Exploring the Baseline Knowledge and Experience of Healthcare Professionals in the United Kingdom on Novel Psychoactive Substances

Ramos, Camille Rabello; Guirguis, Amira; Smeeton, Nigel; Zaman, Hadar; Felice, A.; Bancroft, Stephanie; Gittins, Rosalind; Hawksworth, Gill; Corkery, John; Schifano, Fabrizio

doi:10.3390/brainsci10030142

Cited by 11 publications

(11 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study has clinical implications. Most NPS users are new to drug treatment services ( 19 , 69 ), where healthcare professionals report feeling less confident managing cases of novel compared with established substances ( 70 ). As such, “club drug” clinics require specialist staff and training to better understand the complexity of NPS types, the context in which they are used and the most appropriate treatment strategies.…”

Section: Discussionmentioning

confidence: 99%

“Hot” and “Cold” Cognition in Users of Club Drugs/Novel Psychoactive Substances

et al. 2021

View full text Add to dashboard Cite

Novel psychoactive substances (NPS) are popular “club/party” drugs that first attracted attention in the UK in 2009 and remained legal until the 2016 Psychoactive Substances Act criminalized their distribution. Unlike “traditional” illicit drugs, very little is known about the influence of their analogs on neuropsychological functioning. We characterized the cognitive and emotional profile of NPS/polydrug users using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and EMOTICOM test battery in adult male (aged 20–49 years) recreational users without psychiatric comorbidities (n = 27; “psychonauts”), service users attending a UK specialist “Club Drug” Clinic for problematic use (n = 20) and healthy control volunteers without significant drug-taking histories (n = 35). Tasks were selected to distinguish “hot” cognitive processes that are highly influenced by emotion from “cold” cognitive processes that are largely independent of emotional influence. Both user groups reported significantly higher sensation-seeking traits compared with non-users. Recreational NPS users demonstrated more risk-taking behavior compared with controls and treatment-seeking NPS users showed poorer learning, episodic memory and response inhibition compared with the other two groups. These effects persisted, when controlling for age, intelligence, alcohol and cannabis use severity, nicotine dependence, trait anxiety, depression, childhood adversity, impulsivity, and sensation seeking. Overall, recreational NPS users showed elevated “hot” (emotion-laden) cognition in the absence of “cold” (non-emotional) cognitive deficits, whereas “cold” cognitive dysfunction was pronounced in individuals seeking treatment for problematic NPS use. High trait impulsivity and poor self-control may confer additional risk to NPS/polydrug use severity and separate those seeking treatment from those using NPS recreationally.

show abstract

Section: Discussionmentioning

confidence: 99%

“Hot” and “Cold” Cognition in Users of Club Drugs/Novel Psychoactive Substances

et al. 2021

View full text Add to dashboard Cite

show abstract

“…This study bridged the knowledge gap that pharmacist may have on the pharmacodynamics/pharmacokinetics of psychoactive substances and along with specialist substance misuse knowledge and competencies and multidisciplinary team working have set the foundation for holistic and tailored patient-centred care. In our previous research, we made recommendations on designing specialist curricula to enhance knowledge of healthcare professionals of psychoactive substances [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Piloting the UK’s First Home-Office-Licensed Pharmacist-Led Drug Checking Service at a Community Substance Misuse Service

Guirguis

Gittins²,

Schifano

2020

Behavioral Sciences

Self Cite

View full text Add to dashboard Cite

(1) Introduction: Drug-related deaths in the UK are at concerning high levels. The unknown content and purity of illicit substances can cause unpredictable adverse effects and thus a public health risk with no sign of abating. On-site drug checking is a public health strategy that has previously been implemented, predominantly in festival settings, but without Home Office licensing. (2) Aims: The aim of this study was to pilot the UK’s first pharmacist-led, Home Office-licensed community drug checking service. (3) Methods: A bespoke protocol incorporating legally, professionally and ethically binding documents was implemented. This free, confidential service ran between February and March 2019, was available to anyone over 18 who were purposefully recruited, gave informed consent and agreed to relinquish their drug sample. Samples were checked on-site within an established Substance Misuse Service (SMS) using a handheld Raman spectrometer to determine likely drug content and adulterants. In parallel, participants completed a questionnaire about their substance use and the drug sample(s) being tested. A pharmacist-led multidisciplinary approach was adopted to discuss the analytical findings. Informed by the results of the analysis and the questionnaire, people who used the service received tailored harm reduction advice. (4) Results and Discussion: The pilot operated for a total of four days over four weeks. Eleven people visited and relinquished a total of thirteen samples. Half of the participants had previously overdosed and were known to the SMS. Seventy per cent were male, all were White British individuals, 30% were employed and two people disclosed visiting from another nearby town. Samples included what was thought to be heroin, synthetic cannabinoids, stimulants, benzodiazepines and LSD and none required activation of the “alerts cascade” process. Most participants drank alcohol regularly and the concomitant use of traditional illicit drugs and prescribed medication (including opioids, anxiolytics and antidepressants) with sedating profiles was common. Given some of the ethical decisions and interpretation of the results, specialist pharmacist involvement was deemed essential. (5) Conclusions: This pilot demonstrated the proof-of-concept that a pharmacist-led Home Office-licensed drug checking service can be successfully implemented in community SMSs.

show abstract

“…The emergence of new and adulterated drugs with variable toxicity and unknown clinical effects presents an additional challenge in contemporary emergency toxicology [14,15]. The constantly evolving chemical structure of novel psychoactive substances and limited range of routine toxicology tests undertaken in most EDs [16], has been linked to lower clinician confidence in managing acute toxicity from novel psychoactive substances compared to conventional illicit drugs [17,18].…”

Section: Introductionmentioning

confidence: 99%

‘Trial by fire’: An online survey exploring confidence of junior doctors in managing toxicology presentations to the emergency department

Smith

McCutcheon

Weber

et al. 2022

Drug and Alcohol Review

View full text Add to dashboard Cite

Introduction:The often unknown nature of acute drug intoxication, especially with illicit drugs and emerging novel psychoactive substances, can present a significant challenge for emergency clinicians. Less experienced clinicians are particularly vulnerable to the diagnostic dilemmas of complex toxicology emergencies. We sought to better understand the confidence of junior doctors in assessing and managing toxicological emergencies across two emergency departments in Perth, Australia. Methods: An online survey was conducted between August 2020 and February 2021. Self-rated confidence was measured on a five-point Likert Scale across 10 statements. Two open-ended questions were included to capture perceived barriers and facilitators impacting clinical confidence. Quantitative data were analysed using descriptive methods and Fisher's exact test. Free-text responses were analysed using content analysis.Results: A total of 104 surveys were completed (19.2% interns, 40.4% resident medical officers and 40.4% registrars). Self-rated confidence varied across statements and by staff type. The lowest confidence rating was for managing a patient who had overdosed from an unknown substance (31.7%) and the highest rating for referring a patient to psychiatry following deliberate self-poisoning (86.6%). Confidence increased with greater clinical experience for all statements. Qualitative analysis revealed perceptions of clinical preparedness, complexity of patients and a safe and supportive culture as key factors impacting confidence.Discussion and Conclusions: Overcoming perceived deficits in knowledge and clinical experience were key to building confidence. Our findings highlight the need for improved access to toxicology-specific curricula and training, and strategies to ensure adequate supervision from senior clinicians.

show abstract

Exploring the Baseline Knowledge and Experience of Healthcare Professionals in the United Kingdom on Novel Psychoactive Substances

Cited by 11 publications

References 58 publications

“Hot” and “Cold” Cognition in Users of Club Drugs/Novel Psychoactive Substances

“Hot” and “Cold” Cognition in Users of Club Drugs/Novel Psychoactive Substances

Piloting the UK’s First Home-Office-Licensed Pharmacist-Led Drug Checking Service at a Community Substance Misuse Service

‘Trial by fire’: An online survey exploring confidence of junior doctors in managing toxicology presentations to the emergency department

Contact Info

Product

Resources

About