The UK recently issued a blanket ban on “legal highs” in an effort to curb the rapid spread of new psychoactive substances like 25I-NBOMe and W-18. It was a futile attempt: If the results of the Global Drug Survey 2016 are any indication, these drugs, synthesized in labs and sold easily and inexpensively online, will be around as long as users remain cheap, lazy, and willing to take health risks. Unfortunately, that also means they’ll continue winding up in emergency rooms across the globe.

Collecting data from 101,300 people from over 50 countries, the survey found that NPS are slowly but steadily becoming more popular worldwide, with certain nations taking to them more quickly than others. American consumption, in particular, is on the rise. This year, 11.2 percent of people surveyed in the U.S. said they bought novel psychoactive substances; last year, that figure was only 6.1 percent. In the UK, Scotland, Canada, and the Netherlands, their popularity has also increased.

The number of people who bought NPS in the last year generally rose between 2015 (red) and 2016 (green), according to the GDS.

The rise in popularity initially puzzled researchers because these drugs aren’t exactly fun to take. The researchers behind the GDS describe them as “typically less pleasant” than their traditional counterparts, with a “less nice effect profile.” If you asked them what was causing the uptick in NPS use four years ago, they would have told you that drug users were simply pressed for choice: Traditional drugs weren’t as easy to get a hold of, let alone high-quality ones. New psychoactive substances and research chemicals appeared in the late 2000s as the quality of traditional stimulants — drugs like MDMA, for example — started to decline. But those drugs are more widely available now, and their quality has improved, GDS researchers state. What’s driving users to take NPS now is the fact that they’re cheap and easy to get.

Asked to rank their motivations for buying NPS on a scale of 1 (completely disagree) to 10 (completely agree), participants revealed they valued value and accessibility above all other factors.

The survey results show that users are willing to put up with a potentially unpleasant experience as long as it’s affordable and accessible. Globally, the GDS found that the biggest factors motivating NPS purchasers were the drugs availability online and their high “value for money.” What didn’t motivate users was the drugs’ perceived safety — users don’t consider them any safer than traditional drugs — but danger doesn’t seem to factor into drug-related decision making, at least not when there’s a cheap high to be had.

“Given the choice, most people will opt for a drug (or form of a drug) with the nicest effects and the smallest risk of harm,” the GDS report states. “Not having much money limits that choice.”

Poverty and drug use have always been closely linked. If NPS dealers are going to find a foothold anywhere and there’s little data to indicate that they won’t — they’re going to find it among the world’s poor, who, unfortunately, are the least likely to be able to afford the hospital bills that appear to be an inevitable consequence of NPS use. In the survey’s analysis of substances that send drug users to the emergency room, NPS stood out as the riskiest.

“Overall it is clear that that substances that carry the highest risk for needing emergency medical treatment are NPS,” the researchers wrote. “[One] suspects this because of their varied potency and effect profile and the fact there is little guidance on how to minimize the risk associated with their use other than ‘Don’t take them.’”

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