Young people’s perceptions of Novel Psychoactive Substances JODIE MARY FREEMAN B.Sc. (Hons) Psychology., M.Sc. Investigative and Forensic Psychology. A thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the degree of Professional Doctorate in Health and Wellbeing This work or any part thereof has not previously been presented in any form to the University or to any other body whether for the purposes of assessment, publication or for any other purpose (unless otherwise indicated). Save for any express acknowledgements, references and/or bibliographies cited in the work, I confirm that the intellectual content of the work is the result of my own efforts and of no other person. The right of Jodie Mary Freeman to be identified as author of this work is asserted in accordance with ss.79 and 78 of the Copyright, Designs and Patents Act 1988. At this date copyright is owned by the author. Signature…………………………………… Date…………………………………………. 1 Abstract Novel Psychoactive Substances (NPS) also known as “legal highs” replicate the effects of illegal substances such as ecstasy and cocaine. The most common NPS reported are stimulants and synthetic cannabinoids. Despite the Psychoactive Ban (2016) recent reports identified the UK as having the largest market of NPS use anywhere in Europe. These substances have a short history of consumption and consequently little is known about their effects and health implications. Despite this, the sale of NPS is easily achieved through the internet and street dealers. Increased reports of negative health consequences from NPS consumption and research findings highlighting the willingness of young people to consume drugs without knowing what they are, mean it is vital that we investigate young people’s understandings and perceptions of them. At present there are very few in-depth qualitative studies on NPS. A series of 7 focus groups with a range of young people (40=N: aged 16- 24 years) across the Merseyside area were carried out. Research sites included colleges, youth groups, supported living accommodations, and youth drug and alcohol services. Focus group interviews explored participants’ perceptions of NPS and were followed up with a few semi structured interviews with selected participants. The direction of the study focused on mainly on synthetic cannabinoids which may reflect the age of the study’s population. Using thematic analysis informed by a social constructionist perspective, three main themes were identified around stigma and identity, attractive features of NPS and risk. Findings showed that young people’s perceptions of these substances were dependent on their level of experience with illegal substances and NPS. A novel finding was that synthetic cannabinoid use is employed in the normalisation of cannabis use. Local, national and policy recommendations are made on how youth and health services in both educational and specialised services could work more closely and effectively with young people NPS. They also identify a need among young 2 people for specific guidelines on how to use the Internet and Print media in relation to previous knowledge and experience. 3 Acknowledgements This study would not have been possible without the involvement and support from many people. I would like to take a little time to thank them and to mention the part they have all played in helping me to survive and finish this journey. At the start of my doctorate journey I was inspired by Dr Dee Drew and my colleagues in the clinical team, who in part are responsible for my decision to take on this project. Their ambition and encouragement were infectious, thank you. I would like to thank the participants in this study who gave their time and encouragement while I was completing fieldwork and who I hope in time along with the young people’s services that participated in this study, may experience some benefits if the recommendations in this study are taken forward. I would also like to pay a special thanks to Conrad Foote, a youth manager for Young Addaction who supported the young people and staff by providing invaluable and useful information in the complex area of NPS and also for his continual support of this project. I would like to pay special thanks to Dr Pauline Fuller who arrived just at the right time and provided me with wise guidance, patience, encouragement and inspiration. A special thanks to my second supervisor who survived the entire journey with me, your help and support kept me going through the good and the bad, I can never thank you both enough. Lastly, to my wonderful partner Marco, without his patience, his amazing sense of humour and never-ending support I may never have found the resources to keep going. To my parents, who have guided and supported me my whole life, thank you. To my hard working and supportive friends who have inspired me and encouraged me never to give up and to the friends that although might not be by my side gave me the determination and strength to finish this. 4 CONTENTS Abstract ....................................................................................................................... 2 Acknowledgements ..................................................................................................... 3 CONTENTS ................................................................................................................ 4 List of Appendices ....................................................................................................... 8 Glossary ...................................................................................................................... 9 Chapter 1. Introduction 1.1 Introduction ......................................................................................................... 10 1.2. The research background .................................................................................. 11 1.2.1 Young people and substance use .................................................................... 11 1.2.2 History of NPS ....................................................................................... 12 1.2.3 Defining NPS ......................................................................................... 12 1.2.4 Prevalence of NPS use ......................................................................... 14 1.2.5 The Government’s response to NPS: Early warning systems ............... 15 1.3 Rationale for the research ................................................................................... 16 1.4 Direction of the study .......................................................................................... 18 1.5 The change in the legal status of NPS during the study ..................................... 20 1.6 Overview of chapters .......................................................................................... 21 Chapter 2. Literature Review 2.1 Introduction ......................................................................................................... 23 2.2 The impact of the legal status on NPS ................................................................ 23 2.3 Attractive features of NPS ................................................................................... 26 2.4 The consideration of risk and NPS ...................................................................... 29 2.4.1 The relationship between perceptions of risk, identity and NPS .......... 33 2.4.2 The relationship between risk, stigma, normalisation and labelling ..... 35 2.4.3 Stigma develops into moral panic ........................................................ 39 2.5 Sources of information on NPS ........................................................................... 40 2.5.1 Internet as a source of information on NPS ........................................... 41 2.5.2 The media as a source of information on NPS ...................................... 42 2.6 Gaps in academic and professional knowledge of NPS ...................................... 45 2.7 Conclusion .......................................................................................................... 46 5 Chapter 3. Methodology and methods 3.1 Introduction ......................................................................................................... 47 3.2 Theoretical approach / methodology ................................................................... 47 3.2.1 Ontological and epistemological assumptions ....................................... 47 3.2.2 Theoretical assumptions ....................................................................... 48 3.2.3 The nature of social constructionist knowledge in relation to this study ................................................................................................... 499 3.3 Research topic and research questions .............................................................. 51 3.3.1 Research objectives and questions ................................................. 51 3.3.2 The choice of qualitative methodology and methods ......................... 52 3.4 Research ethics ............................................................................................ 53 3.4.1 Beneficence and non-maleficence ........................................................ 53 3.4.2 Respect for human dignity ..................................................................... 54 3.4.3 Justice – fair treatment, privacy, confidentiality and data protection issues ............................................................................................................