1 DRUGS ACTION “New Psychoactive Substances”. & Overdose Training Gillian MacleanDrugs Action7 Hadden StreetAberdeen Tel:HELPLINE
2 New Psychoactive Substances. Definition (but by no means definitive)“ Legal Highs are substances made from assorted herbs, herbal extracts and ‘research chemicals’, which emulate the effects of some illegal drugs such as, Cannabis, LSD, Cocaine or others. These substances are not currently controlled by the Misuse of Drugs or Medicine Acts”Arthur and Grunert 2005
3 NPS Packaging ALL PACKAGES WILL STATE : Not for Human Consumption. SOLD AS :Herbal Incense,Bath Salts,Plant Food,Novelty Item Only,For Research Use Only.etc. etc.
13 Concerns !With the continuing release of new psychoactive substances on the drug market, there is concern that new or obscure substances that havecontributed to deaths may escape detection.The high potency of some synthetic substances further complicatestheir detection, as they will be present only at very low concentrations inthe blood.The emergence of highly potent synthetic substances also has implications for law enforcement, as even small quantities of these drugs can be converted into multiple dosesEMCDDA 14
14 Commonly Used NPS UK. Cannabinoids 3rd Generation 2-nel / sts - 1355f – akb – 485f – pb 22akb – 48fub – pb – 22( SOMETIMES THESE CHEMICALS ARE MIXED TOGETHER and SOLD AS BLENDS )In the first six months of 2013, eighteen countries reported more than1 800 seizures of synthetic cannabinoids. The largest seizures were reported bySpain (20 kg) and Finland (7 kg).
15 S.C. Adverse Effectsreported adverse effects include agitation, seizures, hypertension, emesis (vomiting) and hypokalemia (low potassium levels). researchers have concluded that ‘legal highs’ containing synthetic cannabinoids are potentially more harmful than cannabisassociated with psychiatric symptoms, including psychosisinvestigations underway in the US regarding links between the use and acute kidney injuryEMCDDA 2013
18 “Withdrawal” and “Comedown” AgitationParanoiaFatigueIrritabilityInsomniaPanic AttacksBrain FlashesHypnic JerksIncite client 2012Feeling anxiousFeeling shakyCan’t think ofanything elseFeel depressed,hopelessFeeling sweatyLeeds Addiction Unit 1996
19 Treatment Drug counselling. Residential treatment. Fellowship and self-help.Alternative therapies such as auricularacupuncture.Sleep management.Clinical Prescribing (GP’s)Tapering strategies.(especially synthetic cannabis)
20 Harm Reduction Advice around administration route Test dosing and dosage informationAvoid poly drug use including alcoholConsider “Set and Setting”Having a “sitter”Think about “safe sex”Getting home safelyGoing to sleep on their side
21 Overdose : Definition“Use of any drug(s) in such quantities that acute adverse physical or mental effects occur. It can be deliberate or accidental; lethal or non lethal”
22 Overdose: Main Risk Factors ToleranceInjecting drugsMixing drugs - primarily depressantsLonger history of drug useDepression and low moodContd.
23 Significant life events Contd.Poor physical healthUsing aloneHomeless userNot being in treatmentSignificant life events
24 Signs of NPS overdose Dizziness, Dehydration, Rapid heart rate, Dizziness, Dehydration, Rapid heart rate, Seizures, Severe nausea and vomiting,Hyperthermia, (very high body temperature, overheating) Serotonin Syndrome
25 High Risk TimesDifficult life events – bereavement, loss of contact with children, separation / divorcePoor emotional healthWeekends, festive period, leaving homeUsing aloneRelapseIsolationBuying from a different source
26 Dealing with an Overdose Don’t inflict painDon’t give other drugs e.g. stimulantsDon’t put in bath / showerDon’t walk the person aroundDon’t leave person on their ownRecovery position / CPRPhone 999 without delay
27 Dealing with overdose? Common myths DON’TAttempt to walk casualty aroundInflict painInject stimulantsInject salt waterPlace in cold bath / showerInsert ice / ice cream in rectum
28 DRUGS ACTION “New Psychoactive Substances”. & Overdose Training Gillian MacleanDrugs Action7 Hadden StreetAberdeen Tel:HELPLINE