Novel Psychoactive Substances

Question 1

State 4 categories of drugs (by psychoactive effect)

Answer 1

Stimulants, sedatives, hallucinogens, dissociatives

Question 2

Name at least 2 stimulants

Answer 2

Cocaine, amphetamine, mephedrone, ecstasy

Question 3

Name at least 2 sedatives

Answer 3

Cannabis, alcohol, heroin, codeine phosphate, nitrous oxide, diazepam

Question 4

Name 2 hallucinogens

Answer 4

LSD, ecstasy

Question 5

Name 2 dissociatives

Answer 5

Ketamine, nitrous oxide

Question 6

What percentage of young people below 25 in the UK have used an illicit drug in the past year?

Answer 6

19.2%

Question 7

What is mephedrone?

Answer 7

A synthetic stimulant (cathinone) with amphetamine-like effects

Question 8

State some ‘club drugs’

Answer 8

Ketamine, GHB, MDMA, mephedrone, methamphetamine

Question 9

State at least 4 different populations who used novel psychoactive substances while they were legal

Answer 9

Long-term heroin users, students and club-goers, gay men, young professionals (lawyers, doctors), psychonauts, prisoners

Question 10

Why can mobile phone use trigger relapse in ex-novel psychoactive substance addicts?

Answer 10

Unlike traditional drugs, these are mainly sold via social media and on the internet

Question 11

State at least 2 novel harms of novel psychoactive substances

Answer 11

Ketamine bladder, hallucinogen persisting perception disorder, psychosis

Question 12

Which drugs cause psychosis?

Answer 12

Synthetic cannabinoids

Question 13

Describe ketamine bladder

Answer 13

irritation of the inside lining of the bladder, leading to polyuria, dysuria, and haematuria

Question 14

Describe hallucinogen persisting perception disorder

Answer 14

Users of hallucinogens experiencing ongoing distortions and hallucinations including ‘visual snow’, afterimages, auras, micropsia, macropsia, and brain fog

Question 15

In what year did the synthesis of novel psychoactive substances peak?

Answer 15

2014

Question 16

Why are synthetic cannabinoid receptor agonists (SCRAs) more dangerous than cannabis?

Answer 16

They are much more potent CB1 receptor agonists, undetectable on standard urine drug testing (so healthcare workers don’t know the dose or even specific drug to treat), and non-specific - targeting multiple receptors beyond CB1.

Question 17

When was the UK Psychoactive Substances Act introduced?

Answer 17

2016

Question 18

Give some potential reasons for the downturn in synthesis of novel psychoactive substances

Answer 18

Psychoactive Substances Act stopping the need for new development, loss of interest, coalescing of the market around existing drugs, response of the illicit drug market

Question 19

How did the illicit drug market respond to the popularity of novel psychoactive substances?

Answer 19

Increasing the purity of cocaine and MDMA

Question 20

State the 2 main types of novel psychoactive sedatives

Answer 20

Opioid novel psychoactive substances (fentanyl analogues) and benzodiazepine novel psychoactive substances

Question 21

Name a fentanyl analogue

Answer 21

Carfentanyl

Question 22

What percentage of traditional drugs and novel psychoactive substances respectively are obtained from the internet?

Answer 22

Traditional: 1%
NPS: 37%

Question 23

What is the UK system for reporting illicit drug reactions?

Answer 23

RIDR

Question 24

State at least 2 challenges illustrated by novel psychoactive substances

Answer 24

Dynamic and unpredictable drug market, monitoring is difficult and lags behind trends, building an evidence base takes time, NPS may be outdated as a concept, MDT response

Question 25

State at least 2 new developments because of novel psychoactive substances

Answer 25

More sophisticated drug monitoring systems, legal and enforcement frameworks, new technology (e.g. gas chromatography techniques for drug testing)