This paper aims to set out some of the policy and public health issues raised by the appearance of a wide range of emergent psychoactive substances of diverse origin, effect and risk profile (commonly referred to as ‘legal highs’).

It will start by considering what is meant by the term ‘legal highs’ and consider the historical context that has framed their appearance and must inform any response. It will then consider some of the approaches that have been adopted by different nations to control their availability and associated harms, including a preliminary assessment of their consequences, both intended and not.

To date, the approaches to regulation have varied between nations, both with respect to the nature and specificity of the measures taken and their intended outcome. Such diversity appropriately reflects the marked differences in the existing drug use problems and public health approaches to addressing such issues between nations.

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