'Legal Highs or Legal Killers' Conference Presentations

Legal highs or legal killers?

Tackling the spread of New Psychoactive Substances

Welcome & introduction from the chair

Michael Lawrence, CRI

Doing nothing is not an option: a parent’s perspective

Maryon Stewart, Angelus Foundation

Nottingham Conference Centre – 18th September 2014

PARENT’S PERSPECTIVEMENTOR CONFERENCE

Maryon StewartFounder of The Angelus Foundation

Hester1987 - 2009

The Mephedrone Explosion

Temporary Banning Order

Focus Groups and Surveys

National Poster Campaign

Whynotfindout.org

Focus Groups and SurveysOur schools programme was delivered to over 1,200 young people

Our data shows:

Before viewing the film 50% of young people believe legal highs are not safe at all to not safe

After viewing the film 91% of young people believe them to be not safe at all to not safe

96% of young people said that watching the film has put them off experimenting with legal highs

71% expressed feelings of being misled by so-called “legal” highs

Schools Programme

25 Festivals blackout their website

The Real Deal

• Online challenge - The Real Dealwww.yourvine.com/realdeal

Parent’s Films

Website for parents:

www.angelusfoundation.com

To download parents handbook:

http://www.angelusfoundation.com/parents-handbook/

Parent’s Community

Contact details

www.angelusfoundation.orgwww.whynotfindout.org

Email: contact @angelusfoundation.comOr

maryonstewart@angelusfoundation.com

Tel: 02037007185Mobile: 07973713139

Angelus Foundation is a registered charity (number 1139830)

A brief tour through the world of legal highs

Ricky Bhandal, Public Health Birmingham

Ricky Bhandal@ranjitbhandal

Ricky.Bhandal@birmingham.gov.uk

A VERY Brief Tour Through The World Of Legal Highs: What challenges Do They Pose?

Ricky BhandalBirmingham Public Health

Copyright Ricky Bhandal

Please do not reproduce without permission

Legal Highs, is it new?

Definitions: NPS, legal highs, club drugs

• ‘New psychoactive substances’ (NPS) are drugs which mimic, or are claimed to mimic, the effects of illegal drugs. They are either ‘new’ or ones that until recently were little used in the UK.

• ‘Legal highs’ – see above. Although marketed as legal, this doesn’t mean that they are safe or approved for people to use. They are still normally considered illegal to sell under medicines legislation. Some drugs marketed as legal highs actually contain some ingredients that are illegal to possess.

• ‘Club drugs’ is a collective term for a number of old (e.g. ecstasy, ketamine, methamphetamine and GHB/GBL) and new drugs (e.g. mephedrone) typically used by people in bars and nightclubs, at concerts and parties

• ‘Blah, Blah, Blah’: All these terms are often used interchangeably even in official reports

My History

NPS That have made it

Mephedrone

Past / Present Topical Legal Highs• BZP Benzylpiperazine – De-worming for animals• MPTP - Parkinson's• Neo Dove 3• Neo Malt• Methadrone – Similar to Mephedrone • Khat• MDPV – focused > Cocaine > annoying• Methylone (M1) – More Ecstasy feel £16 and £20 per gram • Butylone – Similar to other Cathinones

Google Trend

Google Trends

The Perfect Storm

Profit

Experiment

And don’t forget the media!

Google Drugs

Do it Yourself

NRG-1 Prices

•1 grams - £20

•2 grams - £30

•10 grams - £100

•100 grams - £550

•500 grams - £1500

•1kg - £2800

Herbal Highs

Raz in Detail

Mary Jane

New Website

All about Recovery!

JWH-018

Lets Buy Some!

Who’s to blame? Social Media

• Twitter• Facebook• Youtube• Erowid• Bluelight• Drugs Forum• http://youtu.be/VMZngerFxjs

Silk Road

Dark Net

Headshops

New psychoactive substances – stocktake

• New psychoactive substances (NPS) are emerging at an unprecedented rate, though treatment numbers are small

• NPS (typically sold as ‘legal highs’) may contain substances that are not legal or even safe. The availability of these substances, especially over the internet and in ‘head shops’, has radically changed the nature of the drugs market.

• UK purchases 4 x more NPS than any other European country (EMCDDA 2012)• Increasing public and government concern• Heavy use can lead to acute health harms and dependency• Little information on new NPS and their associated health risks – surveillance

data takes time to catch up • Problems can be treated, but treatment/GUM services need to be vigilant and

Health risks and dependence-forming potential

• Users also tend to binge on NPS. As a result, they are more likely to show up at A&E or their GP surgery reporting acute health effects such as heart irregularities or feeling paranoid.

• Evidence suggests a minority will use compulsively and develop a psychological dependence that requires treatment. We don’t yet understand why some people develop problems and others don’t

• NPS can kill, very risky when used with alcohol/other sedatives. • Injecting: NPS mostly not injected, but increasing concern about the

injection of mephedrone and methamphetamine• Heavy use can develop into a dependency

Treatment

• Treatment should typically involves psychosocial interventions, which address basic motivation and prevent relapse.

• Promote reliance on core drug working competences, dealing with the individual and HR advice that fits the main 'clusters' of drugs (e.g. encourage services to focus on people not the drugs they are using)

• Support improvements in needs assessment, commissioning and provision for NPS

• Commitment to disseminate NPS clinical guidelines (NEPTUNE) • Encourage better links between treatment, health and sexual health

6 Ways to Deal with NPS

• Acknowledge ignorance

• Work symptomatically

• Share Knowledge

• Cluster Drugs

• Keep sight of skill sets

• Get tech savy

Both sides of Ignorance

Open forum for questionsfollowed by coffee

Integrating legal highs into wider education & prevention interventions

Professor Harry SumnallLiverpool John Moores University

The role of the criminal justice system

D.Supt. Jason Hudson, TITAN

Open forum for questions followed by lunch

Public health messages & working with young people

Andrew Brown,Drugscope

NPS Education and PreventionA tricky balance

Photo by Flickr user stephenjohnbryde

A visible presence

Awareness, knowledge and general attitudes towards “legal highs” amongst UK students

• Survey of 446 students between ages of 13 and 30 in UK (mean age 19, median 18 years) carried out online, late 2010.

• 82% said they had heard of ‘legal highs’, of which 79% offered correct definition (5% wrong)

• 31% lifetime use– 41% mephedrone, – 20% salvia, – 11% ‘spice’, – 16% “don’t know”

• Over half (51%) knew ‘some’ contain illegal or controlled components

• Three in four (74%) said they didn’t consider them safer than illicit drugs

• Of those who had used a ‘legal high’ over half (53%) said the legal status makes no difference to their likelihood of using the drugs, one in four said it would make them less likely to use, and 4% said it would make it more likely.Source: Corazza, O. et al. “Legal highs”: safe and legal “heavens”? A study on the diffusion, knowledge and risk awareness of novel

psychoactive drugs among students in the UK, Riv Psichiatr 2014; 49(2): 89-94

What do we know about young people’s use of NPS• Crime Survey for England and

Wales found young adults, aged 16 to 24:– 7.6% had taken nitrous oxide in the

last year– 1.8% had taken salvia in the last

• Global Drug Survey – 20.4% had taken nitrous oxide in

the last year– 10.9% had taken ‘mystery white

powder’ in the last year– c.13% said they had taken a legal

high/research chemical/synthetic cannabis & electronic THC

Photo by Flickr user Yaniv Golan

Young People in Treatment for ‘Club Drugs’

2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-130

Ketamine Ecstasy MephedroneSource: Young People’s Statistics from the National Drug Treatment Monitoring System (NDTMS), Public Health England (2013)

DrugScope’s Street Drug Survey 2013

• Mephedrone-type stimulant drugs were popular with older teenagers;

• Younger teenagers were more attracted by the synthetic cannabinoids

substances with lurid names such as Clockwork Orange and Exodus Damnation;

• Few young people bought drugs online, but were able to buy not only from head

shops, but a range of high street outlets including petrol stations and take-away

food shops, especially in the north of England;

• While few young people were coming forward to treatment services, outreach

workers told a different story about patterns of use and of young people at risk

of serious health consequences.

NOT JUST ABOUT YOUNG PEOPLEBut remember it’s

Other groups and settings to think about:• LGBT – especially MSM• Complex needs clients (mental health,

homelessness, criminal justice• Prisons• Students• Clubs & some clubbers

WHAT SHOULD WE DO?

Photo by Flickr user Ian Page-Echols

A life course approach

Source: Davies, S.C. “Annual Report of the Chief Medical Officer, Volume One, 2011, On the State of the Public’s Health” London: Department of Health (2012)

And for NPS specifically?

• Increase our understanding of prevalence – use, harms and at risk groups

• Ensure NPS covered in wider personal social and health education

• Think beyond schools and universities– Environment, Community, Family, Workplace

• Tailored messages to reduce harms• Develop and learn from evidence• Understand routes into specialist services

And things we might want to avoid

• Messages that focus on the most extreme outcomes– May work for least likely to use, but it boomerangs

for contemplators and dabblers• Harsh and inconsistent punishment• Knowledge on its own

– Skills and character essential

Thank you

Andrew BrownDirector of Policy, Influence and EngagementDrugScope

@andrewbrown365andrewb@drugscope.org.ukwww.drugscope.org.uk

The Club Drug ClinicDr Owen Bowden-Jones

Quick tea break

Working towards a safer nightline

Marc BlanchetteB Chilled – Phoenix Futures

B-Chilled‘Supporting a Safer Nightlife in Birmingham’

The B-Chilled team

Marc Blanchette - Community Health Champions Project Manager

Olivia Hemsoll – Outreach Support Worker

The project is also supported by a large group of Community Health Champion volunteers whoare selected and trained especially for the service

Background to B-Chilled

There has been a decline in the traditional treatment cohort of heroin and crack users, and a rise in the use of ‘club drugs’, ‘legal highs’, ‘recreational’ or ‘party drugs’.

This has highlighted fresh challenges to those involved, and working, in the night-time environment and traditional treatment services, as a result there has been a need for new approaches to tackle these changes.

In response, Phoenix Futures working in partnership with Public Health England, developed the Community Health Champion’s B-Chilled Project. The project’s aims are also supported by Birmingham City Council and the West Midlands Police.

Since the project’s commencement it’s remit has widened to include alcohol, sexual health and personal safety.

The identified areas of focus of the B-Chilled project are:

• Digbeth• Southside (Arcadian and Hurst Street)• Northside (Broad Street)

B-Chilled provide the following services:

• Club & Pub Interventions – providing harm reduction guidance to help people access information, support and advice on recreational drugs, alcohol, sexual health and personal safety.

• Superclub & Festival Work – creating ‘Chill-Out Spaces’ and providing welfare and harm reduction services to help people access drug information, advice and immediate support.

• Health & Community Fairs – providing information stalls at open days and community events.

B-Chilled Volunteers

•Volunteers are known as Community Health Champions

•We have 70 trained volunteers so far, with more coming through

•Volunteers undertake a minimum of 16 hours intensive training in drugs, alcohol, sexual health and outreach & engagement skills

• Volunteers are supported and supervised by paid staff whilst delivering outreach sessions

• Longer term volunteers are now taking on the role of Lead Volunteer and will soon be supervising teams themselves

How does B-Chilled operate?

• Outreach sessions in clubs & pubs, community events and festivals• Professional, friendly, relaxed and experienced outreach teams• Targeted interventions – drugs (particularly ‘legal highs’), alcohol, safe

sex, personal safety• Quality referrals into treatment providers & ongoing support – one to one,

telephone, via social media

How does B-Chilled operate? • A regular outreach sessions in NTE• ‘Chill Out’ space in venues• Works with Universities and Student Guilds • Partnerships with key NTE stakeholders• Brief interventions & quality referrals

• Via training and on-going support from the B-Chilled project, venue managers and event promoters can better prevent and manage drug related incidents.

B-Chilled benefits venues in Birmingham's night time economy by providing....

• Free service• Proactive approach to customer safety• Staying up to date with changing drug trends• Extra staff who contribute to monitoring and maintaining safety• Enhancement of customer experience in Birmingham's NTE• Prevention or reduction of incidents and risk• Confidentiality• Assistance in developing a bespoke and workable drugs policy• Training for door and venue staff

(Source:http://www.safernightlife.org/pdfs/digital_library/uk_safer_nightlife_guideline.pdf)

Training for ProfessionalsThe project offers up to date in-depth training around drug use aimed at professionals who work within the night-time economy. These include:

• Door supervisors

• Security Staff

• Bar and club staff

• Club and pub managers

• Event/club promoters

• Street & Taxi Wardens

Training for Professionals

The training covers:

• The rise in use of ‘Legal Highs’ and other new drugs• Descriptions of products that are used to bypass current legislation• Recent changes in legislation with regard to these emerging substances• An over view of the effects and risks posed by the use of new drugs and

other legal substances• Statistics on current usage across the UK• Developing workable drug policies to help deal with the use of these

substances in clubs and pubs• Responding to emergencies that involve the use of these substances

The training can give workers valuable information to help them understand the issues and engage with clubbers. This will help reduce the risks posed to them by their use of substances whilst out enjoying the night-time economy. Ultimately this intervention could even save lives

Club Drugs/NPS

• Anything used to “party” – pubs, clubs, parties, raves, festivals, events, private

• Not ‘traditional’ drug service presentations (e.g. heroin and crack)

• Established drugs: ecstasy, cocaine, ketamine, speed, crystal meth

• Newer drugs: GBL, mephedrone• ‘Legal highs’: ‘Ivory Wave’, ‘Spice’, ‘Benzo Fury’

Why are we concerned?• Small number experiencing significant harms• Use of NPS can result in acute toxicity and serious harm. It can

also result in people putting themselves in situations where they may be vulnerable or at risk of other harms (e.g. through collapse, intoxication, etc) including accidents and being victims of crime (e.g. sexual or physical assault).

• Numbers in treatment increasing• Concern of ‘time-lag’ between using and problematic use• ‘Legal highs’ – no evidence base• The harms of NPS are multi-faceted and may be physical (intrinsic

to the drug) or social in nature.

B-Chilled‘Supporting a Safer Nightlife in Birmingham

New challenges• New drugs, with less information• Different (greater) harms• Dependence• At risk behaviour• Delivered in club drug-specific, or club drug-

aware locations• Ever changing substances

B-Chilled‘Supporting a Safer Nightlife in Birmingham

Who are B-Chilled engaging with?• Typically different profile to traditional drug

services• Higher functioning• Less likely to have criminal record• Students & Urban clubbers• Respond well to treatment – ‘recovery capital’• Triggers include arrest & negative experience

whilst using

Further information …..

Marc Blanchette - Community Health Champions Project Manager: 07966 874776 or marc.blanchette@phoenix-futures.org.ukOlivia Hemsoll – Outreach Support Worker: 07817 423963 or olivia.hemsoll@phoenix-futures.org.uk

Office: Phoenix Futures, 2nd Floor, Ruskin Chambers, 191 Corporation Street, Birmingham, B4 6RP. Tel: 0121 212 1122 Facebook page: B Chilled BirminghamTwitter: @BChilledBhamWeb: www.phoenix-futures.org.uk

Key actions going forward

Simon Claridge, Mentor

Alcohol and Drug Prevention

Creating positive change for children and young people

Photo by Flickr user Jon McGovern

“Societies tend to make a small investment in prevention and, on average, they reap a small return.”

Drug and Public Policy Group

Drugs and Public Policy Group (2010), Drug Policy and the Public Good: a summary of the book. Addiction, 105: 1137–1145. doi: 10.1111/j.1360-0443.2010.03049.x

Why we need early interventions

Early Childhood Adulthood

Trajecto

ry of P

roblems/

Increasing C

Source: PriceWaterhouseCoopers

Age 21, cost per person already = £91 - £121k

£827,000Lifetime cost of male problem drug user

between the ages of 10 to 17 years associated with:• 80,640 violent offences per year, and• 27,200 property offenses per year

between the ages of 15 to 16 years is associated with:• 195,000 accidents or

injuries per year,• 39,000 hospitalisation or

admissions to A&E per year, and

• 104,000 cases of unprotected sex per year

Young people’s drinking behaviour

57,616 14-16 year olds have truanted 5 or more times in their lifetime because of excessive alcohol consumption

39,000 15-16 year olds performing poorly or badly at school as a result of their drinking behaviours

Source: Jones, L. et al: A review of the effectiveness and cost-effectiveness of interventions delivered in primary and secondary schools to prevent and/or reduce alcohol use by young people under 18 years old (ADDENDUM Additional economic evidence prepared for the Public Health Interventions Advisory Committee (PHIAC)) (2007)

The Life Course Approach

’s h

What we do

What we knowworks

What we do that we know works

What we do that we know doesn’t work

The Olive of Prevention

Adapted from Harry Rutter, director of the National Obesity Observatory

Traditional perspective on prevention

• Emphasising the harms (health and social) will disincentivise use.

• Young people given enough information will make rational decisions about their health.

• One off interventions are enough.

• Prevention = school drug and alcohol education/posters/TV adverts.

We need to change our perspective

Research has shown• Cautionary stories• Information• Focus on harm or fear• Harsh or inconsistent

punishment

Don’t work

Case study – Scared Straight

• Programme assumes that by showing ‘reality’ of the criminal justice system young people will want to avoid it

• Unfortunately trials of the interventions have shown:

the ‘Scared Straight’ programme actually increased the risk of offending in the juveniles in the intervention group compared with juveniles in the control group

• The Social Research Unit calculated that for every child it is delivered to (£55) it costs a further £14,268 to put right.

Scared Straight and Other Juvenile Awareness Programs for Preventing Juvenile Delinquency: A Systematic Review of the Randomized Experimental Evidence, The ANNALS of the American Academy of Political and Social Science September 2003 vol. 589 no. 1 41-62

Settings

Photo by Flickr user Collin Key Photo by Flickr user adwriter Photo by Flickr user loop_oh

Environment Family School Community

Setting and SystemsEnvironment

Family

School

Community

Photo by Flickr user Australian Govt.

Universal vs. Targeted

Photo by Flickr user Collin Key Photo by Flickr user CliffMuller

Delivered to all regardless of risk.Examples include: • school prevention programmes• public health media campaigns

Photo by Flickr user Ian Freimuth

Delivered to higher risk groups. Examples include:• Family and parenting

programmes• Screening and brief intervention

Case Study – Preventure

• Two or three session targeted programme based on personality type; sensation-seeking, impulsivity, anxiety-sensitivity, and hopelessness

• Outcomes– 40% decreased risk of alcohol

consumption in the intervention group, 55% decreased risk of binge-drinking.

• Need to Treat of twoO’Leary-Barrett M, Mackie CJ, Castellanos-Ryan N, Al-Khudhairy N, Conrod PJ. Personality-Targeted Interventions Delay Uptake of Drinking and Decrease Risk of Alcohol-Related Problems When Delivered by Teachers. J. Am. Acad. Child Adolesc.Psychiatry, 2010;49(9):954 –963

Photo by Flickr user Micah & Erin

So why not just target?

Low Risk – 10% chance

Medium Risk – 40% chance

High Risk – 60% chance

Case Study – Good Behaviour Game

• Classroom strategy for 6 – 8 year olds. Programme assumes that early socialisation into school is protective.

• Outcomes:– Doing well in school– Good behaviour– Not using substances– Not depressed– No suicidal ideation

• SRU benefit to cost ratio shows for every £1 invested £26 is returned. Photo by Flickr user Philippe Put

UN Drug Prevention Model

Nuffield Foundation: The wisdom of the crowd - 65 views of the NHS at 65 (2013)

Contact Details

Mentor1st Floor, 67-69 Cowcross StreetLondon EC1M 6PU

020 7553 9920

Simon.claridge@mentoruk.org

@SiClaridge; @MentorTweets; @MentorADEPIS

www.mentoruk.org.uk

End of conferencePlease hand in your badges and feedback

forms as you leaveThank you and have a safe journey home

'Legal Highs or Legal Killers' Conference Presentations

Government & Nonprofit

Transcript of 'Legal Highs or Legal Killers' Conference Presentations

Legal Highs / Novel Psychoactive SubstancesAnalytical Strategy, HS 2019 Legal Highs Structure and Action –Legal Situation –Detection and Analytics 08.10.2018 1 Legal Highs / Novel

TNI / IDPC Expert Seminar on › files › publication-downloads › report-legal-highs... · TNI / IDPC Expert Seminar on Herbal Stimulants and Legal Highs 30 -31 October 2011 ...

New Psychoactive Substances (Legal Highs)

RCs – Legal Highs – New synthetic substancesnewip.safernightlife.org/pdfs/digital_library/RCs-Legal... · Web viewResearch Chemicals – Legal Highs – New synthetic substances

A Very Incomplete “Legal Highs” Coming to America History ... · “Legal Highs” Coming to America A Very Incomplete History of Cannabinoids • Cannabis medical and recreational

Research Chemicals - KFx Drug Consultancy Initiative ... · Research Chemicals ABOUT THIS BRIEFING: ... AKA: Generic terms: Legal Highs, herbal highs, party pills, Novel Psychoactive

Club Drugs and Legal Highs: New drugs, new harms new users

Brown JK, Malone MH. 'Legal highs'—constituents, activity, toxicology, and herbal folklore (1978) 10.3109 15563657809149579

‘Legal highs’ - Analysis of tablets and capsules ... · ‘Legal highs’ - Analysis of tablets and capsules containing piperazines ... ‘herbal highs’, ‘legal highs’,

LEGAL HIGHS CLUB DRUGScdn.basw.co.uk/upload/basw_111236-4.pdfseeds and cacti - are also legal highs. As they are mainly derived from plants and herbs they are generally considered

Legal highs cardiff lecture

Profiling TEEN KILLERS SCHOOL SHOOTERS MASS …...WITH TEEN KILLERS, SCHOOL SHOOTERS, MASS MURDERERS & SERIAL KILLERS FEATURING LIVE INTERVIEWS Profiling TEEN KILLERS, SCHOOL SHOOTERS,

Legal stand Resources - Drugs and Alcohol Ireland - The ..._headshops_leaflet.pdf · Legal stand The Misuse of Drugs ... advertised as ‘natural’ or ‘herbal’ highs, a large

Stimulating credible responses to legal highs

An Analytical Chemist's Approach to Legalized … Analytical Chemist's Approach to Legalized Marijuana: ... • Herbal Highs • Legal Highs ... • Original labeling listed multiple

ADEPIS - How can teachers include legal highs in their A&D education programme? - KIP Education

LEGAL HIGHS CLUB DRUGS - Cumbria · LEGAL HIGHS & CLUB DRUGS. 2 ... ‘Herbal highs’ - naturally occurring substances such as herbs, seeds and cacti - are also legal highs. As they

Hidden Risks and Dangers: S D Steroids) & Legal Highs Incense – new range of Legal Highs The information contained in this document should be used as a guide and is

The dangers of legal highs page 10 - Pennine Care … · The dangers of legal highs page 10 02 ISSUE25 ISSUE25 03 letter from the chairman contents news Nurses are world leaders with

Workshop #1: Cannabis in DUID Investigations … “legal highs”, “designer drugs”, “herbal highs” or “research chemicals”, finding a wide and efficient dis-