19 March 2010

Media muddle over mephedrone

Mephedrone (aka meow meow, M-Cat etc) clearly has harmful effects - our Druglink magazine recently reported on a case where several young people were hospitalised after using it, and the internet is full of chat about bad experiences under the influence of the drug.

But it is perhaps not surprising that having discovered the latest ‘new drug scare’, the media should have got many aspects of the story wrong either because it didn’t fit what they wanted to write or because one piece of misinformation is picked up and repeated time and again until is becomes enshrined in ‘the facts’. So are what some of the myths about meow-meow?

Mephedrone is plant food
No it isn’t. Try putting it on your tomatoes and see what happens. In fact, mephedrone could have been marketed as shoe polish or anything. This is simply a ruse used by sellers to try and dodge medicines and poisoning legislation by saying that the substance is not being sold for human consumption. Earlier this year a spokesman for the European Fertiliser Manufacturers’ Association said: “It [mephedrone] is never used in any products that people would use to fertilise plants.”

Mephedrone is responsible for drug deaths in the UK
Media reporting has ‘linked’ mephedrone to fatalities, but that isn’t the same thing as the drug being directly attributed as ‘the cause of death’. In fact, the closest to a death directly attributable to mephedrone has been reported from Brighton: toxicology reports on a 46 year old man who died from a heart attack revealed high levels of mephedrone, although the inquest wont take place until the end of May.

Media reporting on the deaths of two young men from Scunthorpe have declared mephedrone as the cause of death. But currently Humberside police are investigating the possible role played by alcohol and methadone as well as mephedrone in the fatalities. Late last year, it was widely reported that the death of a 14-year old girl also from Brighton had been caused by mephedrone. The eventual inquest and toxicology tests determined that the girl had died of natural causes following a "cardiac arrest following broncho-pneumonia which resulted from streptococcal A infection". Despite this, some media coverage is still reporting the case as a ‘mephedrone death’.

Teachers are powerless to act because the drug is legal
Teachers are perfectly entitled to confiscate any item they wish from school students if the item breaks school rules or in any way puts the students or others at risk.

The government is dragging its feet over banning the drug.
No it isn’t. The government is obliged by law to consult its drug experts as part of the process of deciding whether or not a drug should be controlled. If they decide it should be controlled, then the legislation has to be drafted and put through the parliamentary process. Because the Misuse of Drugs Act is a legal instrument, this has to be done carefully and so naturally does take some time. It is simply mischievous to suggest ‘lives could have been saved’ if the government had acted more quickly

Banning the drug would remove the problem
It does seem that some young people who are not normally part of the drug scene have been encouraged both to use and sell the drug because it is legal. It is reasonable to assume that if mephedrone was banned, this group would probably stop for fear of prosecution or because of its illegal status. Banning the drug would address its open sale. However, it is clear from internet postings that regular drug users have been using mephedrone both because it is legal and because the purity level is more guaranteed than drugs like amphetamine or cocaine.

If the drug were banned, it is less likely this group would stop using, unless the very act of banning means that with less of the drug in circulation, it just becomes part of the regular illicit dealing network where all drugs are cut. The additional problem with controlling mephedrone is stopping internet sales from the sites located in countries where the drug is not banned, although imports into the UK would be illegal.



18 January 2010

And here is your starter for 2010

The January/February issue of Druglink, the first for 2010 in this, DrugScope’s 10th anniversary year, focuses on the changing landscape of drugs in the UK. Former legal highs Spice, BZP and GBL are legal no longer. Another ex-legal high, ketamine is now proving to be a real problem for more entrenched users, while the Maudsley Hospital in south London has opened a special clinic for those dependent on GBL. But the biggest surprise has been the rise of mephedrone which has come from the backwaters of internet chatting into the mainstream. Back in March ’09, Druglink highlighted growing interest in the drug; recent media interest reportedly saw online shops selling out. Although the death of a girl in Brighton proved not to be the UK’s first mephedrone-related death, even so there are now several reported incidents of hospital admissions and other problems associated with its use.

In that article, back in March, we suggested that the internet may begin to challenge traditional dealing networks for drugs and this certainly seems to be the case with mephedrone. It also highlights the problems of enforcement. Should the drug be controlled, as seems very likely before the end of the year, this will probably help stifle supply within the UK; shops will stop selling it and those who seem to be dabbling in dealing because mephedrone is currently legal, will probably stop as well. But that still leaves the internet trade and the problems of trying to stop mephedrone coming into the UK through the post . Mephedrone will still be legal in many countries of the world where it will not be illegal to host websites selling it.

There was a time, when years might elapse between new drugs appearing on the scene – the arrival of smokeable heroin, crack and ecstasy was spread over nearly a decade. But the internet offers opportunities for global high speed information exchange and for the wholesale and retail delivery of new substances which can only complicate control efforts and may hasten consideration of alternative enforcement regimes.

The issue of control of course, leads us to the role of the ACMD. Professor Les Iversen is now the acting Chair while his predecessor has established a rival council based at the Centre for Criminal Justice Studies. Professor Nutt has announced that in effect his group will ‘take care of the science’, leaving the ACMD to consider aspects of social policy and treatment. Yet the Independent Scientific Council on Drug Harms will be operating outside government. Irrespective of how many eminent scientists it has in its ranks, it will still be down to the ACMD to make recommendations to government on drug control, including considerations of the scientific evidence.

The big danger is that the new group and the ACMD will be left jousting over analysis of all future drugs which hove into view, such as mephedrone - and the media will lap up any contradictory recommendations. It is important therefore that the work of the ACMD does not become limited to discussions about drug classification. It has a proud tradition of producing landmark reports which have been instrumental in shaping UK drug policy and needs to develop an equally dynamic agenda for the future.

And of course, it is Election year. But we will save that for next blog.

16 November 2009

Wither the ACMD?

The sacking of David Nutt has laid bare some uncomfortable truths for the future of the ACMD. The meeting with the Home Secretary and officials focused on protocols, principles and generally clearing the air. But it remains that whoever wins the next election, any recommendations that a drug be re-graded downwards will likely be rejected, allowing only for initial control or more punitive penalties, very much against the spirit of the three tier classification system.

As Professor Nutt acknowledged in the lecture that prompted his departure, there are many factors other than objective scientific facts which help determine the decisions on individual drugs and the general momentum of drug policy including political drivers and public opinion. But as we all know, the use of drugs is a highly emotive issue, riven with deeply held ideologies and beliefs; for some drug use is a moral issue – all use is bad and the nuances of relative harm are irrelevant. Even so, the Act is a legal instrument and not a vehicle simply for sending out public messages. In all the storm-tossed waters of the drugs debate, it is critical that policy is firmly lashed to the evidence mast, and if government does go against those charged with giving advice, there should be transparent reasoning behind it. Otherwise we face slipping into the American model where the Drug Enforcement Agency for example plays a key role in determining policy and there is hardly any pretence that independent advice has any role at all.

11 September 2009

An idea whose time has come

This year’s Druglink survey of street drug trends found that a drop in the quality of drugs could be accelerating a longer term trend towards poly drug use – taking a variety of different substances in combination or at different times – as users look to ‘top up’ on low quality drugs or experiment with alternatives. In turn, some survey respondents suggested that the shift towards people using a more varied menu of drugs means users are less concerned about the quality of each individual substance.

In some areas older teens and younger adult recreational users are swapping or combining substances including cocaine, ketamine, GHB/GBL, ecstasy, cannabis and alcohol. At the same time, some areas reported an increase in young users turning their back on crack and heroin. Problem drug users in most areas are often using heroin and crack cocaine alongside cheap, strong alcohol, skunk-like cannabis, tranquillisers and, in some cases, ketamine.

The trend is a reminder of one of the issues that came out of our Drug Treatment at the Crossroads report. If we persist with too narrow a definition of ‘problem drug use’ that focuses on heroin and crack cocaine we are unlikely to be equipped to meet new challenges as drug trends change.

Recent discussions we’ve had with young service users, drug education and drug treatment professionals as part of our forthcoming Young People at the Crossroads work have reinforced the fact that the next generation of ‘problem drug users’ appear to be developing issues linked to cheap alcohol cannabis, cocaine, ecstasy and tranquilisers. To what extent are services equipped for this and how flexible can they be?

Survey respondents expressed concerns that the low quality of stimulants such as cocaine, crack, speed and ecstasy pills could be contributing to a growing interest in other substances. Ketamine, the hallucinogenic anaesthetic, was reported as being used by a growing number of older teens and young adults in 18 out of 20 areas surveyed. For the first time in the survey’s five year history, some drug services raised concerns about the use of the so-called ‘legal highs’ GBL and mephedrone.

Although still low on the radar, ‘legal highs’ are set to play a far bigger role in complicating the picture of drug use that frontline treatment workers will be dealing with. And it won’t just be a potential problem for health. A recent EU-funded survey revealed over 300 compounds which mimic the effects of illegal drugs, so the control of Spice, BZP and GBL could just be the start of a very busy time for the ACMD. But with the prospect of many more new drugs appearing quickly on the market, the example of Spice serves to emphasise the need for a review of the Misuse of Drugs Act, promised but not delivered by the government in 2006.

The ACMD concluded that primarily on the basis of the potential harm from the synthetic cannabinoids found in some samples, Spice should be a controlled drug. But they deliberately did not recommend a classification. Why? Because against ACMD advice, cannabis had been reclassified to B. The ACMD clearly did not think that Spice warranted Class B penalties any more than cannabis did – but kept quiet on the matter. Inevitably (and within the logic of the Act) Spice will be made a Class B drug so now we have the bizarre situation where Spice is legally deemed more harmful than the addictive and lethal GBL, not to mention tranquillisers and anabolic steroids.

But it isn’t simply a question of where any particular drug sits in the ABC grading. In the light of an ever-increasingly complex drug landscape coupled with questions over the capacity of the police to enforce the laws and what constitutes a threshold of ‘harm’, we need a root and branch review of the Act.