactive skills, classroom management activities and a school retention programme.

‘Teachers and other school staff may not have the skills required to assess NPS-related risk, respond to questions about NPS from students or deliver specific prevention activities, and therefore other organisations might be best placed to deliver these or to receive referrals,’ the EMCDDA report states. Angelus has also just embarked on a pilot programme focused on NPS education in Luton schools which we are intending to roll out elsewhere.

Other organisations who deliver drug education across the regions to secondary schools students is Solve-It a Northampton based charity and REAL based in Hull.

‘Party-goers’ is a generic term used by the EMCDDA to describe people who enjoy visiting clubs, pubs, raves and festivals, and are often more likely to recreationally use drugs in this setting. The night time economy offers the opportunity to target recreational users who might resist presenting to treatment services. Checkit was founded in Austria in 1997 to provide an on site drug checking analysis service. This service can prevent serious harms from high strength drugs, for example there has been a spate of PMA deaths across Europe in recent years. It is effectively an ‘Early Warning System’ detecting unknown substances - the programme also became a deterrent, as 19% of people who unexpectedly found NPS in what they thought was an illicit substance abstained from use. This model is also replicated in Portugal and the Netherlands. Of course drug-checking indicates the contents of any pill but not its strength.

Chemsex is the use of psychoactive substances like mephedrone, GHB/GBL and methamphetamines that are‘slammed’ (injected) to disinhibit and enhance sexual practise. There has been an upsurge in HIV, Hep C and other blood-borne viruses: in London five people per day are diagnosed HIV. The 56 Dean Street Sexual Health Clinic, offers a broad service addressing issues such as injecting,sober sex, harm reduction advice, sexual health testing and out reach support. The EMCDDA judge this service to being ‘cultural sensitive’, offering clear, honest and non-judgemental advice on the potential harms of chemsex as well as addressing the physical, sexual and mental health needs of the clients.

Across Europe demand for specialist treatment for NPS remains low and represents less than 2% of all clients entering treatment. Traditional drug use continues to be the most popular substances of choice although, such substances continue to be at a high price with some ex-opiate users switching to injecting synthetic cathinone or smoking synthetic cannabinoids. Project NEPTUNE is a national clinical response to NPS treatment that provides guidance for outreach workers, sexual health clinics, GPs, accident and emergency departments and treatment providers in dealing with NPS-admissions.