title: The experience of an increase in the injection of ethylphenidate in Lothian April 2014-March 2015.
abstract: OBJECTIVE
  New psychoactive substances are causing increasing harm across the UK but the use of new psychoactive substance by injecting has become a significant problem within Lothian since the beginning of 2014. Data indicate a rapid rise in the number of existing drug injectors, particularly heroin injectors, moving to new psychoactive substance injecting. This paper reports the experiences within Lothian of a sudden increase in injecting of ethylphenidate over one year. A temporary class drug order was placed on ethylphenidate on 10 April 2015, and as yet the effects of this are unknown.
  
  
  METHODS
  Data specifically relating to new psychoactive substance recorded during injecting equipment provision transactions conducted by the NHS are reported. A survey was utilised to gather more detailed data from new psychoactive substance injectors.
  
  
  RESULTS
  Injection of new psychoactive substance, including ethylphenidate has had significant adverse effects on physical and mental health. Risky behaviour such as sharing of equipment is known, and there are risks of transmission of infections.
  
  
  CONCLUSIONS
  The rapid increase in injecting ethylphenidate has had a major impact on injecting equipment provision services, health services and public health. More work is required to identify routes to recovery.
authors.affiliation: Mental Health Nurse/Blood-borne Virus Prevention Worker, Substance Misuse Directorate, Harm Reduction Team, Spittal St Centre, UK con.lafferty@nhslothian.scot.nhs.uk.
authors.forename: Con
authors.initials: C
authors.lastname: Lafferty
authors.affiliation: Mental Health Nurse/Blood-borne Virus Prevention Worker, Substance Misuse Directorate, Harm Reduction Team, Spittal St Centre, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Smith
authors.affiliation: Specialist Nurse, Substance Misuse Directorate, Harm Reduction Team, Spittal St Centre, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Coull
authors.affiliation: Mental Health Nurse/Blood-borne Virus Prevention Worker, Substance Misuse Directorate, Harm Reduction Team, Spittal St Centre, UK.|Manager, Substance Misuse Directorate, Harm Reduction Team, Spittal St Centre, UK.
authors.forename: Jim
authors.initials: J
authors.lastname: Shanley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D003132:Commerce; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000009:adverse effects*; D012309:Risk-Taking; D013222:State Medicine; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D011619:Psychotropic Drugs; D008774:Methylphenidate; C042400:ethylphenidate
keywords: Injecting; ethylphenidate; legal highs; new psychoactive substances; risk