Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions

ObjectivesAssess the impact of selective prohibition and seizure of novel psychoactive substances (NPS) supply on NPS use prevalence within psychiatric admissions and evaluate demographic characteristics of current NPS users.DesignA 6-month retrospective cross-sectional analysis of discharge letters...

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Veröffentlicht in:BMJ open 2017-12, Vol.7 (12), p.e015716
Hauptverfasser: Bennett, Kyle H, Hare, Helen M, Waller, Robert M, Alderson, Helen L, Lawrie, Stephen
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container_issue 12
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creator Bennett, Kyle H
Hare, Helen M
Waller, Robert M
Alderson, Helen L
Lawrie, Stephen
description ObjectivesAssess the impact of selective prohibition and seizure of novel psychoactive substances (NPS) supply on NPS use prevalence within psychiatric admissions and evaluate demographic characteristics of current NPS users.DesignA 6-month retrospective cross-sectional analysis of discharge letters between 1 October 2015 and 31 March 2016.SettingGeneral psychiatry inpatients and intensive home treatment team (IHTT) community patients at a psychiatric hospital in a Scottish city.ParticipantsAll participants were between the ages of 18 and 65 years. After application of exclusion criteria, 473 discharge letters of general psychiatry patients were deemed suitable for analysis and 264 IHTT patient discharge letters were analysed.InterventionsA nationwide temporary class drug order (TCDO) was placed on 10 April 2015 reclassifying methylphenidate-related compounds as class B substances. On 15 October 2015, local forfeiture orders were granted to trading standards permitting the seizure of NPS supplies.Primary and secondary outcome measuresThe primary outcome measure was to determine the prevalence of NPS use in two cohorts. Second, demographic features of patients and details regarding their psychiatric presentation were analysed.ResultsThe prevalence of NPS use in general psychiatry and IHTT patients was 6.6% and 3.4%, respectively. Inpatients using NPS compared with non-users were more likely to be men (OR 2.92, 95% CI 1.28 to 6.66, P=0.009), have a forensic history (OR 5.03, CI 2.39 to 10.59, P
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After application of exclusion criteria, 473 discharge letters of general psychiatry patients were deemed suitable for analysis and 264 IHTT patient discharge letters were analysed.InterventionsA nationwide temporary class drug order (TCDO) was placed on 10 April 2015 reclassifying methylphenidate-related compounds as class B substances. On 15 October 2015, local forfeiture orders were granted to trading standards permitting the seizure of NPS supplies.Primary and secondary outcome measuresThe primary outcome measure was to determine the prevalence of NPS use in two cohorts. Second, demographic features of patients and details regarding their psychiatric presentation were analysed.ResultsThe prevalence of NPS use in general psychiatry and IHTT patients was 6.6% and 3.4%, respectively. Inpatients using NPS compared with non-users were more likely to be men (OR 2.92, 95% CI 1.28 to 6.66, P=0.009), have a forensic history (OR 5.03, CI 2.39 to 10.59, P&lt;0.001) and be detained under an Emergency Detention Certificate (OR 3.50, CI 1.56 to 7.82, P=0.004). NPS users were also more likely to be diagnosed under International Statistical Classification of Diseases and Related Health Problems, Version 10, F10–19 (OR 9.97, CI 4.62 to 21.49, P&lt;0.001).ConclusionsCompared with previous work, psychiatric inpatient NPS use has fallen. NPS continue to be used by a demographic previously described resulting in presentations consistent with a drug-induced psychosis and at times requiring detention under the Mental Health Act. Further research is required to evaluate the effectiveness of the recent prohibition of all NPS.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2016-015716</identifier><identifier>PMID: 29203502</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Alcohol ; Cross-Sectional Studies ; Ecstasy ; Female ; Festivals ; Hospitals ; Humans ; Letters ; Male ; Mental disorders ; Mental Disorders - drug therapy ; Mental Disorders - epidemiology ; Mental Health ; Mental health care ; Middle Aged ; Patient Discharge - statistics &amp; numerical data ; Patients ; Practice Patterns, Physicians' - statistics &amp; numerical data ; Prevalence ; Psychiatric Department, Hospital ; Psychotropic Drugs - therapeutic use ; Public health ; Public Health Surveillance ; Retrospective Studies ; Scotland - epidemiology ; Substance abuse treatment ; Substance-Related Disorders - epidemiology ; Young Adult</subject><ispartof>BMJ open, 2017-12, Vol.7 (12), p.e015716</ispartof><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>2017 Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-1424fe6c4c6e1c5968eeb8812dea7b91c394bbed4bfc6d8ffd25b1d37e3d68793</citedby><cites>FETCH-LOGICAL-b472t-1424fe6c4c6e1c5968eeb8812dea7b91c394bbed4bfc6d8ffd25b1d37e3d68793</cites><orcidid>0000-0002-3922-7056</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/7/12/e015716.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/7/12/e015716.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27548,27549,27923,27924,53790,53792,77472,77503</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29203502$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bennett, Kyle H</creatorcontrib><creatorcontrib>Hare, Helen M</creatorcontrib><creatorcontrib>Waller, Robert M</creatorcontrib><creatorcontrib>Alderson, Helen L</creatorcontrib><creatorcontrib>Lawrie, Stephen</creatorcontrib><title>Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectivesAssess the impact of selective prohibition and seizure of novel psychoactive substances (NPS) supply on NPS use prevalence within psychiatric admissions and evaluate demographic characteristics of current NPS users.DesignA 6-month retrospective cross-sectional analysis of discharge letters between 1 October 2015 and 31 March 2016.SettingGeneral psychiatry inpatients and intensive home treatment team (IHTT) community patients at a psychiatric hospital in a Scottish city.ParticipantsAll participants were between the ages of 18 and 65 years. After application of exclusion criteria, 473 discharge letters of general psychiatry patients were deemed suitable for analysis and 264 IHTT patient discharge letters were analysed.InterventionsA nationwide temporary class drug order (TCDO) was placed on 10 April 2015 reclassifying methylphenidate-related compounds as class B substances. On 15 October 2015, local forfeiture orders were granted to trading standards permitting the seizure of NPS supplies.Primary and secondary outcome measuresThe primary outcome measure was to determine the prevalence of NPS use in two cohorts. Second, demographic features of patients and details regarding their psychiatric presentation were analysed.ResultsThe prevalence of NPS use in general psychiatry and IHTT patients was 6.6% and 3.4%, respectively. Inpatients using NPS compared with non-users were more likely to be men (OR 2.92, 95% CI 1.28 to 6.66, P=0.009), have a forensic history (OR 5.03, CI 2.39 to 10.59, P&lt;0.001) and be detained under an Emergency Detention Certificate (OR 3.50, CI 1.56 to 7.82, P=0.004). NPS users were also more likely to be diagnosed under International Statistical Classification of Diseases and Related Health Problems, Version 10, F10–19 (OR 9.97, CI 4.62 to 21.49, P&lt;0.001).ConclusionsCompared with previous work, psychiatric inpatient NPS use has fallen. NPS continue to be used by a demographic previously described resulting in presentations consistent with a drug-induced psychosis and at times requiring detention under the Mental Health Act. 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Hare, Helen M ; Waller, Robert M ; Alderson, Helen L ; Lawrie, Stephen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-1424fe6c4c6e1c5968eeb8812dea7b91c394bbed4bfc6d8ffd25b1d37e3d68793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Alcohol</topic><topic>Cross-Sectional Studies</topic><topic>Ecstasy</topic><topic>Female</topic><topic>Festivals</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Letters</topic><topic>Male</topic><topic>Mental disorders</topic><topic>Mental Disorders - drug therapy</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Health</topic><topic>Mental health care</topic><topic>Middle Aged</topic><topic>Patient Discharge - statistics &amp; numerical data</topic><topic>Patients</topic><topic>Practice Patterns, Physicians' - statistics &amp; numerical data</topic><topic>Prevalence</topic><topic>Psychiatric Department, Hospital</topic><topic>Psychotropic Drugs - therapeutic use</topic><topic>Public health</topic><topic>Public Health Surveillance</topic><topic>Retrospective Studies</topic><topic>Scotland - epidemiology</topic><topic>Substance abuse treatment</topic><topic>Substance-Related Disorders - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bennett, Kyle H</creatorcontrib><creatorcontrib>Hare, Helen M</creatorcontrib><creatorcontrib>Waller, Robert M</creatorcontrib><creatorcontrib>Alderson, Helen L</creatorcontrib><creatorcontrib>Lawrie, Stephen</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bennett, Kyle H</au><au>Hare, Helen M</au><au>Waller, Robert M</au><au>Alderson, Helen L</au><au>Lawrie, Stephen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>7</volume><issue>12</issue><spage>e015716</spage><pages>e015716-</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectivesAssess the impact of selective prohibition and seizure of novel psychoactive substances (NPS) supply on NPS use prevalence within psychiatric admissions and evaluate demographic characteristics of current NPS users.DesignA 6-month retrospective cross-sectional analysis of discharge letters between 1 October 2015 and 31 March 2016.SettingGeneral psychiatry inpatients and intensive home treatment team (IHTT) community patients at a psychiatric hospital in a Scottish city.ParticipantsAll participants were between the ages of 18 and 65 years. After application of exclusion criteria, 473 discharge letters of general psychiatry patients were deemed suitable for analysis and 264 IHTT patient discharge letters were analysed.InterventionsA nationwide temporary class drug order (TCDO) was placed on 10 April 2015 reclassifying methylphenidate-related compounds as class B substances. On 15 October 2015, local forfeiture orders were granted to trading standards permitting the seizure of NPS supplies.Primary and secondary outcome measuresThe primary outcome measure was to determine the prevalence of NPS use in two cohorts. Second, demographic features of patients and details regarding their psychiatric presentation were analysed.ResultsThe prevalence of NPS use in general psychiatry and IHTT patients was 6.6% and 3.4%, respectively. Inpatients using NPS compared with non-users were more likely to be men (OR 2.92, 95% CI 1.28 to 6.66, P=0.009), have a forensic history (OR 5.03, CI 2.39 to 10.59, P&lt;0.001) and be detained under an Emergency Detention Certificate (OR 3.50, CI 1.56 to 7.82, P=0.004). NPS users were also more likely to be diagnosed under International Statistical Classification of Diseases and Related Health Problems, Version 10, F10–19 (OR 9.97, CI 4.62 to 21.49, P&lt;0.001).ConclusionsCompared with previous work, psychiatric inpatient NPS use has fallen. NPS continue to be used by a demographic previously described resulting in presentations consistent with a drug-induced psychosis and at times requiring detention under the Mental Health Act. Further research is required to evaluate the effectiveness of the recent prohibition of all NPS.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>29203502</pmid><doi>10.1136/bmjopen-2016-015716</doi><orcidid>https://orcid.org/0000-0002-3922-7056</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adult
Alcohol
Cross-Sectional Studies
Ecstasy
Female
Festivals
Hospitals
Humans
Letters
Male
Mental disorders
Mental Disorders - drug therapy
Mental Disorders - epidemiology
Mental Health
Mental health care
Middle Aged
Patient Discharge - statistics & numerical data
Patients
Practice Patterns, Physicians' - statistics & numerical data
Prevalence
Psychiatric Department, Hospital
Psychotropic Drugs - therapeutic use
Public health
Public Health Surveillance
Retrospective Studies
Scotland - epidemiology
Substance abuse treatment
Substance-Related Disorders - epidemiology
Young Adult
title Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions
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