UK ban on psychoactive substances did not change hospital presentation rates for synthetic cannabinoid poisoning

After the UK's 2016 Psychoactive Substances Act banned the sale of synthetic cannabinoids, hospital presentations for severe synthetic cannabinoid toxicity showed no significant increase or decrease.

Craft, Sam et al.·Addiction (Abingdon·2022·Moderate EvidenceRetrospective Cohort
RTHC-03773Retrospective CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=627

What This Study Found

SCRAs were detected in 35.7% (224/627) of patients with suspected novel psychoactive substance exposure. After adjusting for seasonality and active sites, no significant trend changes were found before or after the PSA for SCRA presentations (post-PSA IRR 0.97, p=0.202) or non-SCRA presentations.

Key Numbers

627 patients (79.9% male); SCRAs detected in 35.7%. Pre-PSA SCRA trend: IRR 1.12 (p=0.068). Post-PSA trend: IRR 0.97 (p=0.202). No significant changes.

How They Did This

Observational study across 34 UK hospitals (IONA study), July 2015-December 2019. 627 patients with severe acute toxicity and suspected NPS exposure. Toxicological analysis by LC-MS/MS. Poisson segmented regression for time-series analysis.

Why This Research Matters

The PSA was designed to reduce harm from novel psychoactive substances, but this study suggests banning sales did not reduce severe synthetic cannabinoid toxicity, possibly because supply shifted from retail to illicit channels.

The Bigger Picture

The failure of the PSA to reduce SCRA hospital presentations mirrors findings from other drug prohibition efforts, where banning substances may shift distribution channels without reducing harm.

What This Study Doesn't Tell Us

Only participating hospitals included. Voluntary consenting may miss some cases. Cannot capture deaths or cases not reaching hospital. Limited pre-PSA data period. May not capture changes in SCRA types.

Questions This Raises

  • ?Did the PSA shift SCRA use to harder-to-reach populations (homeless, prisoners)?
  • ?Would decriminalization with harm reduction be more effective?
  • ?Has the chemical composition of SCRAs changed post-ban?

Trust & Context

Key Stat:
No significant change in SCRA hospital presentations after UK ban
Evidence Grade:
Multi-site observational study with analytical confirmation, though limited by voluntary participation and consent.
Study Age:
Published in 2022 with data from 2015-2019.
Original Title:
Trends in hospital presentations following analytically confirmed synthetic cannabinoid receptor agonist exposure before and after implementation of the 2016 UK Psychoactive Substances Act.
Published In:
Addiction (Abingdon, England), 117(11), 2899-2906 (2022)
Database ID:
RTHC-03773

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Did banning synthetic cannabinoids reduce hospital visits?

No. Despite the UK making the sale of synthetic cannabinoids illegal in 2016, this study of 34 hospitals found no significant change in the number of patients presenting with severe synthetic cannabinoid toxicity.

Why didn't the ban work?

The researchers suggest that while the PSA may have reduced over-the-counter sales, supply likely shifted to illicit online and street markets, maintaining availability among vulnerable populations.

Read More on RethinkTHC

Cite This Study

RTHC-03773·https://rethinkthc.com/research/RTHC-03773

APA

Craft, Sam; Dunn, Michael; Vidler, Dan; Officer, Jane; Blagbrough, Ian S; Pudney, Christopher R; Henderson, Graeme; Abouzeid, Ahmed; Dargan, Paul I; Eddleston, Michael; Cooper, Jamie; Hill, Simon L; Roper, Clair; Freeman, Tom P; Thomas, Simon H L. (2022). Trends in hospital presentations following analytically confirmed synthetic cannabinoid receptor agonist exposure before and after implementation of the 2016 UK Psychoactive Substances Act.. Addiction (Abingdon, England), 117(11), 2899-2906. https://doi.org/10.1111/add.15967

MLA

Craft, Sam, et al. "Trends in hospital presentations following analytically confirmed synthetic cannabinoid receptor agonist exposure before and after implementation of the 2016 UK Psychoactive Substances Act.." Addiction (Abingdon, 2022. https://doi.org/10.1111/add.15967

RethinkTHC

RethinkTHC Research Database. "Trends in hospital presentations following analytically conf..." RTHC-03773. Retrieved from https://rethinkthc.com/research/craft-2022-trends-in-hospital-presentations

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.