‘Legal’ highs – what you need to know
So-called legal highs are as harmful and as addictive as illegal drugs – but information is minimal or inaccurate. Professor Fabrizio Schifano keeps readers in the loop
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Over the last 10 years, novel psychoactive substances – NPSs or ‘legal highs’ – have become increasingly available to those looking to abuse them in the UK. Not only are they advertised and sold widely on the internet and head shops but they are also sold as “safe” and “legal” alternatives to illicit drugs. In reality, they can be just as harmful and addictive as illegal drugs such as cocaine, ecstasy or ketamine. Information on their effects is minimal or inaccurate.
The fast-paced development of further NPSs combined with the ability of the internet to spread information quickly presents a number of challenges for public-health bodies across the globe. In 2013, more than one new substance was reported every week. And in April, the United Nations reported that 348 new types of synthetic drugs have appeared in over 90 countries, with the UK continuing to top the list of usage.
These products are just a ‘click away’ from being delivered to our homes and thus potentially available to everyone, especially young people who are among the most at risk. Convenient labelling of NPSs maintains that they are “not for human consumption”, creating a legal loophole that allows them to be distributed cheaply, remain legal and easy to obtain.
Popularity of NPSs is on the rise because standard drug tests do not have the capacity to identify all the substances within them.
While drug users might view this as an opportunity, it also has very dangerous consequences. With limited knowledge of an NPS pharmacological/toxicological profile, their use is dangerously experimental and potentially fatal. Many of the NPSs are research chemicals, sometimes even discarded products from drug research. They are produced mainly in asian countries and usually on a large scale.
Overall, the NPS pertain to a range of different categories, including:
• Latest generation phenethylamines/MDMA-like drugs, such as ‘fly’, NBOMe, DMAA and indanes’ PIA derivatives
• synthetic cannabimimetics
• synthetic cathinones
• Latest generation tryptamine derivatives such as 5-Meo-DALT, AMT etc
• GHB-like drugs
• PCP-like drugs, such as methoxetamine, 3-MeO-PCP etc
• Piperazines, such as BZP
• Herbs/plants, such as salvia divinorum, mytragina speciosa/kratom
• medicinal products including: tramadol and remaining opiates/opioids, gabapentinoids, novel benzodiazepines/sedatives such as phenazepam ‘Zinnie’, stimulants such as ethylphenidate antiparkinsonian/anticholinergics (e.g. orphenadrine; tropicamide)
• PIEDs: super strength caffeine tablets; cognitive enhancers such as piracetam.
Currently, Misuse of Drug Acts are being amended by governments to cover some of the above, and we can expect to see more updates to cover more products.
PROFESSOR FABRIZIO SCHIFANO MD, MRCPsych, Dip Psychiatry, Dip Clin Pharmacology is chair in clinical pharmacology and therapeutics, School of Pharmacy, University of Hertfordshire, and a member of the Advisory Council on the Misuse of Drugs. He is one of the few physicians with training and specialist qualifications in both psychiatry and clinical pharmacology and has contributed to the biomedical science as well as the clinical science of addiction. He has also made a significant contribution to several areas in addiction psychiatry and general psychiatry, including: stimulant synthetic drugs, mortality studies (Professor Schifano co-supervises and co-leads the National Programme on Substance Abuse Deaths (npSAD)), the internet and drugs. This is a new area of research and Professor Schifano is the Principal Investigator of the third consecutive EU Commission-funded, multi-centre Psychonaut/ReDNet research programme. Results from these studies have provided the only comprehensive and multilingual analysis of the information available online on psychoactive compounds to date.