“Becoming Your Own Psychologist”: Novel Psychoactive Substances (NPSs) for Mood and Anxiety Disorder Self-Medication

People with depression and anxiety often self-medicate with novel psychoactive substances (NPS) such as bromazolam, etizolam, clonazolam, 1P-LSD, and 2-FDCK, perceiving these as more effective than conventional treatment. An online survey of 274 individuals (average age 29.8, 71% male, 18% female, 5% non-binary) and follow-up interviews with five participants revealed that self-medication typically follows failed conventional treatment. Themes included chronic, treatment-resistant depression with comorbidities, attempts to mimic existing treatments, high pharmacological knowledge, and difficulty controlling benzodiazepine use. The findings highlight the need for affordable emerging treatment options for depression and anxiety.

Study at a glance

Abstract

Numerous individuals suffer from mental health issues including depression and anxiety, resulting in substantial societal burden. Data suggests individuals are choosing to self-medicate with Novel Psychoactive Substances (NPS); however, this phenomenon is poorly understood. We aimed to investigate which NPS are being used to self-medicate, evaluate their perceived effectiveness and examine influencing factors. Data from respondents (n = 274) (Mean Age [SD] = 29.8 ± 9.1, Male = 71%, Female = 18%, non-binary 5%) were collected via an online survey, with five participants (male = 2; nonbinary = 3) undertaking further semi-structured interviews and the data examined using a Framework analysis. NPS used included bromazolam, etizolam, clonazolam, 1P-LSD and 2-FDCK. Individuals perceived self-medication to be more effective than conventional treatment (p < 0.001). A Framework analysis identified the following themes surrounding mood and anxiety disorder self-medication: (1) depression being chronic, treatment resistant and often comorbid; (2) individuals attempting to mimic existing treatments; (3) individuals having high levels of pharmacological knowledge; (4) difficulties in controlling benzodiazepine self-medication. This study brings important insight into self-medication practices with NPSs, adding to data demonstrating an increase in bromazolam use. Data suggests self-medication follows conventional treatment and, therefore, we outline the importance of affordable emerging treatment options for depression and anxiety.