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The market in licit recreational drugs is continuing to grow, both in the UK and elsewhere, and the internet has been acknowledged as a key factor in enabling this rapid expansion over the last few years. This is particularly true of the recent rise in popularity of the substance mephedrone (4‐methylmethcathinone) and related cathinones. Keeping up to date with these new drugs and emerging trends is a challenge for both professionals and users, particularly given the relative paucity of balanced and reliable information available and the potential for misinformation to be widely disseminated. This article examines the transmission of inaccurate information in relation to mephedrone and substituted cathinones, and discusses the implication of this for harm reduction and future research, by looking at the results of the European Commission funded Psychonaut Web Mapping project, which used online resources to detect emerging trends, monitor their diffusion, and develop a reasonably accurate profile of these new psychoactive compounds.

Mephedrone is a synthetic stimulant drug causing entactogenic and hallucinogenic effects. A systematic review of all existing empirical research and literature from 2009‐2012 on this new psychoactive drug was conducted. This paper aims to report on that review.

The review was conducted according to PRISMA guidelines. Electronic databases were utilised using the search terms “mephedrone” and product nomenclature; “Plant Food”, “Feeder”, “Meow Meow”, “Miaow”, “Drone”, “Meph” “Bubbles”, “Charge”, and “MCat”. The search was restricted to publications from 2009‐2012, and produced 702 results. Data were collected by one member of the research team and cross checked by another. A primary screening was carried out to exclude inaccurate search results and drugs other than mephedrone. The results were studied and duplicates removed; 598 results were discarded, with 104 deemed suitable for inclusion.

The review underscores mephedrone's popularity despite legislative controls. Drug displacement patterns from illicit to licit were observed prior to controls, with blending of mephedrone and other substitute cathinones with street drugs thereafter. User consumptive choices are grounded in availability, perceptions of legality and safety, curiosity and perceived quality of drug outcomes within poly drug taking repertoires. Clinical reports indicate that mephedrone has high abuse potential and toxicity, with several dependence symptoms. Risk assessment, detection, diagnosis and treatment of mephedrone use are difficult due to polydrug use and associated mental health disorders.

The review points to the need for further research into the pharmacology and toxicity of mephedrone in order to better equip clinicians with assessment, diagnosis and treatment strategies to reduce morbidity.

The increasingly diversified new psycho stimulant market where mephedrone is a major player poses unprecedented challenges for drug surveillance, policy, community and clinical practice.

Stricter legislative controls including internet vendor responsibility for supply of mephedrone have been suggested, along with raising public awareness on an international level through coordinated efforts.

The last review was published in 2009 by the Psychonaut Webmapping Group. This review brings together a comprehensive new set of data sources as they relate to this drug.

Drug-related web forums have been argued to be an effective way to investigate the latest generation of drug users. The purpose of this paper is to explore discussions about drugs and new psychoactive substances (NPS) on an Italian psychonauts’ online community in order to gain a better understanding of the psychonauts’ profiles by scrutinising their main motives for consumption, which is mainly addressed to psychedelic drugs.

To collect data, a keywords list was used in the forum search engine. The first five most recent conversations (threads) for each of ten most frequently mentioned substances were selected. In addition, ten posts written by new forum members to introduce themselves were added to the data set, bringing the total number of threads to 60. The data were coded using Atlas.ti 7 applying a template model analysis (King, 1998).

The forum members present themselves as well-educated, informed drug users, and connoisseurs of the pharmacological properties of chemical compounds: accordingly, they claim to be aware of drug effects and possible risks. The analysis of the motives for using psychedelic drugs substantially confirms previous studies, indicating that the main reasons include spiritual needs, self-exploration and self-treatment. The shift from a recreational use towards more “committed” aims such as self-development is seen as a step forward in a drug user’s career. A generalised interest in harm reduction suggests that the psychonauts’ attitude may be a protective factor against adverse consequences of drug use. The most problematic users represented in the data are those who use drugs for self-treatment, since their discourse focusses on suffering rather than on pleasure.

Most efforts to analyse and monitor drug-related forums have focussed on “leading edge” English-language international websites. No studies have dealt with Italian forums. Furthermore the study address a misleading use of the term e-psychonauts recently introduced by some scholars whose’s studies were focussed on NPS.

“Spice” products are synthetic cannabimimetics (SC; also called “synthetic cannabinoids”)-based designer drugs used as a legal alternative to cannabis for their very strong tetrahydrocannabinol (THC)-like effects. The purpose of this paper is to provide an analysis of more recent clinical and pharmacology/toxicology findings relating to SC and describe how they could impact on health, with a particular focus on mental health.

A systematic search and descriptive analysis of the available evidence on psychopathological issues related to misuse was performed here, whilst taking into account the Pubmed/Medline databases, a range of conference proceedings and national/international agencies’ reports.

While THC is a partial agonist, SC are full agonists on the cannabinoid receptors (CB-rs) and the administration of multiple SC can produce additive and/or synergistic agonistic interaction effects on the endocannabinoid system. These levels of strong CB-rs’ activation may be high enough to produce severe physiological and psychological disturbances. The available evidence suggests an existing relationship between SC use and psychosis (“Spiceophrenia”). The acute SC intoxication is usually characterized by tachycardia/hypertension; visual/auditory hallucinations; mydriasis; agitation/anxiety; tachypnoea; nausea/vomiting; and seizures.

The absence of clinical trials and longitudinal studies, together with the heterogeneity of SC compounds does not facilitate a precise assessment of the health risks related to their use, with long-term effects being of particular concern.

Appropriate, non-judgemental, prevention campaigns with a special focus on the differences between SC and cannabis may need to be organized on a large scale. At the same time, clinicians need to be regularly updated about novel psychoactive substances, including SC, to promptly recognize signs/symptoms of intoxication.

The purpose of this paper is to determine pharmacists’ knowledge of legal highs (novel psychoactive substances (NPS)).

A questionnaire was handed out at two London pharmacist continuing education events in mid-2014. These events update pharmacists about developments of interest/relevance to the profession and to improve their practice. A total of 54 forms were returned; a response rate of 26 percent.

Most pharmacists had poor knowledge of NPS and many considered that NPS were not important to their work, with few having had to advise customers in this area. Despite this, the majority thought that they had insufficient information about NPS. There was a negative correlation between the age of the pharmacist and knowledge of NPS.

The sample is a self-selected one drawn from registered pharmacists working in community pharmacies in northwest London, and thus does not include hospital pharmacies. Self-selection means that respondents may only reflect those who are interested in the NPS phenomenon and not the wider pharmacy community. The geographical area covered may not be representative of London as a whole, or indeed other parts of the UK or other EU countries.

It is clear that pharmacists do not know much about NPS but would like to know more. This information might improve their practice.

Pharmacists, easier to see than general practitioners, could be a useful source of information for NPS misusers.

There have been no previous attempts to gauge the level of knowledge by pharmacists of legal highs/NPS in the UK or elsewhere to our knowledge.

The purpose of this paper is to propose a framework to detect adverse drug reactions (ADRs) using internet user search data, so that ADR events can be identified early. Empirical investigation of Avandia, a type II diabetes treatment, is conducted to illustrate how to implement the proposed framework.

Typical ADR identification measures and time series processing techniques are used in the proposed framework. Google Trends Data are employed to represent user searches. The baseline model is a disproportionality analysis using official drug reaction reporting data from the US Food and Drug Administration’s Adverse Event Reporting System.

Results show that Google Trends series of Avandia side effects search reveal a significant early warning signal for the side effect emergence of Avandia. The proposed approach of using user search data to detect ADRs is proved to have a longer leading time than traditional drug reaction discovery methods. Three more drugs with known adverse reactions are investigated using the selected approach, and two are successfully identified.

Validation of Google Trends data’s representativeness of user search is yet to be explored. In future research, user search in other search engines and in healthcare web forums can be incorporated to obtain a more comprehensive ADR early warning mechanism.

Using internet data in drug safety management with a proper early warning mechanism may serve as an earlier signal than traditional drug adverse reaction. This has great potential in public health emergency management.

The research work proposes a novel framework of using user search data in ADR identification. User search is a voluntary drug adverse reaction exploration behavior. Furthermore, user search data series are more concise and accurate than text mining in forums. The proposed methods as well as the empirical results will shed some light on incorporating user search data as a new source in pharmacovigilance.

The purpose of this paper is to provide health professionals with novel psychoactive substances (NPS) clients with up to date information relating to the background, clinical pharmacology and, when possible, clinical management for each of these categories.

The world of NPS is complex and diverse, including a range of different molecules such as: psychedelic phenethylamines; synthetic cannabinoids, cathinone derivatives; novel stimulants; synthetic opiates/opioids; tryptamine derivatives; phencyclidine-like dissociatives; piperazines; GABA-A/GABA-B receptor agonists; a range of prescribing medications; psychactive plants/herbs; and a large series of performance and image-enhancing drugs. These molecules are sought by users for their psychactive effects.

The NPS categorization and classification provided here is an attempt to identify and better understand some of these substances. Given the vast range of medical and psychopathological issues associated with the NPS described it is crucial for health professionals to be aware of the effects and toxicity of NPS. The EU-MADNESS project aims to both better understand the pharmacology of the available/forthcoming NPS and to disseminate the most current NPS-related information to practising and training health professionals.

Further studies are required to identify a range of evidence-based, NPS-focused, clinical management and treatment strategies.

The rapid pace of change in the NPS online market constitutes a major challenge to the provision of current and reliable scientific knowledge on these substances.

The present review will provide an overview of the clinical and pharmacological issues related to a few hundred NPS.

The purpose of this paper is to investigate motives and modalities of psychedelic substance use in the psychonaut community that is hosted on the Reddit platform (r/psychonaut). Psychonauts are sometimes described as responsible drug users. Elements of responsible use include sharing stories, advice and experiences, reagent testing substances, proper dosing and education on harm reduction and its practical implication. Investigating psychonauts’ substance use can highlight what responsible use means for them and could inform best practices for psychedelic use.

Qualitative content analysis of posts and comments on the r/psychonaut subreddit was completed. In total, 350 posts were investigated. A combination of deductive and inductive methods was used to both structure the research and to allow room for novel information. To investigate participant’s motives, this combination was used to both collect and analyse the data. To examine modalities, concepts and keywords were formed out of the collected data and then analysed.

Motives for use ranged from self-knowledge, self-investigation and self-medication to increasing artistic expression, curiosity and recreation. Concerning modalities, the respondents put a high emphasis on preparation, set and setting, integration, dosage and gathering and sharing information through research, articles and trip reports. These features are identified in the literature as elements of responsible drug use. This investigation can help by unearthing best practices already in use by the community to inform the bourgeoning movement of psychedelic substance use – both in a medical and self-reflexive setting.

This paper is framed in the context of paucity of the academic literature on people taking psychedelic substances in Western society in non-rave and non-medical settings, with findings that indicate important change happening in the psychonaut subculture.

Casey Hardison was arrested in spring 2004 for the production of psychedelictype drugs ie. LSD, 2C‐B and DMT. In the three years since, not one person from ‘authority’ had bothered to ask him what motivated him to synthesise psychedelic drugs. It was as if the a priori assumption that ‘all illegal drugs are bad’ had provided the answer. Hence, the Judge asserted that Hardison did it for ‘that basest of human emotion, greed’ as though the psychospiritual benefits of an alchemical path dedicated to expanding consciousness and personal transformation, through insights integrated into action, upon which he had expounded at great lengths during trial, were some elaborate ‘portmanteau defence’, just some ruse to get him out of the dock. It was not, it was a committed stand for ‘cognitive liberty’ and for a world full of people who understand the fine line between alone and all one.