Diffusion of New Psychoactive Substances: understanding population motives, harms and intervention needs
Background Although there is a growing body of literature surrounding new psychoactive substances (NPS), and reasons for general use have been described, there is little understanding as to why certain NPS spread through user populations and become popular. This research used Rogers’ 1962 diffusion of innovations theory (DOI) to help better understand the NPS market and how it is shaped and characterised. Objective The aim of this research was to explore the diffusion of NPS in the UK and why different NPS diffuse and others fail to do so, to identify appropriate public health interventions to reduce harm. Methodology A mixed methods approach was undertaken, which comprised four studies. The first study involved a critical analysis of the appropriateness of Rogers’ DOI to explain the diffusion of NPS. This study was followed by two sets of interviews. The first interview study was conducted with NPS online retailers based in the UK. The second interview study involved interviews with NPS professionals including law enforcement professionals, drug policy organisations and NPS early warning system representatives from the UK, wider Europe, America and Australasia. These findings were analysed using thematic analysis. The final study was an online questionnaire and choice-based conjoint analysis with UK pre-existing recreational drug users aged between 18 and 35. These findings were analysed using Latent Class Analysis. Results The DOI was found to be applicable for the diffusion of an NPS product. However, the theory should be used in application to different individual NPS; NPS should not be classed as a homogenous group of substances and NPS users should not be classed as a homogenous group either. It was found that the theory should be updated in relation to NPS to include the influence of the internet. The key reason for the diffusion of an NPS was found to be the psychopharmacological effects of a product. However, there should also be an acknowledgment of the importance of friendship networks, and increasingly online forums. Even if a product had the desired psychopharmacological effects, if these are not communicated then it is unlikely to diffuse at a fast rate. Conversely, unless a product had the psychopharmacological effects desired by an individual, despite positive feedback from friends and online forums, it would be unlikely to diffuse. The emergence of NPS did not have a transformative effect for all drug-using groups; instead, it affected different user groups in different contexts. Similarly, it is likely that the introduction of the UK Psychoactive Substances Act will not have a transformative effect on the use of NPS by all drug-using groups. Nevertheless, the changes in health and social harms associated with individuals accessing NPS through the underground market or choosing to use traditional illegal drugs should be recognised. Finally, the need to conduct research with a range of stakeholders, to gain a greater understanding of motivations for drug use to assist with future public health interventions, was an important finding of the thesis.
RA0421 Public health. Hygiene. Preventive Medicine
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