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.
Drug policymakers, toxicologists, emergency physicians, and public health researchers.
No significant change in SCRA hospital presentations after UK ban
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot 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.
How to read the evidence
Multi-site observational study with analytical confirmation, though limited by voluntary participation and consent.
When this study was published
Published in 2022 with data from 2015-2019.
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.
Questions still open
- 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?
Common questions
Did banning synthetic cannabinoids reduce hospital visits?
Why didn't the ban work?
Read the original research
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
Citation
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
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