6 New Users, New Drugs GBL/GHB Crystal Methamphetamine Ketamine MephedroneLegal Highs
7 GBL/GHBColourless, liquid solvent. Pipette into a drink or use nail varnish padsSimilar effects to alcohol: relaxed, euphoria, ↑ sex drive and sensualityUsed mainly for sex and clubbingDifficult to get the dose rightV. easy to overdose – “going under”Physically addictive very quickly with dangerous withdrawals if dependentWill require medical detox if become dependent – outpatient or inpatient depending on severity and risk factors
8 Crystal Methamphetamine Methamphetamine, crystal, Ice, Glass, Tina, Yaba, Krank, TweakTablet, powder or crystals – smoked, injected, insertedCan be taken in ‘runs’ lasting days, sexualised use in MSM communityIntense rush, euphoria, exhilaration, ↑ energy, sex drive, confidence, sociable ↓ appetiteRisk contracting BBV’s through injecting, sharing pipes, risky sex.Paranoia, psychosis, impulsivity
9 KetamineK, Ket, Green, Special K, Super K, Vitamin K, Lady K, Cat Valium, Kit-Kat, Horse TranquiliserAnaesthetic white powder or liquid – usually snorted (ketamine inhalers), occasionally injectedEuphoria, transcendental-like experiences, mild hallucinogenicHigh doses can lead to a ‘K- hole’Ketamine Bladder & Cramps
10 MephedroneMeph, MC, m-cat, 4-MMC, Miaow, Meow Meow, Bubbles, Bounce, Charge, Drone, White MagicPowder or tablets, snorted, mixed with a drink, injectedStimulant: euphoria, speediness, increased sex driveAnxiety, heart palpitations, hallucinations, agitation, psychosisThe original ‘Legal High’, criminalised in 2010 following media activity. Many more sprung up since.
11 Club Drug Clinic: ‘One Stop Shop’ PsychiatryPsychologyPeer SupportSex Health/HIVHepatologyUrologyA&E/ICUClinical, Research, Consultation11
12 The Team..... Club Drug Clinic Consultant Psychiatrist & 2 Training DrsClinical Psychologist + 2 AssistantsClinical Nurse SpecialistSexual Health WorkerEmployment SpecialistANTIDOTE Drug Workers & VolunteersResearch Assistant12
13 How we help Information and advice Assessment of what the client is using & the problems it might be causingAssessment of other problems –physical, psychologicalKeyworking – individual and groupSpecific medical treatmentsSpecific psychological treatmentsSexual Health TestingTraining, teaching, consultationResearch13
14 Referral Process Remove barriers to treatment ‘Sexual Health’ model Any borough, any/no GPConfidential & Non-JudgmentalSelf – phone, (<30 secs!)Staff and Clinicians – Referral form
22 CDC in partnership with ANTIDOTE The UK’s only LGBT Substance Misuse Service10 year history serving the Substance Use needs of London’s LGBTQ community8,000 contacts, 700+ people in treatment each year
31 3, 4 + day “benders” of speedy, unboundaried chaotic sexual marathons. Crystal Methamphetamine, Crystal, Tina.3, 4 + day “benders” of speedy, unboundaried chaotic sexual marathons.Effects managed with GBL use.Repetitive GUM presentations.Increased HIV/Hep C infections.Drug-induced psychosis very common.High likelihood of psychological dependence.31
34 Overdosing in clubs/saunas/ sex-parties. Large numbers of peopleforming dangerous addictions, using hourly every day, just to avoidunmanageable and dangerous withdrawal symptoms.
35 HOW dependence begins, progresses Used to sleep after a big weekend of continual use,leading to..using to manage the comedown during the week,using to aid sleep at bedtime,using for any stress or discomfort,regular use/dependence
36 What to do? Assessment1. Presume clients are using, and use permissive language when asking. "And what drugs are you using at the moment?" is much more likely to get an honest answer than "Do you take drugs?"2. If using, find out the contexts (as clients will often take different drugs for different reasons, sometimes to counteract each other!). "And how often do you use X at the moment?" "Where do you tend to get your X from?" "How much is X costing at the moment?" "What ways do you like to take X?" "Do you tend to use X with others or by yourself or both? How often do you use X during sex? "How long have you been using X for now?" "Have you found yourself using more or less X lately?"
37 What to do? Assessment3. Don't presume problems (many people use safely), but always check: "Are you happy with your use?" "What are the good things you get from X?" "Are there any downsides or negative side effects from X?" "If you wanted to change your use do you know where you'd go if you wanted a bit of support?"4. Check to see if you've missed anything: "Is there anything I've not asked about X you wanted to say?" "Were there any questions you had for me about X?"5. It's fine not to know the answers, be honest and let them know how you're going to find out, and ask them how they'd like you to update you e.g. clinic meeting, phone call, , etc.
38 What to do: Keywork Identifying “Contemplation” or “Action” Setting GoalsRecognising Triggers(Places, situations, people, emotional states, stress, sexual arousal..)List of Pro’s and Con’sManaging CravingsRecognise and anticipate triggers/associated situationsAcupuncture, breathing, meditationRemove yourself from situation “Time Out”Delay, Distract, Decide
39 What to do: Keywork Make a list Saying “no” confidently/setting boundariesAnticipating certain invitations/situationsEncouraging other interestsCommunication skills.Honesty/support from appropriate friends/familyHarm ReductionReferralsListening is Support
40 What to do: Signposting To local borough drug services.To minority group services eg; LGBTTo local sexual health, HIV, Hep servicesCounselling, support groups, NA, AA etcDomestic violence support/helplinesLegal adviceMental health supportYouth supportBenefits/housing adviceBack to work supportNeedle exchange/safer injecting advice