Supply and demand: drug markets in transition

Supply and demand: drug markets in transition

Durham, 26th March, 2015

 

The new drugs scene is changing very quickly and we need to stay on top of what is happening.  In light of this, our first two papers considered key questions in the development of markets for newly psychoactive substances: (i) how can we usefully classify NPS, and (ii) what do we know about synthetic cannabinoid use?

 

How can we usefully classify new psychoactive substances?       Russell Newcombe

 

  • New drugs can be new in several ways: because they have been newly made or newly discovered, because they have been newly formulated (e.g. alcohol in powder or vapour form), because they have been newly marketed on the large scale, or because they are being newly used by larger numbers of people than before.
  • There is nothing necessarily new about legal highs – e.g. laughing gas, alcohol, tobacco.
  • 2009 is a key moment in the development of new drugs because from 2009 onwards, amendments to the MDA 1971 to ban new drugs became routine.
  • New drugs can be classified in several ways: by source (e.g. chemical or electronic), by legal status (how they are regulated), by psychopharmacology (how they affect the brain), or by taxonomy (a combination of chemical groups and mental effects).
  • Almost all new drugs are chemical in nature at the moment, but could we start to see a rise in electronic highs (e.g. altering brain waves using electricity) once the psychoactive substances bill come in?

 

What do we know about synthetic cannabinoid use?     Mike Linnell

  • Cannabis is a partial stimulant of an area of the brain known as CB1. Synthetic cannabinoids are a total stimulant of the CB1 area of the brain, and also stimulate another area known as CB2.  Synthetic cannanbinoids are therefore much more potent.
  • Research chemists developed models for making synthetic cannabinoids in the 1980s, but they have only more recently actually been formulated. The chemicals are sprayed onto smoking materials so they can be used in the same way as cannabis.
  • The synthetic cannabinoids aren’t necessarily chemically similar to THC, but they affect similar areas of the brain. In the early days, synthetic cannabinoids were more cannabis like, but the market is now more dominated by the most potent versions.  Different strains of synthetic cannabinoids can be very different from each other.
  • Preliminary research in a city in the North West of England (conducted by Measham, Linnell and Newcombe, as yet unpublished) suggests that users report finding synthetic cannabinoids much stronger than cannabis, and actually not that similar to cannabis. Not many people are in treatment for their synthetic cannabinoid use, but this may be because treatment is still overwhelmingly geared towards long term, dependent heroin users.
  • The research also found very high levels of use amongst vulnerable groups such as the homeless, people living in care homes, young offenders, and adults residing in prison and leaving prison. It suggests that synthetic cannabinoids have been relatively prevalent within young offenders institutions and prisons for the last 7 years.  Interestingly, many members of the prison population said they initially started using synthetic cannabinoids instead of cannabis so they didn’t get picked up by prison drug tests, but that they would prefer to smoke cannabis if possible.  More recently, members of the prison population report valuing synthetic cannabinoids over cannabis because they are cheaper and more effective.  They have become a drug of choice for those in prison and those coming out of prison.  Most people (e.g. prison staff, treatment providers) think that they are more dangerous than cannabis.
  • Finally, the research points towards a highly addictive nature of synthetic cannabinoids. Users report severe withdrawal symptoms that are not alleviated by cannabis use.
  • A blanket ban on all substances will stop the cat and mouse game that sees new substances produced as older ones are banned and will close down headshops. But there are many other ways to get hold of synthetic cannabinoids and a completely unregulated market will be even more dangerous.

 

 

Given the changes outlined above, we need to explore alternatives to prohibition that deliver the best outcomes in terms of public health.  The next three papers explored the provision of drug checking services in the night time economy and the benefits these could bring to users, particularly in light of the rise in numbers of new psychoactive substances available on the scene.

 

  • Rainer Schmidt discussed ‘Checkit’ which started in Vienna in the 1990s to check ecstasy pills.It is funded by the city of Vienna as an official drug prevention project. It comprises drug checking and information dispersal at large scale music events.  A mobile lab is situated on a bus and a safe space is provided for drug related counselling. The aim is to minimise the harms of recreational drug use by providing drug users with the information they need to take drugs responsibly.  The checking service has to be fast – 20-30 minutes – to be useful to the users.  It is also a good way of finding out information about what people want (what they think they are buying) and what they get.  People seem to want ecstasy and amphetamine, and, on a smaller scale, cocaine. Most people don’t want to buy new drugs.  Only 25% get what they want.  The rest are getting very pure versions of what they want, or getting something different from what they want.  15-20% are getting something very risky like PMA.  It’s a good way to reach groups very quickly in a very credible way, and to provide information that is highly relevant to them.  The information collected can also be used to publish more general and widespread warnings.  The bus is always accompanied by social workers and drug counsellors.  People anonymously donate a small part of their substances for analysis and receive the results.

 

 

 

  • Deirdre Ruane told us about her doctoral research at the University of Kent with the providers of peer to peer harm reduction services, providing care and support for drug users, at festivals. One of the areas Deirdre’s research has explored is the impact of national drug policy on the provision of these kinds of services. In Portugal, for example, this kind of harm reduction service is government sponsored and includes a drug checking service.  At one particular festival, when drug users showed up showing unusual effects from taking LSD, the information from the checking service was able to show that they had taken DOX instead which had a much longer intoxication period.  Providers of harm reduction and medical staff were able to make use of this information to provide better care for drug users, and the users themselves were able to identify and avoid the dodgy batches of LSD.  At a similar festival in the UK, drug use wasn’t officially condoned and harm reduction services had a much less secure footing from the outset.  They didn’t have a drug checking service and didn’t have a link up with medical staff.  When drug users showed up displaying unusual effects from taking MDMA, there was no way to test what they had taken and no one to ask about the best way to care for them.   These results suggest that it is in everyone’s best interest to know what a substance actually is – the police, the health care providers, and the users themselves.

 

 

  • Fiona Measham explained how In the early 1990s harm reduction principles were transferred from problematic drug users to recreational drug users, but by 2012 harm reduction for recreational drug use seemed to have gone backwards with an increased emphasis on absolute recovery. New generations didn’t necessarily know about harm reduction messages from the 1990s.  The Loop was formed in Manchester to provide harm reduction services at festivals and nightclubs.  It provides services every weekend at big dance events like the Warehouse Project and Transmission.  In terms of drug checking, what is sometimes offered in the UK is ‘Back of house testing’ where police and door staff send off samples of what they have found for testing.  This usually takes place off site and the results will go back to the police and may possibly go to medics.  The Loop offers ‘Halfway house testing’ of samples on site provided by a wider variety of sources (e.g. bar staff, cleaners, welfare staff) and returns the results to all those sources as well as via social media.

Results suggest that people mostly want to be taking MDMA or Ketamine, but often end up with NPS.

 

 

The advent of new drugs has also precipitated mutations in the way that substances are marketed and supplied.  The final two papers explored the way that online markets (cryptomarkets) are changing the demand for and supply of new psychoactive substances and human enhancement drugs.

 

  • Monica Barrett focused on whether cryptomarkets facilitate new users of drugs – people who wouldn’t otherwise have bought drugs. Most people who used cryptomarkets had bought drugs previously, but 5% of respondents to the Global Drugs Survey had never bought drugs before the rise of cryptomarkets. These people tended to be young and to have only started using drugs relatively recently.  They tended to bypass cannabis and move straight to psychedelics.  Their motivations for using cryptomarkets were because they didn’t have the connections to buy drugs in any other way, they felt safer buying drugs online, and they preferred the online culture.

 

  • Charlie Mcclean and Jennifer Brizell explored the marketing of human enhancement drugs.  Substances that helped to reduce weight or build muscle were regularly advertised in newspapers in the 19th  The same kind of things are on offer today and advertising strategies remain very similar (celebrity endorsements, harms glossed over), but the reach is much wider because of globalisation and the internet.  The sites are very consumer friendly, but some of the substances on offer are illicit.  Use of these products is starting to move from small communities into the general population.

 

 

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