New Psychoactive Substances: New Service Provider Challenges

To best understand the experiences of men who have sex with men (MSM) who PnP accessing healthcare and social services, the researchers conducted qualitative interviews with 15 MSM who PnP not currently accessing support services in Manchester, UK and 31 service providers working in the mental health, substance use and sexual health sectors. Broadly, MSM and providers both noted a changing scene, describing a trajectory from the use of ecstasy and cocaine to injecting or ‘slamming’ of crystal or mephedrone becoming more common. As well, MSM and service providers noted the growing popularity of PnP amongst MSM.

In response to this changing environment, researchers outline gaps in service provision for service providers to improve on. In general, researchers highlight the importance of addressing the mental health, sexual health and substance use of MSM in tandem, adopting a holistic treatment approach. Further, researchers describe the importance of focusing on preventing overdoses and blackouts linked to the use of GBL/GHB, as these episodes significantly influence a client’s mental and sexual health. However, it seems that clients face a lack of support and expertise around the intersections between sexual and mental health, suggesting that further training for providers in these areas is needed. In association, MSM who PnP reported being unfamiliar with existing services and what specific services could offer. As well, MSM described barriers to accessing services, as many folks in this community work 9-5 jobs that don’t fit well with the opening hours of services.  

Following these identified shortcomings of existing PnP support approaches, researchers outline recommendations for enhancing the efficacy and relevancy of services. Firstly, services that integrate sexual, mental and sexual health are needed to better support MSM facing intersecting health diagnoses, such as living with HIV and experiencing major depression. Further, researchers note the importance of service providers working in partnership with local LGBTQ+ organizations to ensure substance use practitioners are culturally competent. As well, clearer referral pathways are needed to ensure MSM who PnP can be effectively connected to substance use, sexual health and mental health services.

Finally, researchers note the importance of curating innovative service user strategies to enhance uptake and adherence, such as doing targeted outreach at bathhouses and advertising clinics and testing times on Grindr and Scruff, for instance. Although this article considers the UK context, the researchers effectively describe service gaps and in turn, provide recommendations for service providers to better meet the needs of MSM who PnP in their communities. As such, this article highlights relevant areas to reflect upon in local services and practices. In particular, considering how limited clinic opening hours, a lack of wraparound services and a lack of adequate outreach and engagement may act as barriers for service engagement may serve to inform areas for improvement and future change.

Ralphs, R., & Gray, P. (2018). New Psychoactive Substances: New Service Provider Challenges. Drugs: Education, Prevention & Policy, 25(4), 301-312.

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