Objectives: Assess the impact of selective prohibition and seizure of NPS supply on NPS use prevalence within psychiatric admissions and evaluate demographic characteristics of current NPS users. Design: A 6-month retrospective cross-sectional analysis of discharge letters between 1st October 2015 – 31st March 2016. Setting: General Psychiatry inpatients and Intensive Home Treatment Team community patients at a psychiatric hospital in a Scottish city. Participants: All participants were between the ages 18-65. After application of exclusion criteria, 473 discharge letters of General Psychiatry patients were deemed suitable for analysis and 264 Intensive Home Treatment Team (IHTT) patient discharge letters were analysed. Interventions: A nationwide Temporary Class Drug Order (TCDO) was placed on 10th April 2015 reclassifying methylphenidate-related compounds as Class B substances. On 15th October 2015, local Forfeiture Orders were granted to Trading Standards permitting the seizure of NPS supplies. Primary and secondary outcome measures: The primary outcome measure was to determine the prevalence of NPS use in two cohorts. Secondly, demographic features of patients and details regarding their psychiatric presentation were analysed. Results: The prevalence of NPS use in General Psychiatry and IHTT patients was 6.6% and 3.4%, respectively. Inpatients using NPS compared to non-users were more likely to be male (OR: 2.92, 95% CI: 1.28-6.66, p=0.009), have a forensic history (OR: 5.03, CI: 2.39-10.59, p<0.001) and be detained under an Emergency Detention Certificate (OR: 3.50, CI: 1.56-7.82, p=0.004). NPS users were also more likely to be diagnosed under ICD-10 F10-19 (OR: 9.97, CI: 4.62-21.49, p<0.001). Conclusions: Compared to previous work, psychiatric inpatient NPS use has fallen. NPS continue to be used by a demographic previously described resulting in presentations consistent with a drug-induced psychosis and at times requiring detention under the Mental Health Act. Further research is required to evaluate the effectiveness of the recent prohibition of all NPS.

General Psychiatry dataGeneral Psychiatry README.docxIHTT dataIHTT README.docx