New psychoactives within polydrug use trajectories—evidence from a mixed‐method longitudinal study

AIMS: To provide public health‐related research evidence on types and usage patterns of new psychoactive substances (NPS), developmental pathways into NPS and decision‐making factors for, and associated harms of, NPS use. DESIGN: Three‐phase mixed‐methods design, including a latent class analysis (LCA) of the longitudinal Belfast Youth Development Study (BYDS), a narrative analysis of interviews with NPS users and a three‐step approach manual method modelling using regressions to reveal classes of substance use and their associated predictors and outcomes. SETTING: Northern Ireland. PARTICIPANTS: A total of 2039 people who responded to the questions on ‘ever use’ of the drug variables included at wave 7 (aged 21 years) of the BYDS. Eighty‐four narrative interviews with NPS users. MEASUREMENTS: Categories of drug use identified by LCA. Predictors and outcomes included measures of family, partners, peers, substance use, school, delinquency and mental health. FINDINGS: A four‐class solution provided the best fit for the data: alcohol; alcohol and tobacco; alcohol, tobacco and cannabis; and polydrug (the latter including NPS). The qualitative analysis yielded a taxonomy that distinguished how NPS operate within a wider range of drug repertoires from experimental to problematic. CONCLUSIONS: In Northern Ireland, new psychoactive substances appear to be a feature of broader polydrug use rather than a standalone class of drug use.