Qualitative Research of Online Drug Misuse Communities with Reference to the Novel Psychoactive Substances

Objective: This research aimed at reviewing the information provided by the online drug misuse communities with reference to the available evidence-based literature on the novel psychoactive substances. Methodology: Among hundreds of novel psychoactive substances, four groups (phenethylamines, tryptamines, piperazines and miscellaneous) were selected for the study. Various website drug fora were identified by Google and Yahoo search engines using a set of specific key words. The methods consisted of extracting and analysing qualitative data from the identified website fora. This was also supplemented by critical reviewing the existing evidence-based literature search for each of the selected psychoactive compounds.

Results: The combined search results identified 84 unique website fora from which qualitative data were extracted for thirty novel psychoactive substances and organised into technical folders. This data extracted from online communities has thrown some light on factors such as the mode of purchase, subjective experiences, reasons for use, combinations, legislation, mechanisms of action in the CNS, side effects, toxicity and its management. This would enable the clinicians to be obtain full history when assessing and would inform better treatment choices.

Conclusions: A range of novel psychoactive substances have been made recently available across the globe. The sale is easily achieved through the Internet. New legislations are made to control some recreational substances whilst newer substances appear. Furthermore, the distributors sell the backlog of products even after controlling of the substance has occured and hence are liable to potentiating criminal investigations. It is here suggested as well that the 'genuinity' of each onlince susbtance is questionable. Evidence-based literature is scant for the vast majority of these substances. Accidental overdoses are common occurences and some of the potential life-threatening clinical situations include sympathomimetic toxidrome and serotonin syndrome. Benzodiazepines appear to help with agitation and neuropsychiatric manifestations. Better levels of international cooperation and rapid share of available information may be needed to tackle the emerging problem of the novel psychoactive substances.