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Evaluating potential hazards of new trends in psychoactive substance use - literature review of "risk assessment" procedures

Publication at First Faculty of Medicine |
2016

Abstract

In the last decade new trends in the manufacture and retail of new psychoactive substances (NPS) can be observed as a result of the rapid expansion of the Internet and technological developments. Evidence-based drug policy demands an elaborate assessment of the risks that could be caused by the new trends before control measures and other interventions are applied.

AIMS: A systematic conceptual literature review was conducted, with the aims being to: (i) describe currently applied models of risk assessment in practice, (ii) specify the shortcomings of current models that are facing the challenges of new trends in psychoactive substance use, and (iii) propose adaptations of current models to meet these challenges. METHODS: 17 databases of peer-reviewed sources and grey literature were searched with specific search terms in January 2014. 56 relevant documents were further analysed with the use of qualitative content analysis by means of the NVIVO software.

FINDINGS: Risk assessment (RA) procedures consist of three main parts - data collection, data evaluation, and data interpretation based on the consensus of experts. RA procedures take a long time and demand high-level scientific data in order to be reliable.

The large numbers of newly emerging NPS and the lack of information have led to changes in the RA procedures. First, their duration is shortened.

Second, data that has lower scientific reliability but high relevance is being assessed as well, i.e. consumer reports, online discussion forums, drug checking service data, or RAR (risk assessment and response) methods. Further RA procedures could evolve into a continuous process of evaluation and re-evaluation of NPS risks.

Local-level risk assessment should be more involved. CONCLUSIONS: The outcomes of RA should include a greater variety of interventions than a suggestion for control (e.g. prevention, treatment, harm reduction measures, or other control instruments than the simple scheduling of the risky NPS).