UK drug legislation has had limited impact on the availability of novel psychoactive substances (NPS), with international regulations playing a far greater role in shaping the UK drug market.
NPS are chemically engineered substances designed to mimic the effects of traditional controlled drugs such as opioids, stimulants, and cannabinoids. These compounds pose significant health risks due to their unpredictable potency and toxicity.
There is little evidence to suggest NPS are manufactured within the UK. China has long been identified as the primary source of these drugs, with its chemical manufacturing sector supplying to global markets.
The King's College London research, based on data from the National Programme on Substance Use Mortality (NPSUM), analysed drug-related deaths across England, Wales, and Northern Ireland between 2007 and 2022. By examining post-mortem detections of opioids, stimulants, and cannabinoids, the study assessed the impact of legislative controls introduced in the UK, China, and under United Nations conventions.
The findings show that classical controlled substances remain the main drivers of drug-related deaths in the UK, while NPS account for a smaller proportion of cases. Despite the introduction of the Misuse of Drugs Act 1971, Temporary Class Drug Orders, and the Psychoactive Substances Act 2016, UK legislation appears to have had minimal effect on reducing NPS detections in post-mortem reports.
Instead, declines in NPS-related deaths closely followed Chinese regulatory actions. For example, China's 2021 generic ban on synthetic cannabinoids was followed by a near elimination of these substances in UK deaths within a year, whereas earlier UK controls had little effect on successive generations of synthetic drugs.
Similar trends were observed for NPS opioids and stimulants, with reductions aligning more closely with Chinese regulatory measures than with domestic legislation.
NPS are uniquely dangerous due to their extreme potencies, unpredictable pharmacology, and the simple fact that most people have no idea that they are taking them. Our research shows that drug legislation in overseas countries influence the NPS appearing in the UK drug market far more than our own prohibitive laws. To reduce harm, we urgently need to reorientate our approach and focus on education and evidence-based harm-reduction, not just prohibition.
Dr Caroline Copeland, Senior Lecturer in Pharmacology & Toxicology at King's College London
The researchers suggest that UK policy must integrate harm reduction with legislative action and strengthen international coordination to effectively reduce harm from NPS. "Without a combined approach, the cycle of emergence and replacement of new substances is likely to continue, undermining public health efforts", added Dr Copeland.
