• D M Wood, L Hunter, F Measham, and P I Dargan.
• Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and Kings Health Partners, London, UK. David.Wood@gstt.nhs.uk
• QJM. 2012 Oct 1; 105 (10): 959-64.

BackgroundThere has been significant media interest in the use of novel psychoactive substances (also known as 'legal highs') and reports in the medical literature of toxicity associated with their use. However, most surveys of recreational drug use focus on classical drugs such as cocaine and ecstasy, and there is limited information on how commonly emerging novel psychoactive substances are used.AimTo collect data on use prevalence patterns of a wider range of novel psychoactive substances in South London gay nightclubs.DesignQuestionnaire survey.MethodsIndividuals attending gay-friendly nightclubs in South East London (July 2011) were asked about life-time use, last month use and/or use on the night of the survey/planned use later that night of novel psychoactive substances, cocaine and MDMA/ecstasy.ResultsA total of 313 individuals were surveyed over 4 nights; 206 (65.8%) had previously used a 'legal high'. Mephedrone had the highest prevalence of last month use (53.2%) and use on the night of the survey (41.0%). This was greater than both cocaine (44.6% and 16.7%, respectively) and MDMA/ecstasy (26.9% and 5.8%). There was limited on the night use of the non-mephedrone 'legal highs': methoxetamine (1.6%) and 1-benzylpiperazine (0.6%), Spice/K2 (0.6%) and pipradrols (0.6%).ConclusionAlthough a significant proportion of individuals report previous use of novel psychoactive substances, it seems that only mephedrone has become an established part of the recreational drug scene. It is important that there is a considered approach to determining the utilization of drug prevention/education and enforcement budgets to ensure that this is appropriately targeted to drugs that are used recreationally.

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