Liverpool Safeguarding Children Board - Practitioner Information

‘Legal High’ New Psychoactive Substances (NPS)

New Psychoactive Substances (NPS) is the correct term for ‘Legal High’s.

They were substances that mimic the effects of illegal drugs but are not controlled by the Misuse of Drugs Act 1971. Loopholes in the law allowed these substances to be sold as ‘Plant Food’ and Not for ‘Human Consumption’.

‘Legal High’s’ ARE NOW ILLEGAL!!

The term ‘Legal High’ is a nickname, but substances are not always legal and don’t always cause a high. In one study, it was found that 1 out of 6 of these drugs contained an illegal substance.These substances are often sold as: ‘Legal Highs’, ‘Spice’ , ‘Research Chemicals’ ‘Bath Salts’, ‘Plant food’ or ‘Not for Human Consumption’

Drug categories

New Psychoactive Substances (NPS) are synthesised substances that are able to copy all of the existing drug categories;

  • Depressants
  • Stimulants
  • Hallucinogens
  • Opiates / Analgesics
  • Volatile Substances (Inhalants)
  • Image & Performance Enhancing Drugs (IPEDs)

The most popular NPS fall under Hallucinogenic, Stimulant and Inhalant categories.

Chemists in laboratories are able to change or adapt chemical compounds in order to make a new substance which is distributed to many countries. Despite many substances being banned there was a known two fold increase of new legal substances (from EU EWS between 2010 and 2013).

Where are they bought from?

  • ‘Headshops’
  • Drug Selling
  • Internet

In Liverpool, Young Addaction report that service users use headshops for buying legal highs. (Estimated about 5 in Liverpool). All shops will get visited regularly by trading and standards.

Risks

  • New Psychoactive Drugs carry much of the same risks as illegal drugs but it appears that Synthetic Cannabinoids (Spice) causes significantly more harm than illegal Cannabis.
  • Perception of Safety – Young People, Packaging, Labelling,
  • Overdose - risk increased due to unclear and variable potency. Often high potency than illegal counterparts. The difference between active and harmful dose small in some cases
  • Mental health – evidence of psychosis associated with stimulants and synthetic cannabis
  • Dependence – Synthetic cannabis may have more dependence potential than cannabis. Withdrawal associated with a variety of NPS including synthetic cannabis and Mephedrone(4MMC analogues)
  • Asphyxiation – Associated with risky use of nitrous oxide Increased risk in large quantities)

Methods of Administration

Injecting – Safer injecting advice for NPS can be different to opiates so there is a potentially ill-informed user cohort. Some NPS powders corrosive to veins -Injecting problems, more likely to overdose.

BBV risk - HIV and Hepatitis C. When sharing drug-taking equipment including sharing of notes and straws. Corrosive powders breaking down nasal capillaries. Nasal - breaking down capillaries, nose bleeds, Sharing equipment.

Cost and availability – Ease of access and low cost potentially increase risk

  • Secondary selling – Increases risk of contamination, mixing of substances etc. ‘Legal’ more harmful substance increasing risk when added to Illegal drugs (adulterants, what the drug is ‘cut’ with).

DRUGS and THE LAW

The Psychoactive Substances Act 2016

Possession of a psychoactive substance will not be an offence except in a ‘custodial institution’ (prison, young offender centre, removal centre

Offences: Possession with intent to supply, importing or exporting a psychoactive substance will all become offences.

Importation: An offence could include importing of a psychoactive substance could include buying a psychoactive substance from a non-UK based website, which may lead to individuals being prosecuted.

Supply and production: The main thrust of the Act is intended to act against shops and websites supplying ’legal highs’.

Misuse of Drugs Act 1971

Classifies drugs into 3 Groups of A, B and C. With Class A drugs believed to be the most harmful. Sometimes government takes into consideration, the evidence from Advisory Council on the Misuse of Drugs (ACMD).

The Intoxicating Substances (Supply) Act

It is illegal for a retailer to supply, or offer to supply, intoxicating substances to someone under the age of 18. It is also an offence for a retailer to supply intoxicating substances to someone he/she believes is acting on behalf of a person under the age of 18. Only a small number of examples of effective use of this laws, they have not been deemed adequate to cope with the expanding NPS market

‘NEW DRUGS’

Anecdotally, the most commonly used NPS drugs in Liverpool are Nitrous Oxide and Synthetic Cannabinoids.

Nitrous Oxide - Balloons, Laughing Gas or Noz

Used with a cracker and balloon. A short acting depressant like drug which can bring a sense of euphoria, calmness and sometimes cause dizziness. Relatively low risk when taken in small doses, frostbite can happen on the lips if people inhale straight from the canister, without the use of balloons. Deaths reported from use of large canisters, where oxygen starvation can occur.

Synthetic Cannabinoids - Spice, Herbal Incense

Sold as ‘herbal incense’. Although Spice is now illegal, Spice is used as a nickname for these drugs. SC mimics the effects of THC in cannabis but far stronger and more dangerous than Cannabis Resin or Skunk. During 2013 there was over 50 synthetic cannabinoid deaths (Deaths Related to Drug Poisoning in England and Wales, ONS 2013). The majority of people we talk to in Liverpool have tried these once and never go back to them again. Young people who are looked after children, live in hostels or suffer mental health issues are more vulnerable to use and tolerate these drugs. There are local anecdotes of people collapsing from using synthetic cannabinoids after just one ‘spliff’, with people struggling to breath and tightness of chest who are sometimes admitted to hospital as a result.

Powder and pills

There are some stimulant and hallucinogenic drugs in powder and pill form that are used in Liverpool but these vary and the market changes quickly. One substance available is Mexedrone.

Mexedrone (Analogue of 4-MMC/Mephedrone). This drug is close in compound to amphetamines, MDMA and cocaine. The effect will last for about an hour, and make people feel alert, confident, takative and euphoric. It can cause anxiety, vomitting and headaches. The main risk is overstimulating and damaging your heart and circulatory system. It can cause overdose through an overload in serotonin (serotonin toxicity) or difficulty in regulating temperature which can make the person fit.

RE-EMERGING DRUGS

MDMA - In powder form (Magic) and tablet form (Garry’s, Ecstasy). Stamp Names around Liverpool are Goldbars, Louis Viton’s and UPS. Class A. Stimulant (Empathogen) Tablet: swallowed Powder: dissolved or snorted

Mephedrone – Mcat, MeeowThis drug is close in compound to amphetamines, MDMA and cocaine. The effect will last for about an hour, and make people feel alert, confident, talkative and euphoric. It can cause anxiety, vomiting and headaches. The main risk is over stimulating and damaging your heart and circulatory system. It can cause overdose through an overload in serotonin (serotonin toxicity) or difficulty in regulating temperature which can make the person fit.

Ketamine - A general dissociative anaesthetic which stops pain and is used for operations on humans and animals. Ketamine can cause a loss of feeling in the body and paralysis of the muscles as well as experiencing a distortion of reality.

Ketamine can increase your heart rate and blood pressure. It can make you confused, agitated, delirious and disconnected from reality. It can make you feel sick, and causes damage to your short and long term memory. Other risks include loss of feelings, paralysis of the muscles and the mind’s, loss of touch with reality; you can be left vulnerable to hurting yourself or being hurt by others. (Talk to Frank , 2016). Ketamine can cause very serious bladder problems for regular users.

GHB /GBL – Geeb GHB and GBL are closely related,both depressant drugs with similar sedative and anaesthetic effects. Both are similar, they are depressants giving a sedative effect and can lower inhibitions. Both can kill and are particularly dangerous when used with alcohol. When mixed badly they can burn the mouth. They have been used in drug assisted sexual assaults. They can cause physical dependency, unconsciousness, resp. depression, coma and also death. Medical use - prescribed to help narcoleptic people deal with symptoms of excessive sleepiness and cataplexy (sudden temporary muscle weakness).

Sold legitimately as an alloy wheel cleaner but if bought or possessed with the intention of human-use, GBL /GHB becomes a class C drug.

Where to go for advice and support?

Young People aged 10 to 19 (20 to 24 with additional support needs.)

Call 0151 706 9747 to make a referral

Adults from 18 years

Call 0151 541 2856 to make a referral

Responding to Concerns about the Safety and welfare of a Child

Early Help is a key part of delivering frontline services that are integrated and focused around the needs of children and young people. The Early Help Assessment Tool (EHAT) will promote more effective, earlier identification of additional needs, particularly in universal services. It is intended to provide a simple process for a holistic assessment of a children’s needs and strengths, taking account of the role of parents, carers and environmental factors on their development.

Practitioners will then be better placed to agree, with the child and family, about what support is appropriate. The EHAT will also help to improve integrated working by promoting co-ordinated service provision.

Where you have a concern about the welfare of a child or young person - You must review the Responding to Need Guidance and Levels of Need Framework to determine the most appropriate action in response to your concern.

Where your concerns are at level four you should make a referral to Careline. Careline is Liverpool City Council's 24/7 social care call centre, providing a central contact point for enquiries about services for children, adults, homeless families and people with mental health problems.

All referrals about the safety or welfare of a child or young person MUST be made to Careline using the Multi Agency Referral form (MARF) unless an EHAT is in place in which case that should be used to ‘step up’ the concerns.

For more information about Responding to Need Guidance and Levels of Need Framework see