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Phantom menace: novel psychoactive substances and the UK Armed Forces
  1. Alys H Hunter1,
  2. T Ayres2,
  3. N Moreland3 and
  4. A Cox4
  1. 1 MDHU Portsmouth, Portsmouth, UK
  2. 2 Department of Criminology, University of Leicester, Leicester, UK
  3. 3 Directorate of Army Legal Services, Aldershot, UK
  4. 4 Clinical Sciences, St George’s, University of London, London, UK
  1. Correspondence to Alys H Hunter, MDHU Portsmouth, Portsmouth AB42 3WZ, UK; alys.maconie{at}


Novel psychoactive substances (NPS) encompass a large group of synthesised compounds specifically designed to mimic traditional recreational drugs. Current UK Armed Forces compulsory drug testing does not screen for these substances, making them tempting to the small proportion of UK Armed Forces personnel who indulge in recreational drug use. The acute and chronic sequelae of NPS misuse are widely variable and associated with high morbidity. In this paper, we discuss NPS pharmacology and clinical presentation. We describe toxidromes and management of patients who have misused NPS.Finally, we reflect on the legal, ethical and military consequences of NPS misuse for both the service person misusing NPS and the Military Physician providing their care.

  • substance misuse
  • primary care
  • toxicology
  • novel psychoactive substances

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  • Contributors AHH: first author, literature search, wrote main body of text, created tables and organised references. TA: contributed to literature search, writing and reference material. NM: subject matter expert on Military law who provided insight into Military legal policy on NPS and recreational drugs. AC: senior author, edited text and fact checked.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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