Changing patterns of new and emerging psychoactive substances in Australia

1. Changing patterns of new and emerging psychoactive substances in Australia • Rachel Sutherland, Monica Barratt, Lucinda Burns and Raimondo Bruno • The Drug Trends program is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvement Grants Fund

2. What are new and emerging psychoactive substances? • Designer drugs, research chemicals, synthetic drugs, analogues, legal highs. • Substances not controlled by international legislation, but which may pose a public health threat. • Psychoactive drugs that are relatively new to recreational markets.

3. Number of new NPS reported each year Source: EMCDDA, 2017. EMCDDA - Europol 2016 Annual Report on the implementation of Council Decision 20054/387/JHA.

4. 15 January 2015 17 August 2016 23 August 2016

5. NPS use in Australian general population • National Drug Strategy Household Survey • Conducted every 3 years; 2013 survey first to include data on NPS

6. Source: 2013 National Drug Strategy Household Survey

7. Monitoring NPS through Drug Trends

8. Which NPS are being monitored? (EDRS) United Nations Office on Drugs and Crime, 2013, The Challenge of New Psychoactive Substances

9. Past six month use of ‘any’ NPS, 2010-2017 (n=5,703) ** ** * * **p<0.01; *p<0.05

10. NPS Classes: What’s increasing? *** *** ** ***p<0.001; **p<0.01

11. NPS Classes: What’s decreasing? *** *** *** ***p<0.001

12. NPS Classes: Other patterns Synthetic opioids, 2017 (n=3)

13. What might be driving these changes? Legislative changes Consumer preference Matthews et al., 2017. I like the old stuff better than the new stuff? Subjective experiences of new psychoactive substances. International Journal of Drug Policy, 40, 44-49 Sutherland et al., 2017. Motivations for new psychoactive substance use among regular psychostimulant users in Australia, International Journal of Drug Policy, 43, 23-32 Cairns et al., 2017. The impact of Australian legislative changes on synthetic cannabinoid exposures reported to the NSW Poisons Information Centre, International Journal of Drug Policy, 43, 74-82

14. Degree of overlap between use of classes (2010-2017) Note: Does not include synthetic cannabinoids. Repeat participants excluded Note: only first time participants included; n=3593

15. How else do we monitor the NPS market in Australia?

16. What’s being sold online? (July-Dec 2016) Roxburgh, A., Van Buskirk, J., Burns, L., and Bruno, R. (2017). Drugs and the Internet, Issue 8, May 2017. Sydney: National Drug and Alcohol Research Centre.

17. Number of vendors selling NPS (July-Dec 2016) Roxburgh, A., Van Buskirk, J., Burns, L., and Bruno, R. (2017). Drugs and the Internet, Issue 8, May 2017. Sydney: National Drug and Alcohol Research Centre.

18. Summary • NPS use low among general population • Rates of use elevated among people who use illicit drugs • Remains a highly dynamic marketplace, highlighting the importance of drug monitoring systems • Appear to seek out NPS that have similar properties to the ‘traditional’ illicit drugs they are already using • Riskier patterns associated with poly NPS use • Synthetic opioids starting to appear on crypto markets, although use remains low among sentinel samples

19. Rates of unintentional consumption unknown • Other data sources suggest that rates of unintentional NPS use may be much higher: • Existing drug monitoring systems need to be complemented with other data sources (e.g. wastewater analysis, seizure data, biological testing – Salomone et al., 2017) • First pill-testing trial to occur in Australia, 25 November 2017 Source: Thai et al., 2016. Monitoring temporal changes in use of two cathinones in a large urban catchment in Queensland, Australia Salomone, A., Palamar, J. J., Gerace, E., Di Corcia, D., & Vincenti, M. (2017). Hair Testing for Drugs of Abuse and New Psychoactive Substances in a High-Risk Population. J Anal Toxicol, 41(5), 376-381. doi:10.1093/jat/bkx020

20. Acknowledgements • 2017 Drug Trends Team • National Drug and Alcohol Research Centre, University of New South Wales • (National, NSW, ACT, SA and the NT) • Dr Courtney Breen, A/Professor Lucinda Burns, Ms Kerryn Butler, Ms Antonia Karlsson, Ms Courtney O’Donnell, • Ms Amanda Roxburgh, Ms Jennifer Stafford, Ms Rachel Sutherland, Ms Julia Uporova, Mr Joe van Buskirk, and Professor Alison Ritter • Burnet Institute for Medical Research and Public Health (VIC) • Ms Amy Kirwan, Mr Arthur Truong, Dr Campbell Aitken and Professor Paul Dietze • School of Medicine, University of Tasmania (TAS) • Ms Bethany Lusk, Dr Amy Peacock, Dr Allison Matthews and A/Professor Raimondo Bruno • National Drug Research Institute (WA) • Mr James Fetherston, Ms Marina Nelson and Professor Simon Lenton • School of Public Health, The University of Queensland (QLD) • Dr Caroline Salom and Professor Rosa Alati rachels@unsw.edu.au • Northern Territory Department of Health (NT) • Mr Chris Moon, Ms Tania Davidson and Mr Warrant Que Noy