Transcript Legal Highs’ Nature & Extent of Use And How to Respond

The rapidly changing
nature of novel psychoactive substance use
Conference on Legal Highs & Clubbing Drugs: What’s the Story?
Dr Russell Newcombe
3D Research, Liverpool
Chelmsford, Essex, January 23rd 2013
[email protected]
www.3Dresearch.org.uk
The speaker
Dr Russell Newcombe, BA (Hons) & PhD in Social Psychology
Awards: National Rolleston Award for harm-reduction (HRI 2010);
Bing Spear Medal for drug policy reform (DPRG 2011);
Scientific Committee Award: drugs journal paper (EMCDDA 2011)
30 years as specialist researcher, trainer and lecturer in the
field of psychoactive drug use, deviancy and disorder
Currently Director of 3D Research, an independent agency
based in Liverpool, Merseyside, UK
Areas of expertise: prevalence, consumption and effects of
drugs; harm-reduction services & strategies; evaluation;
‘legal highs’ (use of new/unregulated drugs)
NPS/Legal Highs: key questions
1. What are ‘legal highs’ and/or novel psychoactive drugs (NPS)?
2. What are the main types of NPS currently used, and what are
the main trends in the production and sale of NPS?
3. What is the current prevalence of NPS use in the UK?
4. Who are NPS used by, and why are they used?
5. What are the effects of NPS on the body and mind?
6. What are the main risks and potential harms of NPS?
7. How should society respond to users of new psychoactive
drugs (policy and services)?
1. What are ‘legal highs’
(1) Chemicals which alter the normal functioning of the brain
– neurotransmitters and brain-waves - thus producing
changes in our experience and behaviour [i.e. a ‘high’]
(2) Specifically, a ‘legal high’ is a chemical which is:
(a) not controlled by the 1971 Misuse of Drugs Act;
(b) not licensed for legal use (like alcohol and tobacco);
(c) not advertised/sold – and therefore not regulated - as
a medicine (Medicines Act 1968) – see next 2 slides;
AND: mimics the effects of popular controlled drugs [?]
Thus, a legal high is a substance which is not legally regulated
– a more accurate term would be ‘legal loophole’ drugs.
Novel psychoactive substances (NPS)
Over the last few years, the term ‘legal high’ has become
replaced by ‘novel psychoactive substance’ (NPS) – because
if and when possession and trafficking of a particular new
drug is prohibited by the government, it ceases to be a ‘legal
high’.
For example, use of the term ‘NPS’ allows us to avoid the
confusion which currently exists in relation to drugs like
mephedrone (meow/m-cat), which was banned by the UK
government in April 2010, but is still referred to as a ‘legal
high’ by some sources (notably the mass media).
What makes a drug a medicine?
The classification of drug products as medicines is made on a
case-by-case basis by the Medicines and Healthcare
products Regulatory Agency (MHRA) under the Medicines
Act 1968 and the amended Medicines for Human Use
Regulations 1994 (marketing authorisations etc.) .
Medicines are also classified into Schedules 1 to 5, which
determine the control of prescribing and dispensing, eg.
Schedule 1 drugs cannot be prescribed or dispensed (no
medical use = totally prohibited, eg. most hallucinogens);
Schedule 5 drugs can be dispensed without prescription.
The legal loophole used by NPS
Headshops and online retailers of ‘legal highs’/NPS get
round the UK Medicines Act legislation by stating that
their products are not for human consumption, i.e. by
definition not a medicine.
Instead product packaging typically contains a cross/bones
(sign of toxicity), and a warning not to consume the
substance – using euphemisms such as bath salts, pond
cleaner, room odoriser, incense, cream dispenser refills
– and the vaguer product descriptors ‘souvenirs’ and
‘research chemicals’.
Packaging also typically states ‘for sale to adults only’.
Legal Highs: forms & sources
FORMS
Liquid (solvents, solutions, sprays)
Gas (eg. nitrous oxide)
Solid (powder, pills, capsules, organics) *
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
SOURCES
Herbal (leaf, bud, root, seed, sap, etc.) *
Animal (excretions, organs)
Technological: Synthetic chemicals *
Electronic devices
(eg. brain tuners, binaurals)
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
OUTLETS: (1) town/city headshops & (2) online websites
* Most common forms at 2012
Headshops: famous UK chain
Sell ‘legal highs’
and drug-related
paraphernalia
and literature
Dr Hermans at
Bold Street in
Liverpool UK
Online sale of research chemicals
For example: BULK RESEARCH CHEMICALS
“We are the UK's favourite vendor of research chemicals and
run constant quality checks across our whole spectrum of
research chemical products. We sell the UK's most popular
research chemicals at the best web prices such as
Methoxetamine (MXE), MDAI and Methiopropamine (MPA).”
• Combo 1 - MPA 1g & MDAI 1g
• This pack contains 1g each of MDAI and MPA aka
methiopropamine. £24.00
www.bulkresearchchemicals.com
Online Legal Highs sites explode
Typing “buy legal highs” into Google throws up 2.74
million results, while “buy research chemicals”
produces 6.91 million options [August 2012]
The Misuse of Drugs Act now covers over 600
substances, but it is 40 years out of date and
struggles to keep pace with the sheer amount of
new chemical compounds hitting the UK
recreational drug scene each year
http://m.londonlovesbusiness.com/3267.article
2. Main types of NPS being sold from
headshops & websites to 2012
Phenethylamines
Tryptamines
Piperazerines
Cathinones
Cannabinoids
Miscellaneous
Main illegal drugs being mimicked
ecstasy (MDMA), amphetamines
LSD, psilocin, DMT
ecstasy, amphetamines
amphetamines, cocaine
THC (cannabis), hallucinogens, sedatives
stimulant/sedative/hallucinogen/opioid
Source: EMCDDA-Europol Annual Report on the implementation of Council Decision 2005/387/JHA [April 2012]
Timeline of legal highs (novel drugs)
Decade(s)
Initially unregulated drugs becoming popular
1970s-80s
solvents (eg. butane, toluene); poppers (alkyl
nitrites); magic mushrooms (notably psilocybe)
Nineties
(1991-2000)
ketamine; GHB (gammahydroxybutyrate)
khat
Noughties
(2001-2010)
piperazines (notably BZP); cathinones (notably
mephedrone); GBL; N2O (laughing gas)
salvia divinorum; kratom
2011-2012
6APB (eg. Benzo Fury), MDAI (eg. Sparkle),
methoxetamine (eg. MXE); synthetic
cannabinoids (from JWH-018 to AM-2201)
17 new novel drugs, 2011-12
The latest NPS found in Britain by FEWS (Forensic Early Warning
System) between January 2011 and March 2012 – reads like
a scrabble nightmare:
1. DMMA
9. 2-AI
2. MDAI (Sparkle)
10. n-ethylbuphedrone
3. Etizolam
11. 2-CC-NBoMe
4. JWH-250
12. AM-2201
5. JWH-200
13. Ipracetin
6. AM-694
14. Ethacetin
7. 4-Me0-PcP
15. 4-HO-MiPT
8. 5-Me0-DALT
16. 2-CP
17. 25D-NBOMe
NPS obtained from internet, UK, late 2011
A total of 22 ‘legal high’ products were purchased from 5 different
internet sites in late 2011 (18 months after the UK ban on
substituted cathinones was introduced in April 2010), and each
substance was screened to determine its active ingredients.
Two products – both labeled NRG2 – contained a banned drug: each
had methylethcathinone (4-MEC), as well as a smaller amount of a
2nd banned cathinone: methylmethcathinone (mephedrone).
Six products (4 sold as Benzo Fury & 2 as NRG3) contained 6-APB;
three contained MDAI; three contained 5-IAI; three contained
methoxetamine; three contained benzocaine; & 2 contained MPA.
Source: Ayres T & Bond J (2012). A chemical analysis examining the
pharmacology of novel psychoactive substances freely available over the
internet and their impact on public (ill)health. Legal highs or illegal highs?
BMJ Open, July 31, 2012; 2(4).
22 legal highs purchased on internet: compounds detected,
accuracy of description & legal status (Ayres & Bond, 2012)
Supplier Product
Benzofury
Jolly Green Granules
MDAI
A
B
C
D
E
Compounds detected
1-Benzofuran-6-ylpropan-2-amine (6-APB)
Benzocaine
5,6-Methylenedioxy-2-aminoindane
2-(3-Methoxyphenyl)-2Methoxetamine
(ethylamino)cyclohexanone
MPA
N-methyl-1-(thiophen-2-yl)propan-2-amine
4-Methylethcathinone (4-MEC). Contaminant
NRG-2
mephedrone
NRG-3
1-Benzofuran-6-ylpropan-2-amine (6-APB)
5-IAI
5-Iodo-2-aminoindane
Benzofury
1-Benzofuran-6-ylpropan-2-amine (6-APB)
MDAI
Benzocaine
5-IAI
5-Iodo-2-aminoindane
Benzofury
1-Benzofuran-6-ylpropan-2-amine (6-APB)
2-(3-Methoxyphenyl)-2Methoxetamine
(ethylamino)cyclohexanone
Jolly Green Granules Benzocaine
MDAI Gold
5,6-Methylenedioxy-2-aminoindane
MPA
N-methyl-1-(thiophen-2-yl) propan-2-amine
4-Methylethcathinone (4-MEC). Contaminant
NRG-2
mephedrone
NRG-3
1-Benzofuran-6-ylpropan-2-amine (6-APB)
5-IAI
5-Iodo-2-aminoindane
Benzofury
1-Benzofuran-6-ylpropan-2-amine (6-APB)
MDAI Gold
5,6-Methylenedioxy-2-aminoindane
2-(3-Methoxyphenyl)-2Methoxetamine
(ethylamino)cyclohexanone
As described
Yes
Contents not specified
Yes
Status
Legal
Legal
Legal
Yes
Legal
Yes
Legal
No
Illegal
No
Yes
Yes
No
Yes
Yes
Legal
Legal
Legal
Legal
Legal
Legal
Yes
Legal
Contents not specified
Yes
Yes
Legal
Legal
Legal
No
Illegal
No
Yes
Yes
Yes
Legal
Legal
Legal
Legal
Yes
Legal
Review of NPS websites 2012
A survey of the internet was used to identify websites that were
marketing legal highs in the UK. The most fruitful search
terms included desoxypipradrol (Ivory Wave/2DPMP),
diphenylprolinol (D2PM), methylenedioxy-2-amino-indane
(MDAI), methylenedioxy-2-amino-tetralin (MDAT), alphamethyltryptamine (AMT) & 5-methoxy-N,N-diallyl-tryptamine
Conclusions: “Legal highs from the phenylethylamine, cocaine,
tryptamine and phencyclidine classes are increasingly being
marketed, and, in the majority of cases, little is cited in the
literature on their true chemical identity, pharmacology or
toxicology”.
Source: Gibbons S (20120. 'Legal highs’ - novel and emerging psychoactive
drugs: a chemical overview for the toxicologist.
Clinical Toxicology (Phila), January 2012; 50(1): 15-24
3 TYPES OF NPS BASED ON SOURCE
Herbal highs: plant/fungi or animal part/product
Synthetic highs: substance made by means of chemistry
- starting with natural precursors (semisynthetic) or synthetic chemicals
Mixed herbal/synthetic: products with synthetic drugs
mixed into natural drugs, eg. Black Mamba: AM2201
chemical saturated into damiana leaves
Herbal Highs:
Contains
cathinone
- stimulant
Chewed, smoked
or brewed/drank
KHAT: herbal high
(left) – but the most
common headshop
herbal high is salvia
divinorum (below)
hallucinogen
Kratom
Kratom is a tropical tree indigenous to
South East Asia including Thailand, Malaysia,
& Myanmar. The Kratom tree can reach heights up to 50 feet with
a spread of over 15 feet. Normal ingestion methods include
drinking it as a tea, smoking it, and chewing the leaves.
It is sold from websites as dried leaves, powder and resin pellets.
It is stimulant in lower doses, and sedative (opiate-like) in higher
doses. Doses range from 2 to 10 grams.
Kratom has 25+ alkaloids, the primary psychoactive ingredient
being mitragynine (9-methoxy-corynantheidine) Pharmacology
studies show mitragynine has opioid-like activity in animals.
Synthetic Cannabinoids: history
Synthetic cannabinoids are functionally related to THC Δ9-tetrahydrocannabinol, the key active chemical in cannabis
Like THC, they bind to the same cannabinoid receptors in the
brain and other organs as the endogenous ligand (brain
neurotransmitter) anandamide.
Classed as cannabinoid receptor agonists, they were initially
developed over past 40 years as therapeutic agents, often
for the treatment of pain. However, it is difficult to separate
the desired properties from unwanted effects (eg. getting
stoned), and so pharma-companies did not market them.
But in 21st century, legal-high entrepreneurs began exploring,
then marketing, these rejected therapeutic agents as legal
cannabis substitutes.
Why the rise in interest in
synthetic cannabinoid products?
(1) Part of general trend toward using legal highs
(2) Cheaper & more reliable product - Police raids on skunk
farms (E&W) – premises converted to cannabis cultivation,
preventing ‘normal usage’:
2006/7: 800
2009/10: 6,800
2007/8: 3,000
2011/12: 7,900
(3) Series of big rises in price of skunk since 2008 - average
price of 1g skunk 2011 (Druglink survey): £10 – though since
a gram-bag often weighs nearer 0.75g, the true gram price is
probably nearer £13-14 – or £90 to £100 per quarter ounce
(4) Skunk problems: dampness, mouldiness, adulteration
First group of synthetic
cannabinoids banned in UK
Spice, K2, Majik – mainly JWH
series, but also CP & HU series
Black Mamba (AM2201)
Legal-high smokables’
are often inert herbal
mixtures with synthetic
cannabinoids soaked
into them (the latter are
also sold separately as
powders). For instance:
Black Mamba (AM2201),
Zulu, Doob
Herbal products containing synthetic cannabinoids
Black Mamba-type
products are usually
sold as herbal preparations containing
inert herbal material
(leaf etc.) saturated
with synthetic cannabinoids (SCs). The
pure SC powder can
also be got online.
Typical appearance of Black
Mamba/Spice-type products
Unlike herbal
cannabis,
there are no
seeds; unlike
skunk, there
are no buds;
unlike either,
there is no
strong smell
or sticky
texture
Sale of Black Mamba in headshops
Usually sold as ‘incense’ (herbal mixture) or ‘research
chemicals’ (AM2201 powder), and labelled ‘not for human
consumption’ & ‘not for sale to under-18s’
£10 for one-gram bag
£25 for three-gram bag
But just like illicit drugs, the actual weight is usually 5%20% less than described
-----------------------------------------------------------------------Black Mamba = three ‘drugs’ in one herbal mixture
> damiana
> AM2201 (fluoro-pentyl-naphthoyl-indole)
> oleamide
fluoropentyl-naphthoyl-indole
AM-2201 synthetic
cannabinoid: 1-gram
bag of off-white
powder
Source: Bulk Research
Chemicals
www.bulkresearchchemicals.com
Light dose: 250 mcg
Moderate dose: 0.5 - 1 mg
Strong dose: 1 – 2 mg
NPS like ‘Black Mamba’
contain AM-2201 saturated
into damiana leaf to simulate
herbal cannabis in both its
appearance and effects
Synthetic highs: white powders & pills
BUBBLE
-------------------
UPPERS
or TRIPS
Conclusions of Lancashire study *
“whilst Bubble had been used as a slang term for
mephedrone when it emerged in the north west of
England in 2009, by late 2010 and after the ban, Bubble
was evolving into the slang term for any synthetic legal
high or unidentified white powder with stimulant
effects which was available from street dealers …
our survey respondents were not only unclear about,
but also apparently unconcerned about the specific
chemical identity of the stimulant white powders they
consumed” Measham et al. (2011: 140), op cit.
* [based on interviews with people attending
nightclubs in North-West England, 2010]
Some lines of Bubble earlier today
Cocaine – Heroin – Amphetamine – Ecstasy - 2CB – Ketamine – Mephedrone –
Naphyrone - Methoxetamine? – or one of dozens of possible legal highs/NPS
1-Benzofuran-6-ylpropan-2amine (6-APB) – aka ‘NRG3’
6APB – stimulant:
note the use of the
terms ‘research
chemicals’ & ‘pellets’
(not pills), and the
warnings ‘harmful’
and ‘not for human
consumption’
Ivory Wave:
desoxypipradol (2DPMP)
Ivory Wave & Whack
Wood & Dargan used PubMed to search for terms related to
D2PM & 2-DPMP (desoxypipradol). 2-DPMP, usually sold as
‘Ivory Wave’, was found to have similar effects on reducing
dopamine reuptake to cocaine. D2PM was similar, but was
far less biologically effective at boosting dopamine levels.
'Whack‘ was found on analysis to contain 2-DPMP and
fluorotropacocaine, so also had similar effects to cocaine.
Wood D, Dargan P (2012). Use and acute toxicity associated with the novel
psychoactive substances diphenylprolinol (D2PM) and desoxypipradrol
(2-DPMP). Clinical Toxicology (Phila), September 2012; 50(8): 727-32.
Ethylphenidate
Analogue of
stimulant drug
methylphenidate –
better known as
Ritalin (for ADHD)
Annihilation: ‘herbal incense’
Synthetic
cannabinoid in
herbal material,
possibly AM2201 or
one of its chemical
relatives.
Given a great deal
of free publicity by
the mass media.
Legal high?
50 mg tablets of caffeine
(trimethylxanthine) –
sold in pharmacies off
the shelf to anyone aged
12 years or older.
“A stimulant which can
help to maintain mental
alertness and make you
feel less tired”.
Max dose in 24 hours:
12 tablets (0.6 gram).
LD50 = 10 grams (or 4
packs of 48 tablets)
Online price 2012: £4.30
Electronic/Technological Highs
Brain Tuners: computer programs that, via electrodes
attached to skull, produce direct changes in brain-waves
- and thus stimulation, sedation or hallucinations
Perception Tuners: notably visual, tactile & sound-based
(eg. hypnotic images, electro-acupuncture, binaurals)
The Chemputer (Cronin): makes molecules from atoms –
and psychoactive drugs are typically comprised of two
or more of just four atoms: carbon, hydrogen, oxygen
and nitrogen
http://www.guardian.co.uk/science/2012/jul/21/chemputerthat-prints-out-drugs
Trends in NPS availability
According to EMCDDA reports in May 2011 and
November 2012, the number of new NPS
marketed in Europe between 2008 & 2012
climbed as follows:
2008
2009
2010
2011
2012
13
24
41
49
57+ – the equivalent of more than one
new NPS every week
UNODC report, November 2012
Two drug groups - synthetic cannabinoids &
cathinones - dominated the world NPS
market over 2010 & 2011
Source: ‘Tracking designer drugs, legal highs and bath salts’ –
UNODC 1-11-12
http://www.unodc.org/unodc/en/frontpage/2012/November/
tracking-designer-drugs-legal-highs-and-bath-salts.html
EMCDDA/Europol Report 2012
The number of NPS websites (online headshops) quadrupled in
a two year period between January 2010 and January 2012:
Jan 2010
Jan 2011
July 2011
Jan 2012
170
314
630
690
In 2010/11, SOCA closed 120 websites for selling 2 newly
controlled class B drugs: mephedrone (banned 4/10) and
naphyrone (banned 7/10)
3. Estimating levels of NPS use
Problems with estimates of prevalence of NPS use
Parameters: time-period, place, case, type of estimate
Internal validity, eg. dummy drug items (false admissions),
honesty questions (false denials)
Specific problem with NPS: large number & multiple names
External validity, eg. body fluid tests on a sub-sample
Reliability, eg. repeat questions, replicable surveys
Representativeness, eg. using sampling & statistical methods
which ensure sample is representative of source population,
so that findings are generalizable
EU Survey of legal highs, mid-2011
EU survey in June 2011 found that of the 27 EU
countries:
• The UK was ranked fourth for legal high use
(Ireland was first)
• The UK ranked top for the proportion of legal
high users who were offered them in clubs &
parties
Prevalence of use of legal highs
Mixmag survey: comparison of 2009 and 2010 findings *
%
poppers
nitrous oxide
mephedrone
salvia
BZP
Spice/Magic
methylone
GBL
Lifetime
2009 2010
69
56
59
57
42
61
29
..
26
17
13
10
11
14
6
6
Last-year
2010
20
38
(4 in 10)
51
(5 in 10)
..
5
2
9
2
_________________________________________________________________________________________________
* 2009 findings reported in February 2010; 2010 findings given in March 2011
2010 sample: 69% male, modal age 20 years (3/4s 18-27), 89% heterosexual
British Crime Survey: 2009/10 - 2011/12
Adults in England & Wales reporting last-year use of 5 drugs:
^ 367,000
Mephedrone
Spice *
BZP
Khat
GBL/GHB
16-59
09/10 10/11 11/12
..
1.4
1.1^
0.4
0.2
0.1
0.5
0.1
0.1
0.2
0.2
0.2
0.1
0.0
0.1
~ 220,000
16-24
09/10 10/11
..
4.4
1.2
0.4
1.4
0.2
0.5
0.3
0.5
0.1
.
11/12
3.3 ~
..
..
..
..
_____________________________________________________________________
All five drugs were ‘legal highs’ until controlled by the UK Misuse of Drugs Act in
2010 – the exceptions being GHB (banned in 2005) & khat (still uncontrolled)
* and other synthetic cannabinoids
.. not reported
E&W = England & Wales
~ 95% CI: 173,000-267,000 last-year mephedrone users in E&W: 16-24s, 2011/12 (7th)
^ 95% CI: 317,000-416,000 last-year mephedrone users in E&W: 16-59s, 2011/12 (4th)
Global Drug Survey: use of NPS UK 2010/11
%
Last 12 months
Nitrous oxide
Mephedrone
Isopropyl nitrate (poppers)
Methoxetamine
Synthetic cannabis (some legal)
Benzo Fury (6APB)
MDAI (Sparkle)
Methylone
GBL (gammabutyrolactone)
MDPV (methylenedioxypyrovalerone)
AMT (alphamethyltryptamine)
Kratom
Solvents
27.2
19.5
13.1
4.2
3.3
2.4
2.2
1.4
1.6
0.5
0.4
1.1
0.4
Last month
..
7.2
5.2
2.4
1.5
0.8
0.5
0.4
0.5
0.0
0.2
0.2
0.2
4. Who uses NPS, & why?
3 main groups:
Clubbers/partiers (mainly young adults & students)
Psychonauts (all ages - main interest is hallucinogens)
Poly-drug users (esp. prior cocaine/speed/heroin-users)
Demographics
About 2:1 male-female ratio for regular users
Main age-range of 16-45 – peak age-range 20-29 yrs
Gay men use (& initiate use) more than heterosexuals
Use found among all races & social groups, esp. Whites/Mixed
Characteristics of mephedrone users
British Crime Survey 2011/12: levels of last-year use in E&W
Age: 16-19 (2.9%) & 20-24 (3.6%) vs 25-59 (0.5%)
Sex: men 1.5% vs women 0.7%
Ethnic group: white (1.2%) & mixed (1.9%) vs other races (0.3%)
Marital status: single (2.7%) vs others (0 to 1%)
Occupational status: students (2.7%) & unemployed (2.2%) vs
others (0-1.3%)
Area: city-dweller (2.8%) vs others (0.5%-1.4%)
Past-month nightclub attendance: 9+ (9.7%) vs none (0.5%)
Past-month pub/bar attendance: 9+ (4.7%) vs none (0.3%)
Main reasons for taking legal highs
Mixmag survey of readers/clubbers, 2009 (N = 2,220)
1
2
2
2
2
6
7
7
other illegal drugs not available
they are not illegal
able to buy them online
more reliable product than illegal drugs
price - cheaper than illegal drugs
better quality than illegal drugs
safer than illegal drugs
a better high & fewer side-effects than illegal drugs
Why have legal highs/NPS become
so popular over the last 5 years?
Not just because of price – many illegal drugs are cheaper than
they were 20 years ago, and NPS can cost more.
Main reasons seem to be:
(1) the drop in the purity of several popular drugs (next slide)
(2) the drop in availability of some popular drugs (eg. skunk)
(3) the advent of the Internet and headshops as new ways of
buying psychoactive drugs
(4) Entrepreneurs prepared to research, produce and market
many new legal substances for getting ‘high’ (notably China)
(5) Modern society: consumer-oriented, pleasure-oriented
Annual trends in average purity of drugs seized by the police in England & Wales, 2003-2011
80
Crack
70
Cocaine
Heroin
60
Amphet.
50
%
40
32%
30%
30
28%
20
10
9%
0
2003
2004
2005
2006/7
2007/8
2008/9
2009/10
2010/11
Sources of legal highs in UK
Mixmag survey of readers/clubbers, 2009 (N = 2,220)
Friends
Websites
Headshops
Festival stalls
Drug dealers
%
95
92
78
67
51
nearly all
9 in 10
8 in 10
7 in 10
half
5. The effects of NPS
Categories of effects of drugs
Stages:
Short-term: onset > main > residual
Medium-term: after-effects, eg. come-down
Long-term: health/social, eg. dependence
-------------------------------------------------------------------------Mental:
thought emotion perception motivation
Physical:
muscular respiratory circulatory sensory
digestive hormonal sexual facial
Snorting & Smoking: fastest hits
…excluding injecting
Swallowing delays effects by 30 to 90 minutes
The facial effects of
stimulant / empathogen
drugs:
* bin-lids - dilated pupils of eyes
* wide-open eyelids, jerky eyes
* Flushed/hot-looking skin
* Clenched jaw, teeth-grinding
* Muscle-rippling, lip-chewing
The facial effects of
depressant drugs
(esp. opiate-type):
* pinned (constricted) pupils
* sagging/droopy eyelids
* paler complexion
* relaxed facial muscles
* nodding head (gouching)
Psychoactive drugs: 2-dimensional
model of their general effects
Hallucinogen
(trip)
|
Stimulant
(upper)
▬▬
▬▬
|
Anti-psychotic
(normalizer)
Depressant
(downer)
Drugs classified by effects model
Hallucinogen
(trip)
LSD
MDMA
mephedrone
Stimulant
amphet.
(upper)
nicotine
|
|
▬▬ ▬▬
ketamine
methoxetamine
heroin
|
|
Depressant
(downer)
cannabidiol (CBD)
quetiapine (Seroquel)
Anti-psychotic
(normalizer)
Hallucinations: Machine-Elf (DMT)
Mephedrone Hallucinations
“I was staring at the pattern on the carpet in the centre of
the room, and first some black smoke came up out of it,
then I saw Michael Jackson float out of the smoke.
I said ‘that can’t be Michael Jackson, he’s dead’, and
anyway I don’t even like Michael Jackson – then I
thought ‘it’s OK, I’m in District-9’ – then I came right out
of it, and felt shocked, real terrified ... I hope I see Elvis
next time”.
R. Newcombe (2009). Mephedrone: the use of m-cat (Meow) in
Middlesbrough. Manchester: Lifeline Publications.
http://www.lifeline.org.uk/wp-content/_old-site-docs/Mcat%20report%20small.pdf
6. Risks & Harms from use of NPS
RISKS
HARMS
Behaviours involved in
consumption of drugs
Consequences of using
drugs in specific ways
7 types of risk/safety
9 types of harm/benefit
eg. Injecting with used needles
Infections (eg. HIV, HCV)
Taking too-high doses
Overdose
Toxicity of substance
Bodily damage etc.
.
Risks of using NPS/legal highs
The Risk CAMP-MAP identifies the 7 core areas of the riskiness/
safety of drug consumption (drug-taking behaviour):
1
2
3
4
5
6
7
What drugs are they taking (at same time)?
How are they getting hold of it (who/where)?
What are the contents of products being used?
What setting do they use it in (place, time)?
How much are they using (per dose, per period)?
How are they consuming it (prep. & admin.)?
How frequently & regularly are they using it?
Mixture
Access
Product
Context
Amount
Method
Pattern
Source: Newcombe R (2010). A multi-disciplinary theory of drugrelated harm reduction. http://www.3dresearch.org.uk/?p=info
Model of drug-related harms
Level
of Harm
Individual
Community
Societal
Type of Harm
.
Health
Social
Economic
Main harms of NPS/legal highs
Health Problems
Mental disorder: anxiety, psychosis, mood
Dependence: craving, tolerance, withdrawals
Physical health: ‘route’ damage, diseases
Poisoning: acute intoxication, overdose
Death: fatal ODs, accidents, suicide
Social Problems: crime & CJS, relationships,
children, social exclusion, discrimination etc.
Economic Problems: personal debts, policy costs etc.
Extent of these problems: mostly unknown
Economic costs of drug prohibition
THE UK spends more than any other country in Europe on
its drugs policy – 0.48 per cent of GDP according to
EMCDDA (European Monitoring Centre for Drugs and
Drug Addiction) – City AM 15/1/13
BODILY DAMAGE CAUSED BY
MEPHEDRONE INJECTING
Image of left upper
limb of Patient 3
(mephedrone
injector) post
debridement.
Causes: toxicity? adulterants?
dose? injecting frequency?
Dorairaj J, Healy C,
McMenamin M, Eadie P
(2012). Journal of Plastic,
Reconstructive & Aesthetic
Surgery, 65, 37-41.
DEATHS
The Sun Newspaper,
Thursday 3rd May
2012: article about
death from use of
“legal highs”, when
the drug involved was
GBL – which was
banned in UK in
December 2009
Trends in deaths from ‘legal highs’
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Mephedrone
BZP/TFMPP
GBH/GBL
0
0
0
0
0
0
0
0
0
6
6
0
0
0
0
0
0
0
0
9
5
2
1
5
6
1
4
7
9
20
16
12
20
Source: Office of National Statistics (England & Wales); 2012
Deaths related to legal inhalants
2006
2007
2008
2009
2010
2011
nitrous oxide poppers
4
3
3
2
2
3
..
..
..
..
..
..
solvents
37
39
46
31
..
..
helium
2
2
12
21
33
40
Sources: Office for National Statistics. Deaths related to drug poisoning in
England & Wales 2010 (August 2011)
.. Not available
Trends in Death Associated With Abuse of Volatile Substances 1971-2009.
St. Georges Hospital, University of London (2010).
Note: helium deaths are mainly suicides
Poppers = alkyl nitrites
Inhalant: drug ingested by inhaling a gas or the fumes of room-temp. solvent
7. UK Responses to use of NPS
Legal bans & controls
Police & CJS responses
Educational responses (schools, mass media
Hospital responses (A&E, psychiatric, etc.)
Treatment responses
Harm Reduction
Legal Regulation & Users’ Rights
MODA amendments: TCDOs 2011
2011
Temporary Class Drug Orders - Police Reform &
(Nov)
Social Responsibility Act 2011, Sec. 151 & Sch. 17
Home Office can place a drug in a TC if the ACMD
advise that (a) it is or is likely to be misused, and
(b) it has or could have harmful effects – and
that a fast response is required to protect public.
Covers all MoDA offences for 12 months – except
possession, though police can still confiscate TCDs.
Penalties as for class B/C (max. 14 years custody)
In first 6 months, just one new drug has been placed under a
TCDO: methoxetamine (MXE)
Import bans, 2010 to 2012
2010
(Nov)
2011
Import ban on desoxypipradol (2DPMP) [stimulant]
{Ivory Wave}
Import ban on phenazepam [benzo]
(June)
2011
(Nov)
Import bans on pipradol analogues of 2DPMP)
2012
First TCDO under MoDA: methoxetamine
Also: 2DPMP (Ivory Wave) & phenazepam (Bonsai)
(April)
[draft Misuse of Drugs Act 1971 (Amendment) Order 2012]
Banning of synthetic cannabinoids
Under the 2009 Amendment Order to MoDA 1971, four
types of synthetic cannabinoid were added to class B,
schedule 1 of Misuse of Drugs Act [see Appendix]
Further Consideration of Synthetic Cannabinoids (Oct 2012)
“The ACMD recommend that the substances detailed in
Annex A have potential harms commensurate with those
of cannabis and should, therefore, be classified and
controlled under the Misuse of Drugs Act (1971) as Class B
[and Schedule 1] under an extended generic definition”.
BUT many groups of synthetic cannabinoids remain legal…
Banning of arylcyclohexylamines
“the harms of methoxetamine are commensurate with Class B,
of the Misuse of Drugs Act (1971); and it should be
scheduled under Schedule I of the Misuse of Drugs
Regulations (2001) (having no known recognised medicinal
use). The ACMD also recommend that a number of closely
related analogues of ketamine and phencyclidine, some of
which have already appeared on sale as “legal high
alternatives”, be controlled by means of a generic chemical
description detailed in Annex 3.”
Advisory Council on the Misuse of Drugs, Methoxetamine
Report, October 2012
But many groups of arylcyclohexylamines remain legal…
Prohibition of khat?
In January 2013, the UK government will make
a decision about whether or not to control
khat under the 1971 Misuse of Drugs Act
ACPO position on TCDOs
Submission from Association of Chief Police Officers to Home
Affairs Select Committee on drugs policy, 2nd April 2012
“the solution to the particular challenge of legal highs does not lie in
adding inexorably to the list of illicit substances.
A key question for the Government to determine is the extent to
which legislation can realistically be used to address active choices
being made by people and to tackle the undoubted harms caused
by the misuse of substances taken essentially for pleasure.
The police will continue to focus their energies on serious criminality
and take a less robust enforcement approach on matters relating
to personal possession”
ACPO also warned the Government that the banning of ‘legal high’
drugs will fail, and forces will treat anyone found with them
leniently – cautioning instead of prosecuting them.
Other recent major reports re NPS
UK Drug Policy Commission: A Fresh Approach to Drugs (10/2012)
Recommended depenalization and harm reduction approach
Advisory Council on the Misuse of Drugs (October 2012)
Recommended decriminalizing the possession of drugs
Home Affairs Committee, House of Commons (December 2012)
9th Report: Drugs – Breaking the Cycle
Recommended decriminalization & harm reduction approach
All-Party Parliamentary Group for
Drug Policy Reform, Jan 2013
Towards a Safer Drug Policy: Challenges & Opportunities arising
from ‘legal highs’ – Inquiry into New Psychoactive Substances
Recommended decriminalization and harm reduction policy
Proposed that the “less harmful” NPS be regulated and sold
from retail pharmacies
UK PM David Cameron: rejected all of the recent calls for drug
policy reform – including a Royal Commission on drug policy
- yet in 2002 stated that the War on Drugs “does not work”
Attitudes of politicians & top officials
Government’s leading adviser, Prof Les Iversen (head of ACMD)
said in October 2012 that young people caught in possession
of banned substances such as cannabis should be spared
criminal prosecution to prevent their futures being blighted
Ken Clarke, Justice Minister, also claimed in 2012 there was no
evidence that the ‘war on drugs’ had had any effect over the
past 30 years
Tom Hollis, drugs spokesman for the Association of Chief Police
Officers stated in January 2013 that responsibility for drug
policy should be moved from the Home Office to Dept of
Health: “the police are ‘flat-footed’ trying to keep up with
the pace of change” (eg. training sniffer dogs, etc.)
How many new drugs (NPS/legal
highs) are possible?
“Each new substance that emerges from the
laboratory is a tabula rasa: its effects on human
consciousness cannot be predicted simply from its
chemical structure … The permutations may be, to
all practical purposes, infinite” (p105-6).
_____________________________________________
Mike Jay (2010). High Society: Mind Altering Drugs in
History and Culture. London: Thames & Hudson
Legal regulation of psychoactive drugs
Ultimately, legal regulation – as with alcohol and tobacco - may
be the only viable solution to the exponential increase in
ways of getting high which have emerged in the 21st century
– from tweakable legal highs to electronic highs. If banning
an NPS only leads to increased use and/or problems, the
outcome is harm maximization not harm minimization.
The optimal solution would be to make available for adults’
private use the least toxic versions of each of the main kinds
of psychoactive drug: notably stimulant, depressant,
hallucinogenic and anti-psychotic drugs.
Transform’s report shows how legal regulation would work:
‘After the War on Drugs: Blueprint for Regulation’ (2009)
Responses to NPS/legal high use
Early-warning monitoring systems (eg. Drugwatch)
Multi-agency approaches – local & national
In-service staff training – to stay up to date –
especially drugs workers & paramedics
Consultation with/representation of LH users
Exploration of prescribing/treatment options
Risk-reduction information – esp. online & apps
Working with headshops & ‘legal high’ websites
Research – evidence-based services/strategies
Monitoring systems
European Monitoring Centre on Drugs & Drug Addiction:
EMCDDA Early Warning System - for new synthetic drugs
European Medicines Agency
Pharmacovigilance System - to monitor abuse of medicines
UK National Poisons Information Service – annual reports
FEWS – UK Home Office Forensic Early Warning System
Drugwatch
Substitute prescribing
Stimulant substitutes for mephedrone
dexamfetamine (Dexedrine): max dose 60 mg/day
methylphenidate (Ritalin, etc.)
modafinil (Provigil): average 100-200 mg per day
class/schedule
B2
B2 .
POM
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Forms: tablets or syrup.
Medication for stabilizing & treating mephedrone users
anti-depressants (for mood disorders)
hypnosedatives (for sleep disturbances & anxiety)
vitamins/nutrients (for malnourishment)
______________________________________________________________________
POM = prescription only medicine (Medicines Act 1968)
Lifeline
leaflet/card on
safer use of
mephedrone
Guide to safer use of
hallucinogenic drugs
(Lifeline Publications,
Manchester 2005)
www.lifelinepublications.org
Apps for smartphones
etc. are now one of the
best mass media for
providing information
about safer use of
legal and illegal drugs
Agency Interventions
with NPS users: needs
consultation with and
representation of
clients/users on
policy-making groups
and service providers
Appendices
ABSTRACT:
The rapidly changing nature of novel psychoactive substance use
Issue. Although use of many illegal drugs has stabilized or declined over the 21st century, this has been accompanied by a
significant rise in the use of 'legal highs' - unregulated novel psychoactive substances (NPS) designed to mimic the effects of
banned drugs like cocaine, amphetamines, MDMA, cannabis and ketamine. Also, some NPS have fairly unique effects, and these
include laughing gas (nitrous oxide), salvia and kratom. These NPS are sold online and from street headshops as 'not for human
consumption' in order to sidestep medicine laws. First, ketamine, GBH and magic mushrooms became popular from the 1990s,
followed by party pills (notably BZP), GBL and laughing gas during the early 'noughties'. But, following the government’s banning
of most of these NPS, by 2008 the market for new synthetic drugs was showing a notable surge. In particular, sensationalist media
coverage helped to make mephedrone (meow/m-cat/drone) and other cathinones (eg. methylone/bk-MDMA) the most popular
NPS ever. Indeed, by 2010, the British Crime Survey reported that mephedrone had become the 4 th most popular drug, resulting
in the government banning it along with a dozen other cathinones. Predictably, by 2009, online and urban headshops responded
to the cathinone ban by marketing a wide range of new NPS with a much wider variety of chemical structures, including Benzo
Fury, Ivory Wave, Annihilation, Black Mamba and methoxetamine.
Key arguments. Indeed, according to a 2011 EMCDDA report, the number of NPS marketed in Europe climbed from 13 in 2008, to
24 in 2009, 41 in 2010, 49 in 2011, and over 57 in 2012 – the equivalent of more than one new NPS every week. The most popular
new types of synthetic NPS include cannabinoids (eg. AM2201) and cathinones (eg. MDPV, NRG1), while the most popular natural
NPS include salvia, khat and kratom. A further concern for the drugs field is the advent of electronic highs, which work through
the brain’s perceptual and electrical systems rather than directly on its neurotransmitters - such as binaurals (mind-altering
sounds), dream machines (mind-altering visual displays), and brain tuners (brain-wave modifiers).
Despite the vast numbers of NPS available, in October 2012 the UK government announced it would be banning just two main
groups: synthetic cannabinoids such as Black Mamba and methoxetamine-type drugs (which had already been made the sole
target of the new TCDO ‘holding class’). This clearly shows that the legal machinery available for controlling drugs is hopelessly
out of date, and just as it failed to prevent the use of traditional drugs like cannabis and cocaine, UK drug laws are now patently
failing to control use of NPS. Attempts at legal prohibition have been an outright failure - as demonstrated by the increase in
mephedrone use and harm after it was banned - and interest in NPS continues to rise across many groups. For instance, an EC
survey published in mid-2011 reported that one in 20 young adults (15-24s) across the EU's 27 countries had tried NPS - with the
top four countries including Britain (one in 12) and Ireland (one in six).
Conclusion. This paper concludes by arguing that current British policies toward NPS are ineffective and counterproductive, and
that interventions are urgently needed to minimize harm from NPS use – including advice and education on safer use, outreach
work in clubs, relevant treatment responses (eg. substitute drug prescribing), and legal regulation which prioritizes harm
reduction and respect for human rights over the criminalization of people who take drugs (a victimless crime).
1. What are legal highs/NPS?
Natural product ‘legal highs’
“Natural product legal highs are by their very nature highly
chemically complex, and in the clear majority of cases,
chemical studies were conducted some considerable time
ago. Their pharmacology and toxicology generally focuses on
the major active principles with few studies detailing the
potentially highly complicated and multiple effects of their
extracts. This complexity, coupled with the inherent natural
product variability of plant and fungal species, adds a further
dimension to the potential harms associated with natural
product legal high use”.
Source: Arunotayanun W, Gibbons S. (2012). Natural product 'legal highs'.
Natural Product Reports, November 2012; 29(11): 1304-16.
Police definition of ‘head shop’
A commercial retail outlet (including online businesses)
specialising in the sale or supply of equipment,
paraphernalia or literature related to the growing,
production or consumption of cannabis, or other drugs, and
includes the sale or supply of ‘New Age’ herbs, exotic plant
materials or other ‘New Psychoactive Substances’ (aka ‘Legal
or Herbal Highs’)
Their primary function is to promote, facilitate and glamorise
the cultivation, production, preparation and consumption of
drugs.
Source: ACPO Guidance on Policing New Psychoactive
Substances Including Temporary Class Drugs (Nov. 2011)
Is your legal high really legal?
Answer depends not only on which drug it is, but:
* when (the year)
* where (the country)
and
* who you are (eg. adult, doctor etc.)
Also: if not legal, how illegal is it? MoD Act 1971 UK class A, class B, class C or TCDO (supply only) – or
Medicines Act 1968 etc..
2. Main types of NPS being sold
from headshops & websites to 2012
7 major structural groups of
synthetic cannabinoids
1.
2.
3.
4.
5.
6.
7.
Naphthoylindoles
Naphthylmethylindoles
Naphthoylpyrroles
Naphthylmethylindenes
Phenylacetylindoles
Cyclohexylphenols
Benzoylindoles
The history of headshops
1990s
mainly inert/mild herbal substances
(khat tincture banned as class C drug prepar.)
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
20002006
fresh psilocbye mushrooms/kits (banned 2005)
party pills: ‘ecstasy-like’ drugs (some banned 2009)
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2007-
mephedrone & cathinones get popular
2010
(13 & relatives banned in 2010); salvia div.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2010now
synthetic cannabinoids (eg. Black Mamba)
laughing gas (nitrous oxide) – refill capsules etc
various new stimulants & hallucinogens
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Next:
Deep Web (eg. Silk Road); electronic highs
3. Estimating levels of NPS use
The Sun: Thursday
th
5
May 2012
Legal Highs still for sale: Replacements for banned drugs
MARY JOY (£10 a gram): Similar to cannabis, users report
hallucinations and insomnia after taking it.
HE-MAN (£63 for 2 half-gram sachets): Reported to be the
new “Mexxy”, its named after the cartoon character as it
makes users feel like Masters Of The Universe. Side-effects
include loss of balance and hallucinations.
MPA (£15 a gram): Sold as bath salts and said to emulate
“Mexxy”. Causes palpitations and temperature spikes.
DOVES (£10 for 2 pills): Name linked to Love Doves, a type
of ecstasy. Users can overheat and suffer a racing heartbeat.
KARMA (£6 a gram): Leaves users dozy and confused.
4. Who uses NPS, & why?
Main reasons for drug use
Initiation – Continuation – Cessation
Intoxication (high, buzz, pleasure)
Stimulation (energy, excitement; working, dancing, sex)
Relaxation (sedation, trance-state, reducing anxiety)
Psychonautics (exploring mind, tripping, hallucinations)
Socio-economic causes
Family & childhood factors
Income & social exclusion
Peer influence/friend-groups
Genes: personality, attitudes, etc.
Drug Market
Availability
Price
Quality/purity
My Strange Addiction (US TV)
29 episodes about 50+ ‘addictions’ (2010 to 2012): done first
for pleasure – typically a distortion of natural drives:
Snorting baby powder
Inhale fumes: moth-balls, petrol, cleaning fluids
Taste/swallow: toilet paper, cushion-foam, A-B wipes
Eat: cat-food/hair/plaster/tape/glass/soap/dirt/laxatives/ash
Drink: urine, nail polish, detergents, petrol, hand sanitizer
Skin habits: cutting, picking scabs, pulling hair out, nail-biting
Excess grooming: tanning/bleaching, make-up, plastic surgery
Excess exercising – body-building, cycling & risky sports
Excess computer/phone/technological habits – esp. gaming,
social networking, texting
5. The effects of NPS
Venn
Diagram
Model of
PsychoActive
Drugs (by
effects)
6. Risks & Harms from use of NPS
Drug-Harm Ranking 2012
The ranking of combined self and social scores for harm:
Taylor M et al. (2012). Quantifying the RR of harm to self and others from substance
misuse: results from a survey of clinical experts across Scotland. BMJ Open 2012
http://bmjopen.bmj.com/content/2/4/e000774.long
Research has
only started
recently, but
a review paper
on the effects
of synthetic
cannabinoids
and wider
implications is
now available
Trends in deaths from stimulants, E&W
mephedrone *
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0
0
0
0
0
0
0
0
0
6
6
ecstasy
55
56
50
43
58
48
47
44
27
8
13
amphetamines cocaine
24
38
31
37
45
44
50
45
49
48
49
97
128
129
154
176
190
196
235
202
144
112
England & Wales figures come under heading of ‘mephedrone/cathinones’
.
2010: Scotland 4, N. Ireland 1 [UK: 11]
2011: Scotland 1, N.Ireland 2 [UK: 9]
3 other cathinone deaths in Scotland 2011: 4MEC, cathinone & MDPV (one each)
Thus UK had a total of 12 cathinone deaths in 2011.
Source: Office of National Statistics (England & Wales), 2012; etc.
7. UK Responses to use of NPS
MODA amendments, from 2001 to 2010
2001
35 phenethylamines [hallucinogens]
A1
2003
GHB (gammahydroxybutyrate)
C4
2005
psilocin-based mushrooms (live/fresh)
A1
2005
ketamine
C4
2009
(Dec.)
GBL (gammabutyrolactone), 14BD (butanediol)
BZP (benzylpiperazine) & other piperazines
Synthetic cannabinoid receptor agonists *
C
C1
B1
2010
mephedrone & substituted cathinones
B1
(April)
[10+ stimulants + 2 entactogens]
2010
Naphyrone
B1
(June)
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Red letter = MODA class (A-C)
Red number = MODA schedule (1-5)
The annual number of drug-related stops & searches, and
consequent arrests, England & Wales, 1986-2011 [Home Office 2012]
700000
600000
595,200
Searches
Arrests
500000
400000
300000
200000
100000
40,900
0
1986
1988
1990
1992
1994 1996/97 1998/99 2000/01 2002/03 2004/05 2006/07 2008/09 2010/11
250000
0
1920
1922
1924
1926
1928
1930
1932
1934
1936
1938
1940
1942
1944
1946
1948
1950
1952
1954
1956
1958
1960
1962
1964
1966
1968
1970
1972
1974
1976
1978
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000/01
2002/03
2004/05
2006/07
2008/09
2010/11
Annual number of drug offences in the UK, 1920 to 2010/11
300000
270,048
Drug offences
Possession
200000
150000
100000
50000
231,950
Banning of synthetic cannabinoids
Under the 2009 Amendment Order to MoDA 1971, four types
of synthetic cannabinoid were added to class B, schedule 1:
[2,3–Dihydro–5–methyl–3–(4–morpholinylmethyl)pyrrolo[1, 2,
3–de]–1,4–benzoxazin–6–yl]–1–naphthalenylmethanone.
3–Dimethylheptyl–11–hydroxyhexahydrocannabinol.
[9–Hydroxy–6–methyl–3–[5–phenylpentan–2–yl] oxy–5, 6, 6a,
7, 8, 9, 10, 10a–octahydrophenanthridin–1–yl] acetate.
9-(Hydroxymethyl)–6, 6–dimethyl–3–(2–methyloctan–2–yl)–6a,
7, 10, 10a–tetrahydrobenzo[c]chromen–1–ol.
NABILONE was excluded by adding many statements such as:
“Any compound structurally derived from 3–(1–naphthoyl)indole or 1H–indol–3–yl–
(1–naphthyl)methane by substitution at the nitrogen atom of the indole ring by
alkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl or 2–(4–morpholinyl)ethyl,
whether or not further substituted in the indole ring to any extent and whether
or not substituted in the naphthyl ring to any extent …” and so forth and so on…
Drugwatch
Lifeline originally developed RADAR: Rapid Assessment of Drug
Activities & Risks, designed to provide information about
drug use far more quickly than other systems (eg. NDTMS).
Applied for Lottery Funding, but were unsuccessful.
DrugWatch is currently an informal association of agencies
including DrugScope, Lifeline and Release, who share an
interest in establishing a robust early warning system in the
UK for all types of drugs.
When appropriate, DrugWatch’s early warning system will
communicate information to the drugs sector on new and
emerging compounds, including controlled drugs & ‘legal
highs’
UK Forensic Early Warning System
FEWS was set up to identity New Psychoactive Substances (NPS)
more promptly to enable Government “to take action before
a harmful substance takes a foothold in the UK”, and to feed
into the UK-wide Drugs Early Warning System (DEWS).
Latest report is an annex to Drug Strategy Annual Review, May
2012. Aims are (1) to reduce the demand for NPS, (2) ensuring
statutory services can provide effective treatment/recovery
from NPS, (3) encouraging individuals to take personal
responsibility, & (4) promoting the choice not to take
unknown potentially harmful psychoactive drugs.
Analysis of 1,300 samples tested during January 2011 to March
2012 found 17 NPS (9 already banned in UK): 5 synthetic
cannabinoids, 4 tryptamines, 2 phenethylamines, 1 cathinone
& 5 other NPS.
CLUB DRUG USE IN ENGLAND: LITTLE IMPACT ON
NUMBERS ENTERING TREATMENT
“Data collected since 2005-06 now tells us enough to form an
idea of the scale and nature of the problems associated with
the more established club drugs – ecstasy, ketamine,
methamphetamine, GHB/GBL, and mephedrone. What is
becoming clear is that despite the widespread use of club
drugs, they are currently causing a treatment problem for
relatively few people”.
National Treatment Agency (2012). “Club Drugs: Emerging
Trends And Risks”. December 2012.