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Novel Psychoactive Treatment:
UK Network Guidance on the management of acute and chronic harms of club
drugs and novel psychoactive substances
Dr Dima Abdulrahim NEPTUNE
CNWL
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Expert group membership
Dr Owen Bowden-Jones Dr Dima Abdulrahim
Dr James Bell Dr Nigel Borley
Dr Steve Brickman Ms Emma Crawshaw
Ms Annette Dale-Perera Mr Mark Dunn
Ms Stacey Hemmings Mr Salvo Larosa
Dr Luke Mitcheson Mr. Monty Moncrieff
Mr David McIntosh Prof David Nutt
Dr John Ramsey Dr John Roche
Prof Fabrizio Schifano Mr David Stuart
Dr Ann Sullivan Dr Tim Williams
Dr Christopher Whiteley Dr Adam Winstock
Dr David Wood Dr Dan Wood
NEPTUNE GROUP Professional groups represented
• Substance misuse treatment/ addiction psychiatry
• Clinical psychology • Psychopharmacology • Sexual health/ GUM and HIV
• Urology • Clinical toxicology • Analytical toxicology • Primary care • Emergency medicine
Public Health England, Department of Health, Home Office
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LGBT organisations Antidote@London Friend
Patient representation
Develop clinical guidance on management of club drug harms Review of evidence Clinical consensus
External peer review
Develop and test care bundles
Emergency (ED)
Drug Services
Sexual Health
Primary care
Literature Review
AR Lingford-Hughes, S Welch, L Petersand DJ Nutt et al: BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP 2012 Journal of Psychopharmacology 26(7) 899–952
1 Strong research evidence (e.g. Cochrane reviews, meta-analyses, high
quality randomised controlled trials)
2 Research evidence (e.g. controlled studies or semi-experimental studies)
3 Emerging research evidence (e.g. descriptive or comparative studies,
correlation studies, evaluations or surveys and non-analytic studies for
example, case reports, case series)
4 Expert panel evidence/ consensus
5 Expert by experience evidence (service users/ patients)
6 Lack of evidence (No evidence, for or against)
7 Conflicting evidence
Consensus classification of club drugs
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g g p
GHB/GBL Dependence liability
Depressants
Ketamine and analogues (e.g methoxetamine) Dissociative
Nitrous oxide Dissociative Stimulants including: Cocaine powder (Acute toxicity); Benzofuran
Stimulants
Amphetamine-Type Substances including: Amphetamine; Piperazine Pipradrol (2-DPMP D2PM)
Methamphetamine Sexual disinhibition
MDMA and similar empathogens (e.g. MDEA, PMA, PMMA) Empathogens Synthetic cathinone including mephedrone Sexual disinhibition Hallucinogens (Agonist at serotonin 5HT2A receptors ) Hallucinogen
Synthetic cannabinoid products Synthetic
NEPTUNE addressed • Acute club-drug harms and their management • Harms from chronic use of club-drugs and their
management • Reduction of harms, patient safety and public health
Aim to improve confidence and competence and increase the skills of clinicians •Screening /identification of harms • Assessment of harms • Management of harms
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Contents • Quality of research evidence • Brief summary of pharmacology • Clinical and other uses • Prevalence and patterns of use • Routes of ingestions and frequency of dosing • Desired effects of recreational use • Harms
– Acute harms, management of acute harms – Harms from chronic use, management of harms from
chronic use • Public health, patient safety, harm reduction and recovery
www.neptune-clinical-guidance.co.uk
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NEPTUNE II: The journey continues
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