Legally high in Ayrshire

Summary

Background: The term ‘legal highs’ encompasses a wide range of products, from herbal

mixtures to ‘designer drugs’ and ‘research chemicals’. Used for the same reasons people

use illicit drugs, these products have been marketed as room odourisers, shoe deodorisers

or bath salts, though they are intended for a different use. This diversity makes it difficult to

collect and interpret prevalence data on ‘legal highs’.

Method: The survey set out to ascertain whether legal highs were prevalent in Ayrshire, if

so, which substances were the most popular, with what age group and to identify any

adverse consequences of use. The survey also set out to identify if there were any

differences between localities. A questionnaire was developed and widely distributed

throughout Ayrshire both electronically and in paper form.

Results: A total of 779 questionnaires were returned. 60% of respondents were aware of

the use of legal highs in Ayrshire, the most common drug being Mephedrone (85%). Fifty

eight percent of participants gained their knowledge from either the media or word of

mouth. The most reported age group taking legal highs was between 16-25 years (67%).

Legal highs were purchased mainly form head Shops or friends (58%). The most common

consequence respondents were aware of was death (35%)

Conclusion: The study suggests that legal highs are prevalent across Ayrshire and Arran

and most commonly used amongst the younger age group of 16-25 year olds. The survey

highlights the need for education and training to be developed and delivered throughout

Ayrshire and for up to date reliable information to be gathered and disseminated both

locally and nationally.

Background

The EMCDDA–Europol 2011 annual report on new psychoactive substances found new

drugs were detected in the European Union last year at the rate of around one per week.

A total of 49 new psychoactive substances were officially notified for the first time in 2011

via the EU early-warning system. This represents the largest number of substances ever

reported in a single year, up from 41 substances reported in 2010 and 24 in 2009.

Reliable data on the prevalence of use of legal highs is difficult to obtain. Surveys of young

people suggest that 20-40% had ever tried legal highs. In the case of Mephedrone (pre

ban) one survey indicated 34% had used in the last month, although the British Crime

survey and the 2010 Mixmag magazine survey that this data comes from are heavily

biased and therefore should be treated with caution. The 2012 Global Drug survey tried to

overcome the bias of targeting only clubbers, and collaborated with the guardian

newspaper to widen the demographics. The 2012 Guardian/Mixmag survey was completed

by over 15,500 people with 7,700 from the UK. The survey found that 20% of respondents

had taken legal highs in the past 12 months, with 35% buying them from friend, 45%

online, 42% from a shop and 22.5% from a dealer. The survey found 15% of respondents

say they had taken an unknown white powder in the past 12 months, a third took it from a

stranger, with a third admitting it was supplied by someone they didn't trust. 80% of

respondents were already intoxicated when they took it and despite reports claiming

Mephedrone is more popular among clubbers than before it was banned; results from the

survey show usage has dropped among survey respondents in the past year – from 51% to

19.5%.

There is no single source of information on psychostimulant use in Scotland although An

annual report by NHS Scotland describes the available information on drug use including

the demographic profile of 'new' individuals attending specialist treatment services such as

Ayrshire and Arran Addiction Services for an assessment of their drug use care needs. In

2010/11, 133 'new' individuals reported using Mephedrone, with 69 of these reporting it as

their main drug. The emergence of people attending services that have traditionally been

utilized by clients seeking treatment for depressant drugs in Scotland for emerging psycho

stimulant use is new and the implications for NHS Ayrshire and Arran Addiction Services is

at present unknown. There is therefore a need to ascertain not only local prevalence

across North, South and East Ayrshire, but also the age range of users and the associated

adverse consequences of use. This information is essential in order to plan effectively for

the future to ensure services are equipped to deal with any anticipated growth in clients

requesting treatment regarding legal highs.

Methodology

A ten question online survey was developed by the Prevention & Service Support Team,

Addiction Services, NHS Ayrshire & Arran. It was widely distributed throughout Ayrshire

using the online package Survey Monkey. (See Appendix A) The survey was available

from January 2011 until January 2012. The aim of the survey was to establish an overview

of what was available and popular in Ayrshire within this time frame. It was distributed

electronically within NHS Ayrshire & Arran Addiction Services; all partner addiction

agencies; North, South and East Ayrshire council; University of the West of Scotland, Ayr

and Kilmarnock Colleges; Ambulance Service, Fire Service and Police. The questionnaire

was also printed then completed and manually added to the database to enable it to be

taken to fresher week activities within the university and colleges previously mentioned. Ayr

College also incorporated the survey within Personal Learning and Development sessions.

This proved to be an inexpensive way of gathering information from many different

professions and age groups within Ayrshire. The objective was to ascertain who (what age)

was taking what, (name of drug, on its own or with other drugs) where, (N, S, E Ayrshire)

and any associated adverse consequences of use. We also wanted to know what concerns

were evident in relation to legal highs and therefore added a further comments box. A total

of 779 questionnaires were returned.

Results

The survey was created on line on the 12 th of January 2011, and by the 10th of January

2012, 779 questionnaires had been returned. Question 1 asked respondents if they were

aware of the use of current or former legal highs in Ayrshire. Graph 1 details these results.

Graph 1: aware of the use of current or former legal highs in Ayrshire

Yes No Other 0

50100150200250300350400450500 475

304

7

Of the respondents who answered that they were aware of the use of legal highs, they

were asked to state in which area of Ayrshire. Table 1 details these results.

Table 1: area of Ayrshire

Area Number of respondents

North Ayrshire 67 (13%)

South Ayrshire 202 (38%)

East Ayrshire 97 (18%)

n=533

N=786

All (Ayrshire wide) 167 (31%)

Results indicate that (60%) of respondents were aware of the use of current or former legal

highs in Ayrshire with South Ayrshire being most prevalent. Of the7 people who stated

“other”, Dumfries and Galloway and Glasgow were the most popular

Respondents were asked to state where they gained their knowledge of Legal Highs.

Graph 2 details these results.

Graph 2: where knowledge gained of legal highs

Media

Where yo

u live

Workplac

e/School/C

ollege

Family

affect

ed by le

gal h

ighs

Word of mouth

Point of S

ale

Other 0

50

100

150

200

250

300

205

139 124

38

245

16 12

Results indicate that most respondents gained their knowledge from the “media” or “word

of mouth”, 26% and 31% respectively. Followed by where they live (18%) and

workplace/school College at 16%. Two percent stated that they gained their knowledge

point of sale including festivals, head shops and street level dealers.

n=779

Respondents were asked to state which substances they were aware of being used. Table

2 details these results.

Table 2: substances aware of being used

Substance Number of responses

Mephedrone 376 (85%)

Spice 110 (25%)

Salvia Divinorum 104 (24%)

Ivory wave 84 (19%)

Ephedrine 73 (17%)

Methylone 71 (16%)

Benzo fury 69 (16%)

Naphyrone 67 (15%)

Methylenedioxypryoyauerone (MDPV) 54 (12%)

Kratom 44 (10%)

San Perdro 26 (6%)

**% does not add to 100 due to respondents being able to tick all that apply**

Results indicate that the substances that most respondents were aware of being used were

Mephedrone, Spice, Salvia Divinorum and Ivory Wave. Other substances identified by

respondents as also being used, were moonshine, wizard tears and Bombay blue

Respondents were asked to state the age range of those they believed were using

substances. Graph 3 details these results.

Graph 3: age range of those using substances

Under 16 16 - 19 20 - 25 Over 25 Not sure0

50

100

150

200

250

300

350

110

294

230

137 117

Results indicate that the age range of those using substances was mostly between 16 and

25 with (33%) being between 16 and 19 and (26%) being between 20 and 25.

Respondents were asked to state where or how people were purchasing these legal highs.

Graph 4 details these results.

Graph 4: where/how people are purchasing legal highs

n=888

Internet Headshops Street dealers

Friends Not sure Other 0

50

100

150

200

250

193

229

189

223

101

8

**N= (943) due to respondents being able to tick all that apply**

Results indicate that people are purchasing legal highs mostly from head shops, (24%)

friends, (24%) street dealers (20%) and the internet, (20%) 11% of respondents were not

sure where people were purchasing them.

Respondents were asked if they were aware of any problems resulting from using these.

Table 3: problems resulting from using substances

Response Number of responses

Yes 249 (54%)

No 215 (46%)

Results indicate that just over half, (54%) were aware of problems resulting from using

these substances. They were asked to specify problems that they were aware of.

Problems were identified as follows:

n=464

n=943

Graph 5: Problems resulting from using substances

Death

Physical

health

problems

Mental

health problem

s

Morish/A

ddiction

Socia

l Problem

s

Aggress

ion

Bad co

medown

0

20

40

60

80

100

120104

82

59

21 215 6

N=298 due to respondents highlighting multiple problems

Results indicated that death was the most common problem identified by participants

(35%) followed by physical health problems (28%) and mental health problems (20%)

While 7% thought that the morish nature of the drugs made them more problematic and

perhaps addictive. 7% of respondents thought social problems, and 2% commented on the

bad come downs associated with the drugs. One percent of respondents thought

aggression was an adverse consequence of taking legal highs.

Respondents were asked, to the best of their knowledge if they were aware if legal highs

were generally used with alcohol. Graph 6 details these results.

n=298

Graph 6: legal highs used with alcohol

Yes No Not sure 0

50

100

150

200

250

300261

43

168

Results indicate that over half of respondents, 55% stated that to the best of their

knowledge, legal highs were generally used with alcohol, 9% stated that they weren’t used

with alcohol and 35% were not sure.

Respondents were asked to the best of their knowledge if legal highs were generally used

with other drugs. Graph 6 details these results.

Graph 7: legal highs used with other drugs

Yes No Not sure 0

50

100

150

200

250

300

164

61

247

n=472

n=472

Results indicate that 35% of respondents stated that legal highs were generally used with

other drugs, 13% stated that they were not used with other drugs and just over half, 52%

were not sure.

Respondents were asked to state any further comments they would like to make with

regards legal highs in their area or any other general comments. Graph 8 categorises

these comments into themes.

Graph 8: Further comments

Negative

Comments

Legali

tyMed

ia

Prevele

nce

Servic

es

Educati

on/Inform

ation

Other0

5

10

15

20

25

16

20

11 10

6 6 6

Results indicate that 27% percent of the comments made were concerning the legality of

the drugs. 21% of the comments were of a negative nature, fifteen percent of participants

commented specifically on the media attention legal highs have. Thirteen percent

commented specifically on the prevalence of legal highs. For eight percent of respondents

commented on the lack of education and information available in connection to these

substances and eight percent commented on the services available to deal with legal

highs. Eight percent of the respondent’s comments did not fit into any of these categories.

n=75

Finally, respondents were asked if they would like to know more about legal highs. Table 4

details these results.

Table 4- more information on Legal Highs

Response Number of responses

Yes 208

No 545

Results showed that (28%) of respondents wanted to know more about legal highs, for

those who provided contact details this report will be sent to them in addition to reports and

updates provided by the newly formed Emerging Drug use Monitoring Group in Ayrshire.

Conclusion

In order to ascertain if anyone was taking legal highs in Ayrshire and identify any negative

consequences of this use, the Prevention & Service Support Team NHS Ayrshire & Arran

developed and disseminated an online survey. The major findings of this survey are as

follows: 60% of respondents were aware of the use of legal highs in Ayrshire, South

Ayrshire being the most prominent area. This finding may be biased by the high number of

questionnaires completed by Ayr College which is based in South Ayrshire. More than half

gained their knowledge from either the “media” or “word of mouth”. Due to the high media

coverage Mephedrone had pre ban it is highly likely that this contributed to Mephedrone

being the substance that most respondents were aware of being used. The most reported

age of users was between 16- 25yrs. People are purchasing legal highs mostly from head

shops, friends, street dealers and the internet. At the time this survey was in circulation

there were three head shops in Ayrshire: one North, one South and one East. Presently

there is only one left in South Ayrshire. It would be interesting to know if this has has an

impact. Just over half of respondents were aware of the problems resulting from using legal

highs; the most reported problem resulting from taking legal highs was “death”, followed

physical or mental health problems. 55% of respondents thought that legal highs were

n=753

taken with alcohol and (35%) with other drugs, again highlighting the need for education

around adverse consequences of this.

The opportunity for respondents to add any further comments to the survey provided a

range of responses. These were gathered into themes’ with examples of each theme as

follows:

The most common comment was regarding the legality of the drugs: “worse than illegal

drugs”; “people only take them because they are legal”, “should be made illegal”

The next most common theme was of a negative nature: “legal highs are bad”, “wrong”,

“will make you ill”

Comments concerning the media’s role in “legal Highs” “media coverage is unhelpful”,

“sensational reporting makes people want to take them”

Prevalence comments: “so easy to get” “they are everywhere”.

Services available for legal highs: “no services for people addicted to them” more services

needed”.

Lastly information and education was mentioned: “lack of education and harm reduction is

unsatisfactory”

The fact that some respondents did not know that moonshine/meow meow and

Mephedrone are all one drug is of concern. This is important as people may want to avoid

Mephedrone because they are aware of effects and they don’t appeal, but might then take

moonshine not knowing that this is what Mephedrone is called in Ayrshire. This highlights

how important it is to get up to date reliable information gathered and disseminated locally.

It also highlights the need for education and training to be developed and delivered locally.

Discussion

The most cost effective way of gathering this information was via survey monkey. However,

this has several limitations. Although survey monkey was sent to all addiction partners in

Ayrshire and North, South and East Ayrshire council workers, only the staff in these

organisations that had access to a computer was in a position to receive it. The students

targeted at fresher’s fairs and the responses generated by Ayr College were the only paper

copies completed. This had its own limitations however because it gave us a higher

number of respondents based in South Ayrshire.

Recommendations:

As a result of the survey, it is recommended that Ayrshire Emerging Drug Use Monitoring

Group consider the following recommendations

Information should be given to all staff concerning the need to ask about all drugs (including legal highs) on assessment , not just depressant drugs

Information about legal highs should be added to the Emerging Drug Use Monitoring Form and submitted to enable up to date information to be gathered and disseminated throughout Ayrshire

Training packages must be regularly updated to ensure the most up to date information is being used, including information on Legal Highs.

All partner agencies and addiction services should be make aware of the training available by the PSST.

References

Annual report on the state of the drugs problem in Europe (EMCDDA),

http://www.emcdda.europa.eu/publications/annual-report/2011

The British Crime Survey 2010/11

Dick, D. and Torrance, C. (2010), 'MixMag Drugs Survey', MixMag 225, pp. 44-53.

Drug Misuse Statistics Scotland 2011 NHS Information Services Division (I SD, 2012)

Winstock, A., Global drug Survey Mixmag/Guardian (2012)

www. globaldrugsurvey .com/ mixmag 2012

Prepared by: Marie Wilson

Addiction Education & Prevention Specialist

Prevention & Service Support team

Email: marie.wilson@aapct.scot.nhs.uk

Tel: 01563826312

Thanks to

Louisa Stewart Student President Ayr College

Doreen Wales Curriculum Manager Essential Skills Ayr College

Denise Brown PSST

Julie Lindsay PSST

Appendix A

Legal Highs Survey

1. Are you aware of the use of current or former legal highs in Ayrshire

Yes No (if NO, please continue to Q11)

If other area, please specify: _________________________

2. If YES, which area of Ayrshire? (please tick all that apply)

North Ayrshire South Ayrshire

East Ayrshire All (Ayrshire-wide)

3. Where did you gain your knowledge of Legal Highs?

Media Where you live

Workplace Family affected by legal highs

Word of mouth Other (please specify) _____________________

4. What substances are you aware of that are being used? (please tick all that apply)

Mephedrone Spice Naphyrone (NRG 1, 2, 3)

Salvia Divinorum Methylenedioxypryovaurene (MDPV) stimulant

Ephedrine – (Ma Huang) stimulant San Pedro

Methylone Kratom Benzo Fury

Ivory Wave Other (please specify) ____________________

5. Please indicate the age range of those that are using these substances (please tick all that apply)

Under 16 16-19 20 -25

Over 25 Not sure

6. Where/how are people purchasing these legal highs?

Internet Head shops Street Dealers

Friends Friends Not sure

Other (please specify) _______________________________________

7. Are you aware of any problems resulting from using these substances?

Yes No

If yes, please specify problems you are aware of

8. To the best of your knowledge are the legal highs generally used with alcohol?

Yes No Not sure

9. To the best of your knowledge are the legal highs generally used with other drugs?

Yes No Not sure

10. Please state any further comments you would like to make with regards to legal highs in general

11. Would you like to know more about legal highs?

Yes No

If yes, please contact the Prevention & Service Support Team, 38 Lister Street, Crosshouse Hospital, Kilmarnock, email: irt.info@aapct.scot.nhs.uk; or provide your email./contact details in the box below

Thank you for completing this questionnaire