Guidance on the Clinical Management of Acute and …

1 Novel Psychoactive Treatment UK NetworkNEPTUNEG uidance on the Clinical Management of Acute and chronic Harms of Club Drugs and Novel Psychoactive SubstancesNEPTUNEThis publication of the Novel Psychoactive Treatment UK Network (NEPTUNE) is protected by copyright. The reproduction of NEPTUNE Guidance is authorised, provided the source is acknowledged. 2015 NEPTUNE (Novel Psychoactive Treatment UK Network) 2015 Club Drug Clinic/CAPSC entral and North West London NHS Foundation Trust (CNWL)69 Warwick RoadEarls CourtSW5 9 Guidance is based on a combination of literature review and expert Clinical con sensus and is based on information available up to March 2015.

2 We accept no responsi bility or liability for any consequences arising from the use of the information contained in this recommended citation of this document is:Abdulrahim D & Bowden-Jones O, on behalf of the NEPTUNE Expert Group. Guidance on the Management of Acute and chronic Harms of Club Drugs and Novel Psychoactive Substances. Novel Psychoactive Treatment UK Network (NEPTUNE). London, is funded by the Health Foundation, an independent charity working to improve the quality of health care in the production and page design by Ralph Footring Ltd, (Novel Psychoactive Treatment UK Network).

3 Expert Group membersNEPTUNE Expert GroupDr Owen Bowden-JonesNeptune ChairClinical and programme leadConsultant Psychiatrist and Lead Clinician for Club Drug Clinic, Addictions Directorate, Central and North West London NHS Foundation TrustHonorary Senior Lecturer, Imperial College, LondonDr Dima AbdulrahimNEPTUNE Programme/ Manager SecretariatNEPTUNE Lead ResearcherCentral and North West London NHS Foundation TrustDr James BellConsultant PhysicianSouth London and Maudsley NHS TrustDr Nigel BorleyConsultant UrologistChelsea and Westminster NHS TrustDr Steve BrinksmanGP BirminghamClinical director of Substance Misuse Management in General Practice (SMMGP)

4 Ms Emma CrawshawService Delivery ManagerCrew 2000, EdinburghMs Laura DayProject workerCrew 2000, EdinburghMs Annette Dale-PereraDirector of Addiction and Offender Care Central and North West London NHS Foundation TrustMr Mark DunnClinical Nurse SpecialistClub Drug Clinic, Central and North West London NHS Foundation TrustMs Stacey HemmingsAssistant PsychologistClub Drug Clinic, Central and North West London NHS Foundation TrustMr Salvo LarosaClub Drug Clinic, Central and North West London NHS Foundation TrustDavid MacKintoshDirectorLondon Drug and Alcohol Policy ForumDr Luke MitchesonConsultant Clinical PsychologistSouth London and Maudsley NHS Foundation TrustPublic Health EnglandMr Monty MoncrieffChief ExecutiveLondon FriendProf David NuttEdmond J Safra Professor of Neuropsychopharmacology Director of the Neuropsychopharmacology Unit in the Division of Brain Sciences.

5 Imperial College LondonDr John RamseyAnalytical toxicologistDirectorTICTAC Communications Ltd St George s, University of London NEPTUNEE xpert Group members ivDr John RocheConsultant PsychiatristLeeds and York Partnership NHS Foundation TrustProf Fabrizio SchifanoChair in Clinical Pharmacology and TherapeuticsUniversity of Hertfordshireand Consultant Psychiatrist (Addictions)Mr David StuartSubstance Use Lead, GUM/HIV56 Dean Street, Chelsea Westminster Hospital NHS Foundation TrustDr Ann SullivanConsultant Physician in HIV and Genito-urinary Medicine Chelsea and Westminster Hospital NHS Foundation TrustDr Tim WilliamsConsultant PsychiatristAvon and Wiltshire Mental Health Partnership NHS TrustDr Christopher WhiteleyTrust Deputy Head of PsychologyConsultant Clinical PsychologistSouth London and Maudsley NHS Foundation TrustDr Adam WinstockConsultant Psychiatrist and Addiction Medicine Specialist.

6 SLAM NHS TrustSenior Lecturer, Kings College LondonDirector, Global Drug Survey Dr David WoodConsultant Physician and Clinical Toxicologist and Service ( Clinical ) Lead for Medicine, Guy s and St Thomas NHS Foundation Trust and King s Health Partners, London, UK Senior Lecturer, King s College London, UKDr Dan WoodConsultant Urologist in Adolescent and Reconstructive Surgery University College Hospitals, LondonOther contributorsDr Marta BoffitoHead of Clinical Trials, St. Stephen s Centre (SSAT)Consultant Physician, Chelsea and Westminster Foundation TrustImperial College LondonMs Lindsey HinesPhD studentAddictions Department, Institute of Psychiatry, Psychology and NeuroscienceKings College LondonMr Josh HulbertProject Administrator & EU Coordinator Independent Scientific Committee on DrugsDr Duccio PapantiPsychiatrist Trainee Department of Medical, Surgical, and Health SciencesUniversity of Trieste.

7 ItalyObserversMr Pete BurkinshawSkills and Development ManagerPublic Health EnglandDr Mark PruntySenior Medical Officer for Substance Misuse PolicyDepartment of HealthMr John McCrackenDrugs Programme ManagerDepartment of HealthMs Melanie RobertsDrug Strategy Reducing Demand TeamHome OfficeNEPTUNEA cknowledgementsNEPTUNE was hosted by Central and North West London NHS Foundation Trust (CNWL).We would like to acknowledge the generous support of the Health Foundation, which has funded the NEPTUNE are very grateful for the independent peer reviews on the draft of this report by Dr Paul Dargan (Consultant Physician, Clinical Toxicologist and Clinical Director at Guy s and St Thomas NHS Foundation Trust and King s Health Partners, London) and Dr Jonathan Dewhurst (Consultant Addiction Psychiatrist at Greater Manchester West Mental Health NHS Foundation Trust).

8 We would like to thank Dr Christopher Whitely and Dr Luke Mitcheson for writing the Chapter 2, Psychosocial interventions for club drugs and novel psychoactive substances .We would like to thank Dr Sarah Finley (Consultant in Emergency Medicine) and staff at the Chelsea and Westminster Hospital Emergency Department for their support in developing and testing the GHB/GBL care bundles. We would also like to thank Claire Whitelock and Nick Prideaux-Brune for their listing is hyperlinkedPart I: Introduction, background and overall principles 1 Chapter 1.

9 Introduction This document Novel Psychoactive Treatment UK Network (NEPTUNE): project aims and Guidance development Objectives of the NEPTUNE Project Aims of the NEPTUNE Clinical Guidance Target audience for the Guidance Primary audience Other audiences The process of developing the Guidance .

10 Method for the literature review General inclusions and exclusions in the Guidance Substances and drug groups covered by this Guidance An overview of club drugs Old drugs, new drugs and legal highs New markets and user communication about drugs Club drug use in the UK Overall drug use Club drug and NPS use Drug-using repertoires and poly-drug use Club drug users and contexts of use Clubbers and night-time economy Lesbian, gay, bisexual and transgender populations Psychonauts Overview of the effects and harms of club drugs How drugs work Toxicity and other harms Mortality related to the use of club drugs Response to club drug use Policy response to club drug and NPS use NPS and drug-related presentations to hospitals and treatment Principles underlying the assessment and Management in target settings of the harms associated with the use of club drugs and NPS Emergency departments Sexual health services Substance misuse