DRUGS ACTION

“New Psychoactive Substances”.& Overdose Training

Gillian Maclean gmaclean@drugsaction.co.ukDrugs Action7 Hadden Street Aberdeen Tel: 01224 577120HELPLINE 01224 594700

www.drugsaction.co.uk

New Psychoactive Substances.

• Definition (but by no means definitive)“ Legal Highs are substances made from assorted

herbs, herbal extracts and ‘research chemicals’, which emulate the effects of some illegal drugs such as, Cannabis, LSD, Cocaine or others. These substances are not currently controlled by the Misuse of Drugs or Medicine Acts”

Arthur and Grunert 2005

NPS Packaging ALL PACKAGES WILL STATE :

• Not for Human Consumption.

SOLD AS : • Herbal Incense,• Bath Salts,• Plant Food,• Novelty Item Only,• For Research Use Only.• etc. etc.

NPS Packets

Current Legislation

• Misuse of Drugs Act (1971)• Medicines Act (1968)• Poisons act (1972)• Consumer Protection Legislation• Common Law • Temporary Class Drug Orders (2012)

Alexander Shulgin

Mephedrone Video

EMCDDA 2014

651 Websites in Europe

Online Purchase

the drugs wheel.com

NPS Drug Groups

• STIMULANTS ( mimic; Cocaine, Amphetamines)

• EMPATHOGENS ( mimic; Ecstasy)

• PSYCHEDELICS ( mimic; LSD, Magic Mushrooms)

• DISSOCIATIVES ( mimic; Ketamine ) • DEPRESSANTS ( mimic; Valium, Librium ) • OPIODS ( mimic; Heroin, Methadone ) • CANNABINOIDS ( mimic; Strong Cannabis )

“CREW 2000” 2011

Concerns !• With the continuing release of new psychoactive substances on the drug

market, there is concern that new or obscure substances that have contributed to deaths may escape detection.

• The high potency of some synthetic substances further complicates their detection, as they will be present only at very low concentrations in the blood.

• The emergence of highly potent synthetic substances also has implications for law enforcement, as even small quantities of these drugs can be converted into multiple doses

EMCDDA 14

Commonly Used NPS UK.Cannabinoids 3rd Generation

• 2-nel / sts - 135• 5f – akb – 48• 5f – pb 22• akb – 48• fub – pb – 22

( SOMETIMES THESE CHEMICALS ARE MIXED TOGETHER and SOLD AS BLENDS )

• In the first six months of 2013, eighteen countries reported more than 1 800 seizures of synthetic cannabinoids. The largest seizures were reported by Spain (20 kg) and Finland (7 kg).

S.C. Adverse Effects

• reported adverse effects include agitation, seizures, hypertension, emesis (vomiting) and hypokalemia (low potassium levels). researchers have concluded that ‘legal highs’ containing synthetic cannabinoids are potentially more harmful than cannabis

• associated with psychiatric symptoms, including psychosis

• investigations underway in the US regarding links between the use and acute kidney injury

EMCDDA 2013

Homemade Synthetic Cannabis

Marshmallow Leaf

Synthetic Cannabis Powder

Acetone

Elliot• WASTED! Pandoras

Box trip report legal high - YouTube [360p].mp4

“Withdrawal” and “Comedown”

• Feeling anxious• Feeling shaky• Can’t think of anything else• Feel depressed, hopeless• Feeling sweaty Leeds Addiction Unit 1996

• Agitation• Paranoia• Fatigue• Irritability• Insomnia• Panic Attacks• Brain Flashes• Hypnic Jerks

Incite client 2012

Treatment

• Drug counselling.• Residential treatment.• Fellowship and self-help.• Alternative therapies such as auricular acupuncture.• Sleep management.• Clinical Prescribing (GP’s)• Tapering strategies. (especially synthetic cannabis)

Harm Reduction

• Advice around administration route• Test dosing and dosage information• Avoid poly drug use including alcohol• Consider “Set and Setting”• Having a “sitter”• Think about “safe sex”• Getting home safely• Going to sleep on their side

Overdose : Definition

• “Use of any drug(s) in such quantities that acute adverse physical or mental effects occur. It can be deliberate or accidental; lethal or non lethal”

Overdose: Main Risk Factors

• Tolerance• Injecting drugs • Mixing drugs - primarily depressants• Longer history of drug use• Depression and low mood

• Contd.

Contd.

• Poor physical health• Using alone• Homeless user• Not being in treatment• Significant life events

Signs of NPS overdose 

• Dizziness,

•   Dehydration,

•   Rapid heart rate,

•   Seizures,

•   Severe nausea and vomiting,

• Hyperthermia, (very high body temperature, overheating)

•   Serotonin Syndrome

High Risk Times

• Difficult life events – bereavement, loss of contact with children, separation / divorce

• Poor emotional health• Weekends, festive period, leaving home• Using alone• Relapse• Isolation• Buying from a different source

Dealing with an Overdose

• Don’t inflict pain• Don’t give other drugs e.g. stimulants• Don’t put in bath / shower• Don’t walk the person around• Don’t leave person on their own• Recovery position / CPR• Phone 999 without delay

Dealing with overdose?Common myths

DON’T• Attempt to walk casualty around• Inflict pain• Inject stimulants• Inject salt water• Place in cold bath / shower• Insert ice / ice cream in rectum

DRUGS ACTION

“New Psychoactive Substances”.& Overdose Training

Gillian Maclean gmaclean@drugsaction.co.uk

Drugs Action7 Hadden Street Aberdeen Tel: 01224 577120HELPLINE 01224 594700

www.drugsaction.co.uk