Novel psychoactive substances in the UK 

While illegal drug use has, largely, been declining in the UK over the past decade, this period has witnessed the emergence of a range of new, mostly synthetic substances that mimic many of the effects of “traditional” drugs. These are known as “legal highs”, or new or novel psychoactive substances (NPS). They are psychoactive drugs which are not prohibited by the United Nations Single Convention on Narcotic Drugs or by the Misuse of Drugs Act 1971.

There are wide-ranging grounds for concern about novel psychoactive substance use, including: the technological capacity for continuous product innovations has led to rapid increases in the numbers of different substances available, making it difficult to control access to these substances, notwithstanding recent speeding up of legal processes in the UK and elsewhere; they appear cheap to obtain over the internet and elsewhere; by international standards, there are very high levels of cultural acceptability of NPS use in the UK; they are perceived to be safe or to pose little risk, particularly when they have not been subject to legal control; there has been little consideration of the public health burden associated with NPS use, apart from investigations of acute problems presenting to health services, and fatalities.

The need for evidence has been identified by the UK Government and the Advisory Council on the Misuse of Drugs for some years, and meeting this research need is now a prominent part of the National Drugs Strategy. The overall aim of this project is to inform the development of public health intervention research on NPS in the UK by undertaking an investigation of the current evidence-base. On this basis this project will address gaps in available evidence and make recommendations on research priorities. The project objectives are:

  1. To summarise and evaluate what is known about NPS use in the UK and related harms and responses through the conduct of a systematic review of peer-reviewed and grey literature.
  2. To develop a dedicated conceptual framework for a public health approach to NPS use which identifies the scope for interventions based on approaches developed for the use of other legal and illegal drugs, and the concerns of public health and prevention more broadly.
  3. To produce a statement of public health intervention research issues for NPS use in the UK that makes recommendations on key evidence gaps and priorities for future research.

There are two study components corresponding to the first two study objectives:

Study component 1: NPS systematic review (for objective 1)
This systematic review will summarise and evaluate what is known about NPS use in the UK, and on related harms and responses from the international literature. The overarching objective for this study is to identify what is known about NPS use in the UK.

Study component 2: NPS conceptual framework development (for objective 2)
This study component addresses what might be the broad approach, and the key elements, of a strategic evidence-based public health intervention response to NPS use in the UK. We approach this question with an orientation to explore, and apply as may be useful, perspectives gained from public health sciences more broadly and responses to other drugs, both legal and illegal.

Synergies between the two study components are a key feature of this proposal. The conceptual framework is elaborated in part to assist with the narrative synthesis of the data from the systematic review. It is then used for the construction of a robust assessment of key evidence gaps and research priorities, and articulation of the key issues facing public health intervention research (for objective 3).

Final report


Funder(s): National Institute for Health Research
Start Date: 01-Sept-15
End Date: 31-Oct-16


Internal staff

External collaborators

  • Nick Meader

Mental Health and Addiction Research in the Department of Health Sciences