Self-medication with Novel Psychoactive Substances (NPS): A systematic review (2025)

Currently, novel psychoactive substance (NPS) use presents a challenging issue for authorities. To effectively tackle the use of NPS, a deeper understanding of the motivations of those who use NPS is required. Evidence suggests that a subset of NPS users declare their use as 'self-medicating'; however, there is a paucity of research in this area. The aim of this review is to provide an overview and synthesis of the research concerning self-medication with novel psychoactive substances (NPS). Seven databases (EMBASE, MEDLINE, APA PsychInfo, Global Health, PubMed, Scopus, and Google Scholar) were searched using a search strategy compromising 600 + NPS terms, yielding 3563 articles, 24 of which met the search criteria. Two independent reviewers screened the articles and appraised the quality of the included studies. The results were synthesised using a narrative synthesis approach. We identified 22 NPS being used for self-medication. We found that (1) self-medication with NPS occurs mainly for anxiety, depression, and ADHD; (2) links between cluster headaches, the use of psychedelic NPS, and anxiety and novel benzodiazepines were evident; (3) novel benzodiazepine use by young individuals represents particular concern. There is a need for greater knowledge within healthcare professions concerning self-medication practices with NPS. Primary qualitative research is needed to address the underlying motivations behind this phenomenon.