The NPS Summit held by change, grow, live on Thursday 27 May at Recovery Central in Birmingham was organised to create an approach together, and to make a difference to the lives of the most vulnerable within Birmingham. NPS (New Psychoactive Substances), previously referred to as ‘legal highs’, are made up of seven key types (empathogens, hallucinogens, dissociatives, stimulants, opioids, depressants and cannabinoids), and are presenting as an increasing issue in the substance misuse sector.
The summit was a great opportunity for CGL to invite those working in both the public and third sector to come together, and think about the ways that we can work together to tackle this issue. We started the summit with a talk from Sian Warmer, services manager at Birmingham Reach Out Recovery, who stressed the importance of collaboration in tackling NPS, with the hope to formulate a strategic plan to resolve these issues. She noted that,
“Today may be CGL’s day, but it is a chance for us all to come together to come up with some ideas”.
What challenges surround the issue of NPS?
Outreach worker Marc Blanchette went on to discuss the background and nature of NPS. He noted that NPS is a term for a myriad of drugs all under one umbrella term, meaning there is often a difficulty in explaining its complexities in detail. One of the running themes when dealing with NPS use is the idea that due to its previous legal status, people did associate legal highs with safety, which meant that the dangers were widely underestimated. He noted that “the key message is that you don’t know what it is you are actually taking”, and the constant changing of brand names can be intimidating and difficult to handle for those working in harm reduction.
Another challenge to NPS, Marc explained, was that there are issues with demographics and how people are accessing these drugs. NPS are simple to get online, particularly with the dark net. NPS is are having a notable impact on the culture in prisons; they are being used to intimidate and extort money from other prisoners. NPS are increasingly being used for chemsex, and younger demographics in general are picking up on NPS due to its packaging and marketing (taking a leaf out of the alcopop marketing in the alcohol industry).
Marc did suggest that “there is a conflict between what the media is presenting, and what service providers are actually dealing with”, and made comment that the representation of spice-use as an epidemic may not be necessarily reflective of what is actually going on. However, Marc explained, “this is something we are seeing every day, and we need to find a way to address this issue, and how to keep these people safe”.
The complex nature of NPS use
Lead Consultant for change, grow, live Dr Adarsh Ramegowda went on to explore the complexities of NPS use, explaining that NPS users may not be as inclined to approach substance misuse services as they may feel it is not the correct forum for them. This has led to the brunt of the problem being taken by A&E services, which ultimately stretches services and resources. Using a case study, Adi highlighted the complexity of NPS use, and how more steps need to be taken, alongside collaboration across services to ensure that NPS users can access the best help possible.
Collaboration and communication is key in tackling the NPS issue
The summit then opened up to a Q&A discussion, where it was noted that comorbidity exists within NPS usage, and that a key element in approaching it is in working with mental health services, but that the issue lies on determining who takes the lead. Suggestions were made in regards to intelligence sharing, and ultimately it was agreed that collaborations between organisations (such as the NHS, prisons, substance misuse services and mental health services) is the best possible strategy for tackling the NPS issue, alongside developing NPS-specific harm reduction messages, such as providing information to the public (particularly young people), emphasising the multiple-complex needs associated with NPS usage, and discouraging online ordering (as it notably goes against all safeguarding advice).
A key issue raised, both in the Q&A discussion, and in working in groups on case studies to develop strategies, was the importance of education, both in schools and to the wider public. The limited information going out does seem to have a considerable impact on NPS usage, and it was a general consensus that education would need to be a crucial element in the developing strategy.
Certainly, the Summit emphasised to me the vital need for openness and collaboration across organisations and charities to ensure that NPS users can be a safe as possible, and that one of the best solution for prevention and reduction lies in keeping people educated to make sure that they make informed decisions and keep themselves safe.