Alexander Smith
@MHRAgovuk
Pharmacovigilance Information Coordinator, Medicines and Healthcare products Regulatory Agency (MHRA)
The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and Public Health England (PHE) have launched a new system to report suspected harms associated with New Psychoactive Substances (NPS) and other illicit drugs. The system, called Report Illicit Drug Reactions (RIDR), is based on the MHRA’s Yellow Card online reporting site and aims to provide a simple form for healthcare professionals to report suspected harms associated with these drugs.
NPS are designed to replicate the effects of conventional illegal drugs such as cannabis, ecstasy and cocaine, although very little is known about the short- and long-term effects they may have on the user. Although previously known as ‘Legal Highs’, NPS are now very much illegal in the UK following the introduction of the ‘Psychoactive Substances Act’ last year. Their use however still prevails and harms associated with the products are still being seen.
NPS have the potential to pose a serious risk to public health. The number of new substances identified in recent years has grown rapidly, and hospital admissions for poisoning by psychostimulants with abuse potential increased by 45% over the past five years. One in 40 young adults aged 16-25 took an NPS last year, with evidence pointing towards widespread use among prisoners and homeless people. Additionally, little treatment information is available for healthcare professionals, making managing patients presenting with harms after taking NPS an increasingly difficult task.
The pilot reporting system aims to identify harms associated with NPS and subsequently share information and guidance with healthcare professionals. Although RIDR is based on the Yellow Card Scheme, it was developed alongside experts from PHE’s Clinical Network on NPS to create a reporting form tailored towards capturing NPS-related harms.
Dr Owen Bowden-Jones, consultant psychiatrist and chair of the NPS Clinical Network working group, said “RIDR will allow frontline clinicians to quickly and easily report new drug harms. The submitted reports will help build an up-to-date picture of the types and patterns of emerging harms associated with New Psychoactive Substances and other drugs. By identifying new harms at an earlier stage, clinicians will be better prepared to support people presenting for help.”
Since its launch in March, 130 reports concerning harms experienced with 36 different substances have already been submitted to RIDR. Many cases included harms associated with synthetic cannabinoids – substances designed to mimic the effects of cannabis. These include drugs such as ‘Spice’, ‘Black Mamba’ and ‘Clockwork Orange’. Many other substances have been reported to RIDR, including ‘traditional’ drugs such as cocaine and heroin, and some reports relate to potential interactions between licensed medicines and NPS.
Reports received through RIDR will be assessed in a similar manner to those received via the Yellow Card Scheme. MHRA’s signalling processes will be used to identify new harms, which will then be discussed with experts from PHE and the NPS Clinical Network to determine appropriate actions.
This is the first time that systematic data for harms associated with NPS are being collected and the number of reports received so far is encouraging. Ultimately, the hope is that the data collected through this project will lead to the identification of safety signals associated with the use of NPS and licensed medicines, which in turn will help generate key messages for healthcare professionals to support their patients.