New Psychoactive Substances - Understanding and Overdose Prevention

1. DRUGS ACTION New Psychoactive Substances. & Overdose Training Gillian Maclean gmaclean@drugsaction.co.uk Drugs Action 7 Hadden Street Aberdeen Tel: 01224 577120 HELPLINE 01224 594700 www.drugsaction.co.uk

2. 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

3. 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.

4. NPS Packets

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

6. Alexander Shulgin

7. Mephedrone Video

8. EMCDDA 2014 651 Websites in Europe

9. Online Purchase

10. the drugs wheel.com

11. 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 )

12. CREW 2000 2011

13. 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

14. Commonly Used NPS UK. Cannabinoids 3 rd 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).

15. 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

16. Homemade Synthetic Cannabis Marshmallow Leaf Synthetic Cannabis Powder Acetone

17. Elliot WASTED! Pandoras Box trip report legal high - YouTube [360p].mp4

18. Withdrawal and Comedown Feeling anxious Feeling shaky Cant 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

19. Treatment Drug counselling. Residential treatment. Fellowship and self-help. Alternative therapies such as auricular acupuncture. Sleep management. Clinical Prescribing (GPs) Tapering strategies . (especially synthetic cannabis)

20. 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

21. 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

22. Overdose: Main Risk Factors Tolerance Injecting drugs Mixing drugs - primarily depressants Longer history of drug use Depression and low mood Contd.

23. Contd. Poor physical health Using alone Homeless user Not being in treatment Significant life events

24. Signs of NPS overdose Dizziness , Dehydration , Rapid heart rate , Seizures , Severe nausea and vomiting , Hyperthermia , (very high body temperature, overheating) Serotonin Syndrome

25. 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

26. Dealing with an Overdose Dont inflict pain Dont give other drugs e.g. stimulants Dont put in bath / shower Dont walk the person around Dont leave person on their own Recovery position / CPR Phone 999 without delay

27. Dealing with overdose? Common myths DONT Attempt to walk casualty around Inflict pain Inject stimulants Inject salt water Place in cold bath / shower Insert ice / ice cream in rectum

28. DRUGS ACTION New Psychoactive Substances. & Overdose Training Gillian Maclean gmaclean@drugsaction.co.uk Drugs Action 7 Hadden Street Aberdeen Tel: 01224 577120 HELPLINE 01224 594700 www.drugsaction.co.uk