HMN 2026: How UK drug policy shows limited impact on novel psychoactive substances

Novel psychoactive substances (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 U.K. China has long been identified as the primary source of these drugs, with its chemical manufacturing sector supplying to global markets.

A recent study published in Frontiers in Pharmacology and based on data from the National Program on Substance Use Mortality (NPSUM) analyzed 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 U.K., China, and under United Nations conventions.

The findings show that classical controlled substances remain the main drivers of drug-related deaths in the U.K., 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, U.K. 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 U.K. deaths within a year, whereas earlier U.K. 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 U.K. 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,” said Dr. Caroline Copeland, senior lecturer in pharmacology and toxicology at King’s College London.

The researchers suggest that U.K. 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.

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