New Psychoactive Substances. Legal Highs - The facts

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1 New Psychoactive Substances Legal Highs - The facts

2 Just because they are legal doesn t mean they are safe! In the last few years there has been increasing availability and use of a range of new psychoactive substances (NPS), commonly known as legal highs or research chemicals. New Psychoactive Substances (NPS) is an umbrella term used to describe a broad range of substances with different chemical and pharmacological properties that are not controlled by the UK Misuse of Drugs Act. These products include a wide range of synthetic and/or plant based chemicals intended to mimic the effects of illegal drugs e.g: Stimulants like cocaine and amphetamine, hallucinogens like cannabis and LSD, sedatives like diazepam and ketamine and mood altering/enhancing drugs like ecstasy, to name but a few. These products are widely available from high street shops and via the internet in a variety of formulations (powders, crystals, tablets, capsules, liquids, pre-rolled joints, smoking blends, herbal mixtures). Many suppliers use descriptions such as bath salts, incense or plant food. They are marketed and sold in brightly coloured packaging under the disguise of harmless products like herbal blends, incense, air fresheners, research chemical powders or pills and state on the packaging: Not for Human Consumption Some are cleverly marketed as being plant based natural highs - suggesting they are more natural and therefore less dangerous than other drugs. However, NPS are far from harmless, with increasing reports of a broad range of adverse effects to both physical and mental health. There are often no ingredients listed on the packet, so it is very hard to know what is being taken.

3 The main chemical groups include: Synthetic cannabinoids, cathinones, piperazine-derivatives and hallucinogens. Synthetic cannabinoids Synthetic cannabinoids are dry herbs that have been sprayed or soaked in one or more synthetic chemicals. They are functionally similar to THC (one of the active components in cannabis). Like THC, they bind to the same cannabinoid receptors in the brain. All of the synthetic cannabinoids currently being marketed are much stronger than THC. Street names: Red Dragon, Doob, Exodus Damnation, K2, Cherry Bomb, Spice, Black Mamba, Tai High, Hawaiian Haze, Mary Joy, devil s weed, Clockwork Orange, Bombay Blue Extreme, Blue cheese, Annihilation, Amsterdam gold. Effects: When smoked, is fast acting and has skunk-like qualities but is more likely to cause uncomfortable distortions in reality and hallucinations. Risks: Common side effects are increased blood pressure and heart palpitations, nausea and vomiting, breathing difficulties, painful rash, loss of control of body parts and anxiety attacks with an increased risk of seizures, agitation and acute psychosis. It is reportedly as habit-forming as cannabis but long term risks associated with its use are unknown. Likely to present long-term risks of serious psychiatric disorders like schizophrenia.

4 Some of these compounds have now been made Class B drugs (illegal under the Misuse of Drugs Act), therefore are illegal to possess and supply. Synthetic cathinones Cathinone is a naturally occurring substance similar to amphetamine found in the leaves of the Catha edulis (khat) plant. Mephadrone (MMCat, Miaow Miaow, Bubble, bath salts) is one of the most popular cathinone derivatives. However mephadrone is now a Class B drug hence similar alternatives have been reproduced. Khat was also banned in Sold as a white crystalline powder or as capsules and usually taken via snorting or by either swallowing capsules, bombing (wrapping powder in cigarette papers and swallowing) or dissolving it in liquid. Some have been found to contain ethylphedinate, which when taken with alcohol, transforms into methylphenidate or Ritalin (a drug used to treat ADHD). Therefore, what starts out being legal ends up a Class B drug. Methiopropamine is sometimes mixed with MDAI which is closely related to MDMA (ecstasy) which is a Class A drug.

5 Also, sometimes cut with lignocaine, which numbs your face like cocaine and can also be cut with caffeine. Street Names: Ching, Mr White, Gogaine, Charly Sheen, Sparklee Effects: Users compare its effects to those of cocaine, methamphetamine (crystal meth), amphetamine and ecstasy. Subjective effects most often described include euphoria, increased sociability, increased level of alertness and confidence, intensified sensory experiences, sexual arousal and craving for more. Risks: The most common adverse effects reported are agitation, palpitations, headache, chest pain, tremor, insomnia and paranoia, also facial tics and increased risks of arrhythmia and cardiac arrest. Piperazine Derivatives Benzylpiperazines (BZP) and trifluoromethylphenylpiperazine (TFMPP) are being used as substitutes for amphetamine derived so called designer drugs. BZP produces a stimulant effect similar, although milder, to that of methamphetamine (Crystal Meth) and when combined with TFMPP it produces euphoria similar to ecstasy (MDMA). Street Names: Herbal Ecstasy, 2-DMP, Mitsubishi, Pink Panthers, MDAI

6 Methylenedioxypyrovalerone (MDPV) is currently being marketed with names such as Ivory Wave, Vanilla Sky, Pure Ivory and Purple Wave. Benzo Fury is now banned, so it is illegal to possess or supply. Effects: Users report effects similar to ecstasy ; increased energy, sociability, euphoria, mental stimulation, sexual stimulation and empathy. Side effects include: fatigue, insomnia, nausea, muscle twitching, palpitations increased body temperature, difficulty breathing, hypertension, confusion, tremors, vomiting, anxiety and paranoia. Risks: Hyperthermia, irritability, paranoia and panic, low mood, hallucinations, seizure, collapse, liver failure and heart problems. Risks can be more extreme if you already have underlying mental health problems or heart or liver problems. Other Examples: Methoxetamine (Mexxie, MXE, MKet) is an anaesthetic with painkilling and hallucinogenic properties similar to ketamine. It was produced as a legal alternative to ketamine, until it was made illegal in February 2013.

7 Effects: Dissociative ; numbs the body, and creates the effect of removing users from their sense of reality. The effects depend on the amount used but are also influenced by the user s mood and environment. The effects can be inconsistent, and vary from session to session and person to person. Small amounts can cause feelings of euphoria and stimulation. At higher doses it can make you feel floaty and disconnected from reality. At larger doses it can bring on confusion, hallucinations, paralysis and out-of-body experiences. Risks: Confusion and loss of spatial awareness and can lead to accidents and serious injury without realising you ve been hurt. High doses can cause breathing problems, unconsciousness or heart failure. They can be extremely dangerous when mixed with other drugs or alcohol. They can cause agitation, tachycardia (racing heart), hypertension (high blood pressure), ataxia (unsteadiness on the feet), perceptual changes or hallucinations, in addition to their effects on reducing bodily sensation. Users can trip for up to an hour or more and may feel after-effects for several hours afterwards. Some users have experienced traumatic flashbacks. What to do if someone is anxious or panicky: Seek medical help Keep them away from loud noises and bright lights, encourage them to go to a quiet, dimly lit room.

8 Speak in a calm, normal voice. Reassure them that their feelings will go away. If they re breathing fast and shallow tell them to take long slow breaths. Don t startle or frighten them. What to do if someone is drowsy: Seek medical help immediately! Don t give them anything to eat or drink. Get them to somewhere they won t fall over or injure themselves. Stay with them and talk to them to try to keep them awake. Try to stop them becoming unconscious and don t put them to bed. What to do if someone is unconscious: Call for help immediately Dial 999 If person is breathing, place in recovery position

9 Anecdotal Evidence from users of New Psychoactive Drugs: I became psychotic, as if someone was taking thoughts out of my head...no one really knows what the long term problems will be. if you get addicted you will do anything to get hold of it, it becomes a vicious circle until you get help. my friend was so bad on it he tried to hang himself.

10 it s just a business for drug dealers, they don t care about you or have morals. they mess with your brain and you don t know what s in them....i really thought I was going to die.

11 Patient Advice and Liaison Service The Patient Advice and Liaison Service (PALS) acts on behalf of service users, families and carers to negotiate prompt solutions and help bring about changes in the way that services are developed. As well as providing a confidential advice and support service, PALS will help guide you through the different services available from the NHS. Tel: Comments and complaints We want to learn from comments and complaints about our services. If you have any, please speak with a member of staff. Every effort will be made to resolve any concerns and complaining will not cause any difficulties in your care with us. You can also contact the Trust s Complaints Department via post at Trust Headquarters, 225 Old Street, Ashton-under-Lyne, OL6 7SR. Tel: complaints.penninecare@nhs.net Become a member of our Trust You can be the voice of your community by electing or becoming a governor, find out more about your local mental health and community services, and receive updates, comment on our plans and get invitations to health events. Tel: ftmembership.penninecare@nhs.net Alternative formats If you need help to understand this information, require it in another format such as large print, spoken (on CD) or Braille, or require it in a different language speak to a member of staff.

12 For further advice and information Contact your local drug and alcohol service. If you want to talk, you can call FRANK 24 hours a day, 365 days a year on or Date of publication: March 2015 Reference: 3512/Psychoactive Substances leaflet Pennine Care NHS Foundation Trust