Young people have always experimented with drugs and alcohol as part of adolescence and the transition to adulthood. Ravers have always used substances to get pleasure and enhance the individual and group experience of the substance-using environment. Such use may be to; ‘aid’ communication, digest music, discover and experiment with sex and substances, or simply to relax and ‘chill’.

Until recently, ‘Legal highs’ was the buzz phrase in drug services. However, on 28^th May 2016, the Psychoactive Substances Act 2016 came into force, replacing the term with ‘New Psychoactive Substances’, or NPS for short. The Act also states that, although it is an offence to produce, supply, offer to supply, or possess with intent to supply NPS, it is not an offence to be in possession of them.

Whatever the terminology, these substances seem to be presenting workers and services with a new challenge. In response, many organizations have incorporated services for users of NPS into their remit and employed specialist workers.

NPS have received attention in light of the different client groups seen by services eg., young people, ravers, the LGBT community, and working people. Drug use within these groups is not new but they have previously proved to be difficult to engage in services. Reasons may include fear of exposure, fear of judgement, and fear of losing their job. Services have responded by opening evening clinics, employing specialist workers and taking services to settings where drug use is prevalent.
Ecstasy and ‘rave’ drugs have been around since the mid 1980’s, and when users of these drugs approached services, treatment was designed to cater to individual need. Young people are often seen by youth workers rather than drug workers because of cuts to services, and members of the LGBT community can be reluctant to engage with drug services because of perceived negative judgement about their sexual practices.

So, given that substance misuse services can expect to see a more diverse client group, they may need to review the interventions they use in order to meet those groups’ differing needs. Current interventions include relapse prevention, motivational interviewing, harm reduction etc. These interventions help drug users gain insight, be honest about their using, address cravings and reduce harm. Where drug use is linked to other behaviours, these links are explored and examined.

The real problem with NPS is the easy potential to cause harm. NPS mimic the four main categories of drugs and might often be misleading by name. This can lead to users taking the same amount of an imitation drug as they would of the real drug. Users will also take more if they do not feel much effect in the expected time. These situations are where the risks of NPS are most prevalent, and where they can often lead to hospitalization.

It may therefore be necessary for drug workers and services to be better placed to offer harm reduction interventions to users of NPS when they first access services. This approach will engage the drug user in a tested and proven intervention. But it might also raise questions. For example, if harm reduction interventions are used for longer periods with users of NPS, do they actually differ from the interventions experienced by many of the other clients who currently access services?

An additional factor to consider is the health problems that can be associated with regular use of some NPS. Ketamine, for example, is associated with bladder problems that are irreversible. Drug services have much experience of supporting clients with health problems associated with their drug use. They have long helped drug users to access mainstream health services, often bringing services into the treatment centre so that clients are more likely to engage. And, as with existing clients, services develop referral pathways for the specific needs of their clients and aim to develop a collaborative relationship in order to benefit the client. Services will need to develop these referral pathways for users of NPS, as they have for users of other drugs.

Finally, we must not forget the fundamental issue that exists for the service user, irrespective of their drug or drugs of choice. That is their desire to experience pleasure, to change feelings and behaviour, and to pursue these sensations at all costs. At this level, there is no differentiation between NPS and illegal drugs.

When the term “legal highs” was coined, it seemed at last to acknowledge that the objective of a drug and alcohol user is to experience the high that is on offer from their substance of choice. The phrase has a certain honesty about it, whatever these substances’ legal status. The term NPS may not convey the same weight of meaning, but it is here to stay.

At Janus, we have found that the flexibility of our Resonance Factor approach has much to offer those whose use of NPS has become problematic. The Resonance Factor empowers clients to rid themselves of ‘victimhood’ and/or passivity, encourages them to take responsibility for their own decisions and enables them to regain control, over their own lives.

What changes have your services made and are they sufficient to meet the need?

– See more at: http://www.janussolutions.co.uk/legal-highs-novel-psychoactive-substances-nps/#sthash.CmUMAtbG.dpuf